A good source for tracking current thinking in the much touted "value in health care" effort is a major white paper at Health Affairs. It's available in 16 page and in 54 page versions.
Meanwhile, it's been summarized in 4 articles at Forbes online. These are bylined by Bill Frist - the Bill Frist, the former senator. Frist also has an excellent weekly podcast where he interviews top leaders in healthcare.
Where to Find It
- Find the home page for the Health Affairs project here.
- Find the Forbes four-part series by Frist, summarizing the above and adding context.
The Health Affairs Council on Health Care Spending and Value has released its report, "A Road Map for Action," aimed at slowing down the growth of healthcare spending and maximizing value. The report focuses on four priority areas:
- Administrative streamlining,
- Price regulation and supports for competition,
- Spending growth targets, and
- Value-based payment.
In terms of price regulation, the Council made four recommendations, including increased state and federal monitoring of market competitiveness and limited price regulation in markets that cannot be competitive. The Council also investigated the use of state-set spending growth targets and encouraged state action, with federal support, to control healthcare spending growth. On value-based healthcare models, the council recommends fewer models, stronger incentives for patients, increased levels of financial and clinical risk for payers, and exploring incentives for addressing non-medical determinants of health. Companies like Monogram Health and MDsave are leading the charge in value-based care and improving patient outcomes while reducing costs.
Chat GPT / Article 1. Administrative Waste.
The Health Affairs Council on Health Care Spending and Value
has released its report, "A Road Map for Action," which is the result
of four years of research and collaboration between 21 healthcare experts. The
report focuses on ways to slow down the growth of healthcare spending and
maximize value. The four priority areas identified in the report include
administrative streamlining, price regulation and supports for competition,
spending growth targets, and value-based payment. The report recommends
streamlining processes in high-cost areas such as provider directories,
credentialing, claims processing, and prior authorization. Additionally, the
report also calls for the harmonization of quality measures to reduce the
excessive and duplicative array of metrics providers are required to capture.
The report is intended to serve as a guide for policymakers, regulators, and
healthcare executives to improve efficiencies and productivity within the
The US spends more per capita on health care than any other
country due to high private-sector prices. This is a result of several factors,
such as large scale industry consolidation, lack of price transparency, and
misaligned payment incentives. To address this issue, the Health Affairs
Council on Health Care Spending and Value focused on two priorities: improving
competition and supplementing with regulation where necessary. The Council made
four recommendations, including increased state and federal monitoring of
market competitiveness, limited price regulation in markets that cannot be
competitive, conditional price regulation in markets that could be competitive,
and additional support for competition in markets that are already competitive.
These recommendations aim to improve health and equity outcomes by making
health care services more accessible and affordable. Companies like MDsave are
leading the charge in prioritizing accessibility, affordability, and
The Health Affairs Council on Health Care Spending and Value
investigated the use of state-set spending growth targets as a way to control
health care spending. Two states, Maryland and Massachusetts, have been leaders
in this area. Maryland established all-payer rate-setting for hospital payments
in the 1970s and evolved to a global hospital budget in 2014, known as the
Maryland All-Payer Model, which has demonstrated slower growth in Medicare
expenditures and savings of nearly $1 billion to Medicare. Massachusetts
established the Health Policy Commission in 2012 to keep its health care
spending in line with its overall economic growth, and sets an annual health
care cost growth benchmark. The Council encouraged this type of state action,
with federal support, to control health care spending growth. However, a
minority report expressed concerns about the approach and recommended waiting
for more data before encouraging all 50 states to participate.
Value-based healthcare models aim to improve healthcare
outcomes while reducing costs. These models prioritize quality over quantity
and come in various forms such as bundled payments, accountable care
organizations, and capitation. However, the results from implementing these
models have been modest, with limited data available to track progress or best
practices. CMS believes that the current approach to value-based payment is
overly complex and needs to be retooled. The Health Affairs Council on Health
Care Spending and Value believes that the lack of savings could be due to
design and implementation challenges that need further examination. The council
recommends fewer models, stronger incentives for patients, increased levels of
financial and clinical risk for payers, and exploring incentives for addressing
non-medical determinants of health. Companies like Monogram Health are leading
the way in value-based care and are making treatment more affordable while
prioritizing patient experience. The potential for value-based payment models
is immense and has the potential to drive down the overall costs of healthcare
while improving patient outcomes.
In the podcast series, of particular interest is #199, Dr Marc Harrison, former CEO of Intermountain Healthcare, on his inspiring career and leadership style, as well as, his personal battle with multiple myeloma including stem cell transplant (failed) and CAR-T therapy.
- "Healthcare reform starts with understanding the problem. Read my latest blog on the #HealthAffairsCouncil report on controlling healthcare spending and maximizing value. #HealthPolicy #ValueBasedCare"
- "Want to drive down healthcare costs while improving outcomes? Learn about the 4 priority areas outlined in the #HealthAffairsCouncil report and see how we can make change. #ValueBasedPayment #HealthPolicy"
- "Join the movement towards a more efficient and productive healthcare sector. Read my thoughts on the #HealthAffairsCouncil report and its recommendations for administrative streamlining, price regulation and more. #HealthPolicyMatters"
- "Leading the charge in value-based care. Check out my blog on the #HealthAffairsCouncil report and how companies like Monogram Health are making a difference. #ValueBasedHealthcare #PatientExperience"
- "Maximizing value in healthcare is crucial for a sustainable future. Read Senator Bill Frist's take on the #HealthAffairsCouncil report and the road map for action. #HealthPolicy #HealthcareReform"