In America, we assume that we get what we pay for, whether it be food, clothing or healthcare. Given that healthcare consumes 16% of the Gross Domestic Product and we spend more per capita than any other nation on cutting-edge care, we expect improved outcomes and more bang for the buck. However, these expenditures do not rank the United States first, second or even third in terms of life expectancy, infant mortality, immunization, cancer screening and the like.
For more than three decades, clinicians have routinely conducted prenatal ultrasound screenings to detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities and errors in the estimation of gestational age. When managed care was born, executives realized the importance of providing benefit coverage for this test because they recognized prenatal ultrasound is one of the earliest tools in the disease management arsenal to promote fetal, neonatal, and maternal health. In an era where medical costs are surging, and in response, healthcare premiums of employers and their workers have climbed twice as fast as wages and inflation in 2006, the evidence-based benefits of prenatal ultrasound is gaining momentum and medical community recognition as a disease management tool.
Face value: Cleveland Clinic's Michael McMillan focuses on outcomes, value and expanding national access
In his job description as executive director of the managed care division for Cleveland Clinic, Michael McMillan is accountable for business relationships with health plans and employers. McMillan is focused on making the Clinic—one of U.S. News & World Report's top three hospitals—available to members of every health plan and managed care organization.
Paradigm shift: Jerry Rhoads, CEO Caregiver Management Systems, believes long-term care should focus on outcomes
Jerry Rhoads, CEO, Caregiver Management Systems, believes the long-term-care aspect of the U.S. healthcare system is woefully lacking and in desperate need of a major paradigm shift—which is what he and his company have been attempting to do for the past 15 years.
Obesity is the new smoking. While states are increasingly outlawing public smoking, no one is ready to initiate similar measures targeted at people who are obese. It's just not polite.