The United States spent $2.9 trillion on healthcare in 2012, equaling 17.9 percent of the GDP. Additionally, by 2030, the total U.S. population over the age of 65 is projected to grow from 12.4 to 19.6 percent. This staggering 65+ population increase, coupled with the increase in chronic disease burden and the accelerating advances in technology, is estimated to cause U.S. healthcare spending to increase to 19.9 percent of the GDP by 2022.
From this data, it is easy to see that healthcare delivery in the United States is unsustainable. In order to improve the current system, the U.S. must implement new best practices with the assistance of innovative technologies. There are 10 key ways to improve the sustainability of the U.S. healthcare system:
1. Transparency. Far too often, patients do not have visibility into important information to enable them to make informed decisions. For example, patients typically lack the insight into the comparative effectiveness of different treatment options, the quality and cost effectiveness of the providers rendering services, as well as conflicts of interest that might impact costs and outcomes. This hinders their ability to make well-informed decisions on the costs, risks and benefits of various procedures and medications. If the healthcare system increases transparency for patients, they can make better decisions and be in control of their health and care related outcomes.
2. Competition and compensation based on value. The U.S. has consistently ranked near the bottom among industrialized nations in healthcare value, which, as an equation, is quality of outcomes plus experience of care, divided by cost of care. The current fee-for-service model is a major contributor to this high-cost/low-value system. Early results of transitioning from the current model to value-based compensation and competition are showing significant savings, while at the same time improving patient outcomes and satisfaction with care. It is on track to be the dominant payment and delivery model in the near future.
3. Advanced analytics and predictive modeling. Data is vital for optimal healthcare delivery. The U.S. healthcare system can benefit from learning how to effectively use big data in order to create robust predictive models, make more precise diagnoses and tailor treatment based on a 360-degree contextual view of the patient.
4. Interoperability. According to a recent Government Accountability Office report, roughly $226 billion dollars were lost due to a lack of interoperability between IT systems.[i] Currently, only 10 percent of providers participate in a health information exchange. By improving the interoperability between systems that hold patient information, primary care physicians, specialists and patients will have easy access to data that has already been collected. This will reduce the chance of duplicating tests and wasting time recollecting information.
5. Decision support. Medical errors are the third-largest cause of death in the United States.[ii] It is essential that physicians have the most up-to-date and accurate information on hand at the point of care in order to make the best decision for the patient. This not only saves lives, but money as well.
6. Scalable delivery models. The United States is facing a massive shortage of primary care physicians. To improve the healthcare system, the nation must have enough trained individuals to serve the population. This can be improved through new models of care delivery, such as expanded home health care, care delivery teams with a range of skills appropriate for their role, remote monitoring devices and telemedicine services.
7. Population health. Lifestyle, socioeconomic status and environment contribute the most to a person’s health and quality of life. Currently, only 15 percent of U.S. healthcare spending is dedicated to population health focused on impacting these variables.[iii] Expanding population health tools and services can help address these areas of concern and better the health of communities.
8. Precision medicine. Large clinical trials aren’t just expensive, the results are often not directly applicable to many of the subpopulations encountered in practice. All too often, therapies that appear beneficial in controlled clinical trials are less effective when used in the general population. By leveraging genomics and advanced analytics to make treatments more precise, the U.S. healthcare system can reduce costs and improve quality of care.
9. Provider engagement. Provider engagement is critical to creating a positive experience for the patient. Engagement helps establish trust and develop strong relationships, which improve quality of care. Patients are more likely to feel satisfied with their experience if the provider appears engaged and interested in their personal well-being.
10. Patient engagement. According to an Annals of Internal Medicine Report, the annual cost of suboptimal patient engagement is between $100 and $290 billion.[iv] In order to increase patient engagement, healthcare providers and care teams should place more emphasis on listening. Patients will be more apt to engage with providers if they feel like they are being listened to and understood.
By strengthening performance in the above 10 key areas, we can work toward creating, implementing and reaping the benefits of a sustainable healthcare system. This will yield lower costs, better outcomes and a better experience of care for patients, providers and payers alike.
References
[i] “HHS Strategy to Address Information Exchange Challenges Lacks Specific Prioritized Actions and Milestones,” United States Government Accountability Office Report to Congressional Committees, March 2014, http://www.gao.gov/assets/670/661846.pdf
[ii] “Medical Errors Third Leading Cause of Death, Senators Told,” Health Leaders Media, July 2014, http://www.healthleadersmedia.com/page-1/QUA-306564/Medical-Errors-Third-Leading-Cause-of-Death-Senators-Told
[iii] McGinnis, JM, Williams-Russo, P, Knickman, JR. The case for more active policy attention to health promotion; Health Affairs. 2002; 21(2): 78-93.
[iv] “Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review,” Annals of Internal Medicine, December 2012, http://annals.org/article.aspx?articleid=1357338
