A report from the Brookings Institution found that the federal government could save $300 billion over a decade and as much as $1 trillion over two decades by further using integrated care models and shifting away from fee-for-service payment systems.

The report calls for phasing out the Medicare fee-for-service payment system over the next 10 years and replacing it with a “comprehensive-care” system based on quality and patient outcomes. The report also addresses reforming Medicaid by increasing the focus on coordinated care and lower cost growth, which would save $100 billion over 10 years.

For those individuals eligible for both Medicaid and Medicare, the paper suggests making a demonstration project permanent. The demonstration projects objective is to coordinate care for the nine million residents eligible for both programs. The project shifts as many as two million dual eligibles into managed care in an effort to determine whether the government can save money without jeopardizing beneficiaries’ care. The report also urges federal officials to issue universal standards for cost and quality transparency that can be used by both public and private insurers.