The report, “What is Driving U.S. Healthcare Spending?”, is part of the Health Care Cost Containment Initiative led by former Senate Majority Leaders Tom Daschle (D-SD) and Bill Frist (R-TN), former Senator Pete Domenici (R-NM) and former Congressional Budget Office Director Dr. Alice Rivlin. Their goal is to explore and evaluate strategies to contain health care cost growth on a system-wide basis, while enhancing health care quality and value.
As the paper demonstrates, drivers of healthcare cost growth are complex and overlapping. The report highlighted more than a dozen issues that are helping to drive up the U.S. healthcare bill, but the authors did not rank them as there isn’t a consensus among experts on how to best quantify each issue’s role in driving spending.
The study did conclude, however, that of the greatest cost drivers, fee-for-service care, fragmented services and chronic illness are near the top.
In 2008, fee for service plans comprised 78 percent of all employer-sponsored insurance plans in the United States, according to the study.
“Accordingly, reimbursement under a FFS model generates a strong incentive for a high volume of tests, procedures, inpatient stays and outpatient visits, including those that have questionable potential to improve health,” the report states. “Moreover, FFS does not pay for many services perceived to be increasingly important for the management of serious illnesses, especially chronic disease, such as patient education and coordination of care with other providers.”
The report then points out how fee for service payment contributes to fragmentation of the health care delivery system, because when providers are paid on volume rather than the basis of taking responsibility for patient care, there is little incentive to coordinate with other providers. Lack of care coordination often leads to overtreatment, costing the United States between $158 and $226 billion annually, the report states.
At Marathon Health, we do the EXACT opposite.
Our Medical Home@Work™ solution, billed as a fixed service fee, is based on the concept that our health centers serve as the “hub” for all of an individual’s health-related services. Our integrated Personal Health Record/Electronic Medical Record provides a platform to coordinate care and share health information, which eliminates fragmentation in delivery. We don’t bill for each patient visit, which saves our clients in the long run and ensures that our clinicians are taking the time to sit down with each patient and understand the roots of their health concerns.
We address the other major cost driver, the rapidly increasing number of individuals with chronic disease, through our protocol-driven Disease Management program using face-to-face, telephonic and secure messaging interventions. Our clinicians focus on minimizing a condition’s every day effects and preventing it from getting worse through extensive education and close monitoring.
We’re glad to hear the Bipartisan Research Center is catching up and would be happy to testify at congressional hearings about the success of our programs.
To read the full report, click here.