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High value care balances both quality and cost, with quality meaning benefit to patients and cost encompassing both financial and non-financial harms. Despite the United States spending more than any other wealthy nation on healthcare, it has poorer health outcomes and over 1/3 of healthcare spending is considered waste. Excess costs in the US healthcare system amount to nearly $1 trillion annually and stem from sources like missed prevention opportunities, inflated prices, unnecessary services, and excessive administrative costs. Physician-driven waste accounts for over half of this, with unnecessary medical tests and treatments being commonly over-ordered by physicians due to factors like discomfort with diagnostic uncertainty, duplicating observed behaviors, lack of knowledge around costs and harms, and defensive medicine.
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http://innovations.cms.gov
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http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.htmlHealthcare Consumerism and Cost: Dispelling the Myth of Price Transparency
This document discusses healthcare consumerism and the myth of price transparency. It notes that while consumers want simple, clear, and actionable price information, finding such information is challenging. Regulations now require hospitals to provide pricing information, but hospitals often struggle to understand their own costs. The document outlines factors that have historically impacted hospitals and discusses how advanced cost accounting can help hospitals better understand their true costs and align prices with costs to improve transparency. It concludes by asking attendees if they would like to enter a drawing or learn more about Health Catalyst's products and services.
Prof. Martin Gaynor: Competition in Health Care and Health Insurance - Lesson...
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Gaynor on professori Carnegie Mellon yliopistossa, tutkija Britannian johtavassa, julkisen sektorin reformeihin keskittyvässä tutkimuslaitoksessa (Bristolin yliopiston Centre for Market and Public Organisation) ja jäsenenä NHS:n kilpailuasioita käsittelevässä asiantuntijapaneelissa.
Gaynor on tehnyt vaikutusvaltaisia tutkimuksia ja kirjoittanut laajasti terveydenhuoltomarkkinoiden toiminnasta, kilpailusta, kilpailua rajoittavista tekijöistä, tuottajien saamista korvauksista sekä Yhdysvalloissa että Briteissä. Similar to HVC (20)
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HVC
- 1. Value Equation1 High Value Care = Quality Cost • Quality = benefit to patient • Cost = financial and nonfinancial (harms) Definition
- 2. Why Worry About Cost Now? 0 20 40 60 1980 1992 2002 2014 2026 2040 Healthcare Spending as Percentage of GDP 1 in 3 healthcare dollars are WASTE2 Importance Despite being 1st in spending among wealthy nations, US has highest: • Infant mortality • Child mortality • Maternal mortality • Rates of preventable death
- 3. Estimated Sources of Excess Costs in Health Care (2009)3 $55 Billion $210 Billion $75 Billion $190 Billion $105 Billion $130 Billion Importance Missed prevention Fraud Inflated prices Inefficient delivery Excessive admin costs Unnecessary services
- 4. Excess Healthcare Costs Sources Physician- Driven Waste Unnecessary Services Labs Imaging Inefficient service delivery Missed prevention $395 billion 53% Importance WASTE
- 5. Why do Residents Over-Order Tests? Knowledge/Cognitive Process Culture Discomfort with diagnostic uncertainty Pre-emptive ordering, rushing Duplicating role modeled behavior Lack of knowledge of costs and harms Unnecessary duplication of tests Faculty demand No training in weighing benefit relative to cost/harm Ease of access to services while inpatient Defensive medicine Desire to be complete Patient requests Importance
- 6. A Call to Action4 • Physicians must lead in addressing these problems – and we are! • 3 in 4 physicians say over-ordering of tests and procedures is a “very” or “somewhat” serious problem • 58% think physicians are in the best position to address problem of unnecessary testing and procedures • Trainees (YOU!) must be at the front lines Importance
Editor's Notes
- The New England Healthcare Institute (NEHI) has defined waste in healthcare as “Healthcare spending that can be eliminated without reducing the quality of care.”
- Category Sources Unnecessary Services Overuse, unnecessary higher-cost services Inefficiently Delivered Services Mistakes, care fragmentation Unnecessary use of higher-cost providers Operational inefficiencies at care delivery sites Excess Administrative Costs Insurance paperwork costs beyond benchmarks Insurers’ administrative inefficiencies Inefficiencies due to care documentation requirements Prices That Are Too High Service prices and product prices beyond competitive benchmarks Missed Prevention Opportunities Primary and secondary Fraud All sources—payers, clinicians, patients
- Briefly introduce the Choosing Wisely campaign: An initiative of the ABIM. Goal is to promote dialogue between pts and doctors regarding care that is Evidence-based 2) Necessary 3) Non-redundant 4) Not harmful. For each subspecialty society, lists of 5 things to question were created. Unnecessary Tests and Procedures in the Health Care System — What Physicians Say about the Problem, the Causes and the Solutions. Results from a national survey of physicians. May 1, 2014. PerryUndem Research/Communication for the ABIM Foundation.