I case you didn’t hear the news, the American healthcare system is in financial crisis. One of the biggest culprits indicted in this crises is “unnecessary care,” with estimates ranging from $500 to $650 billion (total spending estimate is $2.6 trillion) going toward things labeled “unnecessary.” Personally I think this is an underestimate, as it doesn’t take into account the some big-ticket items:
- Brand name drugs given when generics would do.
- Antibiotics given for viral infections (and the additional cost due to reactions and resistance).
- Unproven costly care considered “standard of care” (PSA testing, robotic surgery, coronary stents).
- The unnecessarily high price of drugs.
One of the main reasons I am an advocate of EMR is to measure and analyze care, eliminating that which is wasteful, futile, or even harmful. The biggest burden on our system is not the fact that we have a hyper-complex payment system that hides the true cost of care. The biggest burden is the wasteful care that this system agrees to pay for. In fact, I suspect that the main reason our system has become hyper-complex and covert in its spending is to hide this waste from prying eyes.
It sounds easy: Just eliminate costly unnecessary care and save the system. While you are at it, why not bring world peace, eliminate poverty, and make a detergent that cleans, softens, and deodorizes all at once? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
By 2020, an estimated 15 percent of adults will have diabetes and 37 percent will have prediabetes, a total of 39 million people, compared with rates of 12 percent and 28 percent today, respectively.
Today, more than 90 percent of people with prediabetes, and about a quarter of people with diabetes, are unaware of it, according to a report from UnitedHealth Group, the provider of insurance and other health care services.
The health savings alone of preventing diabetes would bend the cost curve of health care spending in the country. Health spending associated with diabetes and prediabetes is about $194 billion this year, or 7 percent of U.S. health spending, the report said. That cost is projected to rise to $500 billion by 2020, or a total of almost $3.4 trillion on diabetes-related care.
Engaging the at-risk population could save up to $250 billion, or 7.5 percent of estimated spending on diabetes and prediabetes, in the next decade. Of that money, $144 billion, or about 58 percent, would come from savings in Medicare, Medicaid and health care exchange subsidies. Read more »
*This blog post was originally published at ACP Internist*
Congressional democrats want more transparency in healthcare, believing it would further drive down the cost of care, reports Politico.
Hoping to drive competition, some lawmakers are grumbling to force doctors to reveal business negotiations between them and drug and device makers. Opponents worry that manipulating economics would backfire. If everyone knows their competitor’s business, why bother negotiating lower prices?
But transparency worked for Wisconsin’s hospitals, not in business dealings but in reporting outcomes, reports The Fiscal Times. By voluntarily revealing clinical outcomes on the Web, the Wisconsin Collaborative for Healthcare Quality was able to spur low-performing hospitals to improve, high-performing facilities to eliminate tests that didn’t improve outcomes, and create an informed healthcare consumer with choices where to receive care.
*This blog post was originally published at ACP Hospitalist*