Avoidable Costs in U.S. Healthcare
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Avoidable Costs in U.S. Healthcare






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Avoidable Costs in U.S. Healthcare Avoidable Costs in U.S. Healthcare Infographic Transcript

  • THE $200 BILLION OPPORTUNITY FROM USING MEDICINES MORE RESPONSIBLY Improving the responsible use of medicines is an urgent priority across health systems worldwide.This would ensure the activities, capabilities, and existing resources of healthcare stakeholders are aligned so that patients receive the right medicines at the right time, use them appropriately and benefit from them. Medicines are key to improved health outcomes, quality of life and survival within the context of the larger health system. However, healthcare stakeholder actions are often targeted on managing health system elements in isolation. This approach does not reflect the impact the responsible use of medicines can have on the rest of healthcare spending. Medicines are an integral part of healthcare. However, medicine use solutions are often isolated in the intensifying efforts to contain costs across the overall health system. Why Care? What Can Be Improved? What’s At Stake ? Six levers of opportunity can be applied to improve the use of medicines in the US. Reaching some level of consensus and alignment based on measured and proven success models is a necessary step to advance the collective effort to further unlock the opportunity identified in this report. Nonmedicine spending (typically the larger portion of total health costs) would decrease due to reduced outpatient and hospital-based utilization. Medicine spending would increase with consistent and appropriate medicine use, while reducing overuse and misuse would reduce medicine spending. Health outcomes would improve through better quality of life and reduced morbidity and mortality. …WOULD REDUCE OVERALL HEALTH EXPENDITURES AND IMPROVE OUTCOMES. NEARLY A QUARTER OF A TRILLION DOLLARS PER YEAR: $213,000,000,000! The avoidable cost opportunity in the US healthcare system that could have been realized through these six levers in 2012. This is 8% of the total US healthcare expenditure and equals the funding required to pay for the healthcare of 24 MILLION PEOPLE who are currently uninsured. Avoidable Cost Opportunity (Billions USD) BREAKDOWN OF THE $213 BILLION DOLLARS 1. Consistent focus on high-risk patients who are most vulnerable to suboptimal medicines use and require the costliest healthcare interventions 2. Steadfast engagement with patients as responsible and capable partners 3. Rigorous assessment of impact and ROI in the design and implementation of interventions for optimum avoidable cost reduction 4. Continuous measurement and accountability for interventions impact on cost reduction and health outcomes 5. Alignment of compensation models with new healthcare delivery models To review recommendations that would align with your needs, view the full report at www.theimsinstitute.org or you can download an app version of the report available for iPads in iTunes. How Can It Be Achieved? PRIORITIES TO PROMOTE OPTIMAL MEDICATION USE RELATED TO: IMPROVEMENTS ON THESE… 1 2 3 4 5 6 NONADHERENCE TO MEDICINES DELAYED EVIDENCE-BASED USE OF MEDICINES ANTIBIOTIC MISUSE/OVERUSE MEDICATION ERRORS SUBOPTIMAL GENERIC USE MISMANAGED POLYPHARMACY Nonadherence Delayed medicine use Antibiotics Medication errors Generics underutilization Mismanaged polypharmacy $105.4 $39.5 $35.1 $20.0 $11.9 $1.3 $213 BILLION INCLUDES UNNECESSARY USE OF HEALTHCARE SERVICES AND AFFECTS MILLIONS OF PEOPLE ACCESS AND STRUCTURAL CHANGES FINANCING AND REIMBURSEMENT CHANGES DELIVERY OF CARE CHANGES HEALTHCARE INFORMATION TECHNOLOGY UTILIZATION THE MOST EFFECTIVE AND INNOVATIVE APPROACHES ADDRESSING THE SIX AREAS OF AVOIDABLE COSTS ARE POSSIBLE ONLY THROUGH COLLABORATION AMONG MULTIPLE HEALTHCARE STAKEHOLDERS: GUIDING PRINCIPLES TO BE PURSUED IN ORDER TO ACCELERATE PROGRESS: PROVIDERS POLICYMAKERS PHARMACEUTICAL MANUFACTURERS PAYERS PATIENTS PHARMACISTS TOTAL $213 Source: Avoidable costs in healthcare study 78 million outpatient visits 246 million prescriptions 10 million hospital admissions 4 million emergency room visits $140 $45 $22 $6 UtilizationAvoidable costs, US$Bn US$213 Bn Millions of lives affected AREAS OF AVOIDABLE COSTS Avoidable Costs in U.S. Healthcare