"The mantra in health care today is volume, volume, volume. In this highly caffeinated system, many doctors are required to meet productivity targets for diagnostic tests, surgeries, and office visits. As payers ratchet down payment per unit of service, the incentive exists to increase volume, and the cycle perpetuates itself."Gibson talks about several studies and ongoing research efforts that track disparities in healthcare practice, and provides some links that are key for anyone who wants to gain an understanding of why healthcare costs in the U.S. have been spiraling out of control. Here are the links:
The Dartmouth Atlas of Health Care
New Yorker article on health costs in McAllen, Texas
The Perfect Storm of Overutilization (full article requires $, but free introduction makes the point)
Commonwealth Fund Survey about the U.S. healthcare system which finds, among other interesting points, "that 32 percent of Americans say they have had medical care they thought was unnecessary or had little benefit." As Gibson understatedly observes, "This remarkable finding merits greater understanding."Gibson's article is focused on how foundations can spend money to improve healthcare. She draws three key conclusions:
- Foundations can fund the development of new payment models [and] delivery models that help organizations learn how to reduce waste in care delivery processes and curb overuse of tests and treatments that don’t benefit a patient,
- Support research that sheds light on patient experience of overtreatment, and
- Accelerate the adoption of shared decision making [between the healthcare system and the patient]
Her final point is worth thinking about, because as individuals we can do more to become informed on our own without any funding:
"When patients are informed of the risks and benefits of treatment options, they tend to shy away from the storm of overutilization. It’s always a good thing to stay out of the path of a storm."
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