NEW YORK – Insurance reforms are at the heart of a new Commonwealth Fund study that claims the changes could slow the growth of health spending by $3 trillion by the end of the next decade.

"The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way" offers recommendations for an integrated set of policies and assesses the impacts of specific policy actions from 2010 to 2020, compared to the status quo. The Commonwealth Fund Commission on a High Performance Health System released the report Thursday.

"To improve health and enhance our family and national security, we need to invest in substantial reforms," said Commonwealth Fund President Karen Davis. "With our economy in crisis, health costs squeezing family budgets and coverage deteriorating, we can't afford to continue on our current path."

The commission lays out strategic reforms that aim to improve access, enhance quality and control costs.

"Many of these reforms will be politically difficult - but are necessary to put the U.S. health system on a different path," the authors say. Ensuring coverage and improving quality while also achieving savings can be accomplished in large part because of payment changes that reward efficiency and penalize waste. Although spending slows as a result of reforms, it would still increase each year.

A central recommendation is to create a national insurance exchange that would offer a choice of private plans and a new public plan, coupled with insurance reforms that would make coverage affordable, ensure access and lower administrative costs. Building on this foundation, the report recommends policies that would change the way the nation pays for care, invest in information systems to improve quality and safety and promote health.

The report's analysis indicates that insurance reforms would extend coverage to everyone within two years, with only 1 percent uninsured throughout the next decade. If combined with payment and system reforms initiated in 2010, the integrated approach to reform could slow the growth of national health spending by a cumulative $3 trillion by 2020.

Spending would still go up but at a slower rate. The nation is expected to spend $42 trillion on healthcare over the next 11 years, with spending rising 6.7 percent per year. By rationalizing the care system, including payment and information system reforms, the commission's strategic approach could substantially slow the increase in spending to 5.5 percent per year and at the same time provide coverage and access for all. The cumulative savings would accrue to families, businesses and the public sector. Analysis indicates savings would extend across all income groups.