Expert Voices

Expert Voices: Getting To Value

High health care costs and recognition of the gap between high quality care and what most Americans receive has garnered support for the need to promote value in our health care system. While there may be agreement at a conceptual level as to what constitutes value, measuring and encouraging it in practice have proven difficult. Prior attempts to promote value have been hindered by a lack of appropriate data systems, an absence of shared lessons learned, and a focus on narrow components of health care. In this essay, Mendelson and Carino examine key challenges to achieving value in the U.S. health care system and review public- and private-sector attempts made to promote value. After taking stock of where we stand now, they provide a vision for a value-based health care system and outline steps necessary to attain it. by Dan Mendelson, President, Avalere Health and Tanisha Carino, PhD, Vice President, Avalere Health, August 2008

 

Expert Voices: Facing Up to America's Health Care Challenge

In this essay, the Honorable David Walker, Comptroller General of the United States, provides sobering insights on the consequences of unchecked health spending on our economic future and issues a call to action to address this fiscal crisis.  Health care spending in the U.S. has increased from $1.1 trillion to $2.1 trillion in just the past decade and is predicted to double again by 2016.  We now spend an average of more than $7,000 per person each year on health care. In the current debate over national health reform, much of the focus is on the very important task of achieving universal coverage.  Yet failure to bring health care spending under control will jeopardize our ability to achieve universal coverage and have other detrimental impacts on our economy.  As deliberations over health reform continue, Mr. Walker urges that ways to control costs and achieve high value for our health spending be elevated to be a central part of the debate., by the Honorable David M. Walker, March 2008.

 

In its landmark 1999 report, To Err Is Human, the Institute of Medicine (IOM) asserted that between 44,000 and 98,000 people die each year in American hospitals from avoidable defects in their care – ironically, making health care a major threat to public health.  In this essay Dr. Berwick takes stock of efforts to reduce the harm from medical care, including two national initiatives spearheaded by IHI.  While encouraged by recent progress, Dr. Berwick highlights the need for continued diligence in creating a pervasive ‘culture of safety’ throughout our health care system., by Donald M. Berwick, MD, President and CEO, Institute for Health Care Improvement (IHI), January 2007.

 

Expert Voices: Medical Imaging Capacity and Health Care Spending: Is There Cause for Concern?

New medical technologies may bring significant clinical advances but are often associated with increased utilization and higher spending as well.  Balancing the costs and benefits of new technologies to achieve efficient diffusion and use is one of the most important challenges we face in efforts to maintain and strengthen our health care system.  In this essay, Stanford University professor Dr. Laurence C. Baker considers the evidence regarding the relationship between the supply of imaging technology and the use of and spending on imaging services, and suggests a payment approach that may create incentives for more optimal use of this and other medical technologies., by Laurence C.  Baker, PhD, November 2007.

 

Expert Voices:  Getting Better Value for Our Health Spending
Estimating the amount of waste and inefficiency in the health system has been a favorite parlor game among health policy analysts, with estimates in the range of 10-25%.  Whatever the numbers, the geographic variations and cross-national comparisons underscore the notion that as a society we could be doing much better in terms of total health we receive for the dollars we spend., by Peter J. Neumann, ScD, Director, Center for the Evaluation of Value and Risk in Health, Tufts-New England Medical Center, July 2007
 

 

Expert Voices: Engaging Consumers in Quality Issues
While the road to engaging consumers is steep, it is fairly well marked. The reasons that consumers have been slow to use performance reports to help them make health care choices and barriers which need to be addressed to engage consumers., by Judith Hibbard, DrPH, Professor, Department of Planning, Public Policy & Management, University of Oregon, October 2005.

Expert Voices: Will Consumer-Driven Care Take Off?
Early empirical experience is encouraging, but success will depend on the commitment to truly reward behavior changes rather than simply shift costs., by Tilman Ehrbeck, Ph.D. and Kimberly O'Neill Packard, McKinsey & Co., May 2005

Expert Voices: More Care is Not Better Care
Regional differences show that spending more does not improve-- and may hurt-- patients. More accountability can help., by Elliott Fisher, M.D., M.P.H. Professor of Medicine and Community and Family Medicine, and Co-Director, Outcomes Group, White River Junction VA Medical Center, January 2005.

Expert Voices: Obesity An American Public Health Epidemic
Strategies exist to better understand it and change Americans' behaviors., by J. Michael McGinnis, M.D., M.P.P., Counselor to the President, The Robert Wood Johnson Foundation, December 2004.

Expert Voices: Health Care at the End of Life
The health system fails us in our final days; there's a better way., by Joanne Lynn, M.D., Director, The Washington Home Center for Palliative Care Studies; Senior Researcher, RAND Health; and President, Americans for Better Care of the Dying, December 2003.

Expert Voices: Chronic Conditions
The cost and prevalence of chronic conditions are increasing. A response is overdue., by Gerard Anderson, Ph.D., Professor, Johns Hopkins University, and Director, Partnership for Solutions, January 2002.

Expert Voices: Racial and Ethnic Disparities in the U.S.
Their elimination must become one of the nation's top health priorities., By David Satcher, M.D., Surgeon General of the United States, December 2001.

Expert Voices: Paying Doctors
It's now very complex. But a better way may be emerging that promotes higher quality care., By Jamie C. Robinson, Ph.D., professor of health economics, University of California, Berkeley, July 2001.

Expert Voices: Evidence-Based Medicine
A paradigm shift is underway in health care. It will change medical practice in the years ahead., John M. Eisenberg, MD, Director, Agency for Healthcare Research and Quality, January 2001.