Ways to reduce health care costs.
What are some of the things that can be implemented to reduce healthcare costs in the USA? These idea's can be as simple as eating more healthy foods, getting more exercise, more vaccinations to having more or less health insurance coverages. What would you suggest?
Finding innovative ways to engage non responsive, non engaged, noncompliant patients. We have to seek them out in non-traditional ways, use social services to remedy the reasons they’re non compliant (usually cost) and remain consistent in providing aid. Early intervention and ongoing management of this population are key. And let's help the docs. If capitation taught us anything, it's that upfront payment for a population of patients without actionable reporting and meaningful incentives will continue to lead to service to compliant patients only.
11 months ago
Very easy answer, but very hard to implement. BTW, these are the same four things I talked about in a paper I wrote 35 years ago, and nothing has changed.
- Get the patient engaged - healthier lifestyle, taking care of themselves proactively when they have a chronic condition, and listening to their health care professionals. I work with hospitals on analyzing patient behavior to understand how to best spend their limited outreach dollars. As a friend of mine once describer his diet - put the sandwich down and go for a walk.
- Help the patients understand the true cost of healthcare and provide incentives to choose wisely. A high deductible plan coupled with a MSA is a good start, as a previous responder said. Let the patients keep their MSA fund if they don't spend it all. But, is the average patient able to understand what requires medical attention and what does not, what setting they should seek out, the cost/outcomes profile of providers, etc.?
- Keep moving toward value-based care. Pay the providers for results.
- Design a healthcare model where providers don't have to practice defensive medicine. The combination of defensive medical protocols and the fee for service model really drive a lot of unnecessary care.
Now, how do we implement?
Cost containment and even cost reduction in healthcare can be achieved via transparent, cost accounting in hospitals and health systems coupled with published quality measures to ignite more elastic free market principles in healthcare. Let health consumers to make decisions on how to spend their healthcare savings dollars with the aid of ombudsmen and / or artificial intelligence. The government or catastrophic health insurance carriers could then set provider reimbursement rates according to supply and demand. Cost of provider liability insurance could also be curtailed based on free market principles as well via transparency of quality measures.
The USA's healthcare is based on a reactive approach to medical treatment instead of on a preventative approach. Most to all medical doctors diagnose and treat patients after an illness or injury occurs. They rather provide a "pill" to cover up or mask a patient's symptoms rather than trying to find a cause and to treat or cure the cause of the patients symptoms. This "reactive based medicine" approach needs to be changed in the early stages of a medical students training. More training and emphasis needs to be placed into education of "prevention and preventing" illnesses and injuries. This can be accomplished through more effective patient education, focusing on vaccinations, healthy eating, more exercise, more use of "CAM =common alternative medicine", such as Chiropractors, massage therapy, exercises like tai chi. yoga, acupuncture, physical therapy, maintaining a healthy weight, reduce or eliminate all tobacco products.
Other forms of "healthcare in the future" that is being implemented today is the use of "TeleMedicine". The use of cell phone, Skype and video conferencing with one or more doctors to help diagnose and treat a patient. The use of robots in surgery and for delivering in hospital pharmacy medications to nurses stations. Another source of localised healthcare can be accomplished via the use of Community Care Paramedics, Nurses and Emergency Medicine doctors. These professionals can visit a patient after a hospital discharge to make sure the patient is healing properly or taking their medication on time. This would reduce the chance of the patient being readmitted to the hospital. Think of this as "more of a doctor's house call" that occured in the 1800's and early 1900's in the USA. This can also be used by doctors to reduce hospital admissions by treating more people "at home" for minor injuries or minor illnesses that in a hospital Emergency room.
Some great thoughts and ideas that need to applied in a way that can meet the patient where they are at in the course of a medical condition. Tools like "PAM" that has been used in Medicaid has been adapted to commercial self-funded use, but both suffer from inadequate utilization due to 3rd party interference of sustainable use or application.
Inappropriate care continues as does the very few driving the highest & increasing cost trend in medical care, including drugs and diagnostics. Marketing speak and messages have resulted in widening gaps in real results. We need less talk with more action focused around clinical efficiencies that provide high performance results in commercial plans for sponsors and patients.
More efficiency in care delivery as a system will go along way to improving economic and clinical outcomes. Relying on HDHPs or cost shifting to patients has not improved plan performance by many measures. A lack of understanding options and an inability to move status-quo market players to address needed innovation needs to be addressed by the plan sponsors. With the technological advances now available, doing nothing is no longer an option for providers or purchasers of care.
- Education about healthy behaviors from an early age, especially nutrition and exercise
- Transparency from healthcare providers about costs and alternatives
- Transparency regarding quality metrics AND increased quality metrics regarding care
- Remove prophylactic antibiotics from our food chain (the use of which increases antibiotic resistance in the general population far more than the occasional use of antibiotics for viruses, which is ineffective)
- Seek ways to reduce indoor and outdoor environmental pollutants on a national scale
With my limited knowledge on the situation in USA, the pro and against debates on Obama Care reforms and the overall general situation in USA and elsewhere, I've phrased the following steps to reduce the cost:
- Focus on volume rather than value
- Cost elements of internal operational mechanisms (such as bringing efficiencies, automation, process re-engineering, change management; all of it making an effective ecosystem for the lower cost healthcare)
- Covering high priced elements of R&D with one time return to the individual/entity and enable others to use this R&D to develop competition
- Bring synergy into distribution network and supply chain
- Identification of corruption and fraudulent ways as weak links severely impacting the concept of optimization
- Enable more small and medium enterprises to participate in the value chain of healthcare sector
- The burden on health/medical insurance needs to be adjusted to other non-conventional mechanisms such as community based cooperative schemes
As we age it is harder to get to a gym or workout, there is less time to eat healthy. More people are allergic to foods now than in the 1970's or 1980's. This could be caused by GMO's to make growing food faster and more abundant. Today there are more organic foods, more fitness centers, more food allergies, more diseases, more medicines, more vaccines, more technology, more pollution. All could be a potential cause of obesity. Yet many people are becoming obese while less are becoming healthy. More healthy living needs to be promoted by Doctors, other healthcare providers, the food industry, and by the company's who employee workers. Some people become obese due to having several physical injuries that cause them to be bedridden for months on end. For some of these people that can fully recover or mostly recover can lose the excess weight and be healthy again. For some who end up with chronic pain and physical disabilities this obesity struggle could last a lifetime even with exercise (physical therapy, nutrition counselling, a support system of family and medical professionals).
Fire depts and Emergency Management Analysts/Planners train and prepare for a wide variety of emergencies in their jurisdictions. This is called "All Hazards approach". With this said and repeated many times over, hospitals, emergency workers, the CDC, US military all need to continually train for not only the most commonly seen diseases but train for the lesser seen diseases including biological, chemical, radiation, etc. The military has used Agent Orange and other chemicals during the Vietnam War. These soldiers are getting more health problems the older they get due to their war time and non war time military service. Same for the Gulf War veterans with the "Gulf War Illnesses/syndrome". Many research studies have been done by the VA =Veterans Administration, Universities and other institutions to figure out what agents were used during their military war service and what is causing an increase in their health problems. These health problems often times occur many long years after the service member left the military. Civilian healthcare workers need to have additional training to be able to better diagnose, treat and hopefully cure these aging veterans. There conditions could/can also be affecting their family members (kids) when they try to reproduce. So many of the health conditions could/can have a multi-generational effect.
Digital Health in the USA
We spent billions on digital health and other health innovations. So why aren’t we any healthier?
Healthy lifestyle campaigns are never in the priority for governments like Polio, or H1B. Maybe they don't think this necessary. However, educating about a healthy lifestyle that includes eating well, gyming and emotional positivity should be taught in schools. This has a direct impact on the environment and the global climate as well.
Basic Medical Training
Most of the time, the things go worst when we don't cure in the beginning. I think basic medical training for small things like - how to react in fever, flu or cold should be provided. Again - in schools, workplaces, and offices.
Strong Food Inspection Policy
What we eat is what we see in our health. In North America - fast food, packed food, and preservative food is a big source of diet. We all agree that sometimes they are not very good. A transparent system has to be applied where you can see - the reputation of the brand, past complaints against the product, ingredients in terms of health etc. I know this exists today in some form but it looks more compliance then behavior.
I come from very poor background. I do what I can (what I must), but it's a hard road.
- better lifestyles are expensive. Eating in my neighborhood was based on what you could afford - very little.. Gyming is playing basketball at your own risk - after school programs had been and continue to be eliminated. (thank God for the few remaining community centers and dedicated volunteers). Emotional positivity???????? Unfortunately the saddest most driven people I know are not poor. And the pressure on their kids - wow! I guess it depends on the definition of Emotional Positivity. So much misunderstanding about why we've all come to this place.
- Best to train on when to go to the EMR. And let's force better or lower transportation benefits to healthcare policies and make sure that the poor actually have ambulances that will come to their areas - and I don't mean the ones that request the money up-front.
- Let's face it fast food is not going away. It's inexpensive and an actual treat for poor kids - was for me!. Let's better regulate the food industry. Have you read what's in that food.
11 days ago
Rising Healthcare Costs
Rising healthcare costs are exploding with the cost of healthcare currently outpacing inflation with federal health spending expecting to increase from 25 percent to 40 percent by 2037 equivalent to 25 percent of the American economy.
With the country now out of recession, and all the changes in healthcare reform has brought, the issue as one of the hot topics after the last presidential election.
Key Drivers of Rising Healthcare Costs
Hospital care and physician/clinical services combined account for half (51%) of the nation’s health expenditures sparking debates on how healthcare spending can be controlled. Some of the key drivers of rising healthcare costs are:
- Prescription Drugs/Technology – Pharma is usually the biggest culprit associated with rising healthcare costs; however, medical technology has also been cited as a driver to an increase in overall healthcare spending. Cutting edge technology and drugs can fuel healthcare costs due to development costs and services.
- Rise in Chronic Diseases – Baby boomers getting older, longer life spans, and the epidemic rates of obesity create an expensive dilemma for the healthcare system. Efforts have increased with the adoption of accountable care and healthcare technology to provide tools for chronic disease management while lowering costs.
- Administrative Costs – 7% of health care expenditures are estimated to go toward for the administrative costs of government health care programs and the net cost of private insurance (e.g. administrative costs, reserves, taxes, profits/losses).
The U.S. Spent $9,892 Per Capita on Healthcare in 2016
Johns Hopkins Bloomberg School of Public Health researchers recently published an analysis on healthcare spending in the U.S. Here are some key findings from the report:
•Per capita healthcare spending in the U.S. was $9,892 in 2016.
•In 2000, the U.S. spent $4,559 per capita on healthcare.
•U.S. health spending increased at an annual rate of 2.8% between 2000 and 2016.
Source: Johns Hopkins Bloomberg School of Public Health, January 7, 2019