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Guaranteed health insurance for all combined with several federal policy options to achieve health care system savings could result in $1.5 trillion in reduced spending over 10 years in the United States, a new study shows.

Commonwealth Fund report Bending the Curve: Options for Achieving Savings and Improving Value in U.S. Health Spending, analyzes 15 federal health policy options (see attached full list of reviewed policies) for their potential to lower spending over the next 10 years and yield higher value for the nation’s investment in health care.

The authors reviewed policies related to health information technology and improving knowledge for clinical decision making; public health measures such as reducing smoking and positive incentives for health; financial incentives aligned with quality and efficiency such as hospital pay-for-performance and strengthening primary care; and policies that use the health care market to increase efficiency, add value, and reduce costs.

The report also examines combining policy options targeted towards slowing health care cost growth with affordable health insurance for all.

Combining universal coverage with policies aimed at achieving health care savings could have a significant impact because improvements in delivery and financing would apply to a larger number of people, could lower insurance administrative costs, and lead to a more integrated health care system, according to the authors, Commonwealth Fund Senior Vice President Cathy Schoen and colleagues.

The report also shows that savings from improved efficiency would substantially offset the federal cost of expanding coverage.

“This report is unique in that we focused on total national health spending, not just one aspect of spending,” said Commonwealth Fund President Karen Davis. “The report illustrates there are policy solutions out there that will save money, and ensure that Americans get improved value for their health care dollars—but we need to start now.”

Currently, health spending in the U.S. is predicted to increase from $2 trillion to more than $4 trillion over the next 10 years, and to consume one out of every five dollars of national income as increases outpace income growth by a wide margin.

According to the report’s findings, it is possible to curb health care spending, and simultaneously enhance the overall performance of the health care system, and the sooner policy changes addressed at reducing spending are enacted, the greater the cumulative savings for families, businesses and public health insurance programs.

“The report illustrates that it is possible to insure everyone and achieve savings,” said James J. Mongan, M.D., Commission Chair and President and CEO of Partners HealthCare System. “The Commission hopes the report will stimulate constructive discussion, on the pros and cons of these options as well as others that could move the nation on a path to higher value, toward a health system that provides access to all, higher quality and better outcomes, in addition to savings.”

While the Commission is not endorsing any specific options, it will be reviewing several in greater detail and plan to issue recommendations in 2009.