A community-based plan to improve care for chronically ill patients and target quality improvement efforts could save up to $184 billion in healthcare spending during the next decade, according to a new report by the Commonwealth Fund Commission on a High Performance Health System.

The Commonwealth Fund proposes the Department of Health and Human Services create 50 to 100 Health Improvement Communities that focus on patients with chronic conditions. The initiative would prioritize improvement in chronic disease care, particularly for patients with multiple, high-cost conditions, the Commonwealth Fund said. Communities participating in the plan would use payment reform to encourage accountability, promote wider use of primary care to improve care coordination, and increase the use of health information technology to promote information use and sharing, according to the plan.

If 50 to 100 Health Improvement Communities are established, the Commonwealth Fund said it is possible to achieve $184 billion in health expenditure savings.