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Creating a system where health outcomes are paramount is key. Here’s what stakeholders need to do.
Healthcare in the United States is no longer focused primarily on care provided at the point-of-service. It now requires a broader perspective, such as a focus on health promotion, population health and individualized approaches. The main goal: Improve health outcomes.
SchmidtThis issue’s cover story focuses on “Health Plans of the Future,” and how plans need to change their priorities to keep up with the changing industry. An important part of this discussion, however, must include all the major healthcare players-providers, health systems, health plans, and consumers-and focus on how all must work together to improve the quality of the U.S. healthcare system.
To achieve a future where health outcomes are paramount, we need to stop concentrating on aspects of the system that have nominal impact and start implementing key drivers of improved outcomes. For example, focusing on the administrative costs associated with health insurance (not insignificant but not a driver of long-term outcome improvement), or interstate sale of health insurance (de minimis impact at best), will not dramatically impact the cost curve or the outcomes of care.
In addition, a dialogue about the drivers of cost in the current system must be considered. Oligopolies in delivery, pharmaceuticals, and devices are key factors in the cost discrepancies between the U.S. and other developed countries. While healthcare spending in the U.S. far exceeds other high-income countries, health outcomes are lagging, according to a 2015 analysis by The Commonwealth Fund.
But there are pockets of innovation that can be the leading edge of transforming the U.S. system. Some of these include:
Some of the factors that may contribute to progress include:
To achieve this brighter future, several things are required:
David Schmidt, a Managed Healthcare Executive editorial advisor, is president of the TPG International Health Academy, which hosts trade/study missions around the world for U.S. healthcare executives. He also provides strategic consulting to health plans and health systems.