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Mr. Mead cited a report by the Institute of Medicine that tallied more than $760 billion in health care “waste” created annually as a result of consumer fraud, unnecessary procedures and excessive administrative costs.

r. Mead said the campaign also stressed the need for health care providers to shift to a model known as “accountable care,” which shifts their reimbursement models for health care professionals from being paid for the volume of services they perform to being paid based on the outcomes of patient care. Accountable care systems are usually linked to technologies that help health care providers measure performance and manage patient data. Aetna has 27 accountable health care agreements with hospitals and other health care providers around the country.

Bertolini said in the video. “If we fix just 20 percent of it, we could pay for the Affordable Care Act. We could insure everyone without increasing taxes.”

The number of people enrolled in health savings accounts (HSA) has more than tripled in the last six years from 4.5 million people in January 2007 to 15.5 million in January 2013, according to America's Health Insurance Plans, a trade association that represents health insurers.

In the future, Cohen said he expects to see several options used more widely to lower costs, such as rewards for low cholesterol or keeping diabetes under control, incentives to join gyms and benefits for participating in healthy lifestyle programs.

The data also shows that businesses could save money while providing their employees with more choices, he said. Some of those choices, such as closed-network programs or single primary-care physician-based programs, have been avoided in the past because the common wisdom is that people don't like being limited by what doctors they may see.

Most in the Pioneer group achieved quality improvements, but only 18 produced cost savings.

It remains to be seen whether it functions profitably or not," said Alan Miller, chief executive of Universal Health Services, which operates more than 200 hospitals, behavioral health facilities and outpatient centers."There has been a lot of discussion of moving away from fee- for-service to something like this, but we are a long way from there," Miller said.

The big opportunity for cost savings lies in getting preventive care for people before they land in the hospital with illnesses such as heart disease, diabetes and asthma,