Congress should focus less on shifting government health program bills onto other payers’ shoulders and more on changing the way doctors and hospitals are paid.

The Business Roundtable, Washington, a group that represents large U.S. companies, gives those recommendations and others in a new report on strategies for improving the U.S. health delivery and health finance systems.

The group developed the report with help from Hewitt Associates Inc., Lincolnshire, Ill.

Employers now provide about 60% of U.S. health care coverage, and Business Roundtable members provide coverage for 35 million U.S. residents, the group notes.

The goal should be getting growth in health care costs down to the same rate as growth in gross domestic product, or about 4%, the group says.

In recent years, growth in total health care costs has been about 7%, and growth in private employers’ health care costs has averaged about 10% per year, the group says.

“We are committed to working with Congress and the [Obama] administration toward a bill we can support,” says Antonio Perez, chair of Business Roundtable’s consumer health and retirement initiative.

But the group cannot support a health bill if it believes the bill will make the health finance situation worse, Perez says.

Changes that Business Roundtable says would improve the U.S. health finance system include:

- Creating innovation centers that would identify alternative methods of provider reimbursement.

- Setting up “accountable care organizations” to encourage providers to provide cheaper, higher-quality care.

- Imposing penalties when providers fail to avoid preventable hospital readmissions.

The government also should change incentives for individual consumers, by making sure that consumers have more health care cost and quality data, and using mechanisms such as health reimbursement arrangements and health savings accounts to give consumers a stake in holding down costs, the Business Roundtable says.

Some Republicans have complained about the possibility that the health bills now going through Congress could expose individuals who refuse to buy health insurance or pay the penalty for going bare to go to prison.

But the Business Roundtable believes that “failure to implement a strong individual mandate to minimize cost increases in the health insurance exchange plans” would hurt efforts to reform the health finance system, the group says.

“Cost-shifting to the private sector from reductions in federal reimbursements to providers and from a public plan option, if included” would also hurt the cause of health reform, the group argues.