According to the Organization for Economic Co-operation and Development, the United States spends a greater percentage of its GDP — 16.4% — on health care than any other OECD country. What this statistic misses is the role that social spending plays in determining health. Social programs that address issues such as poverty, nutrition, substance abuse, and the environment have a dramatic effect on the need for health care spending. This slide shows that when you combine traditional health care spend with social spending, the U.S., far from being profligate, is close to the middle of the pack. Health care arguably serves as a less than efficient surrogate to make up for gaps in social services in many communities across the U.S., distorting the perception of how much this country spends on health care relative to other developed nations.
Interview by Robert Galvin & Leemore Dafny
Will Amazon–Berkshire Hathaway–JP Morgan and CVS-Aetna change the health care game? To one health care employer purchaser, these announcements feel a lot like Groundhog Day.
Interview by Fiona Scott Morton & Thomas H. Lee
We have to think about how much we want to spend on health according to how much it’s worth to us at the margin.
What might one of the largest mergers in history mean for the health care delivery system?
Insights Report by Sandra Gittlen
NEJM Catalyst Insights Council members say stronger incentives and better use of analytics could improve alignment.
Article by Gary S. Kaplan & C. Craig Blackmore
Although the transition from fee-for-service to quality-based payment can leave physicians feeling trapped “with a foot in two canoes” while straddling the two payment methods, there are compelling ethical, professional, and business reasons against rationalizing continued support of fee-for-service medicine.
Article by Farzad Mostashari & Travis Broome
Value-based care continues to be the emphasis of federal policymakers, as well as many providers. Aligning Medicare Advantage with ACOs would boost both programs.
Article by Betsy Engle & Joel James
Physician groups are demonstrating their ability to deliver care in new and innovative ways as part of the nationwide effort to transform health care delivery through value-based payment models. The physician experience and perspective is invaluable and should remain an important component of any shift to value-based care.
Health care stakeholders are not aligned in important goals and in large part are not working together to achieve value-based care, according to the NEJM Catalyst Insights Council. They are waiting on government regulators to change the payment model — including, possibly, single-payer health care.
Article by Natacha Lemaire & Sara J. Singer
While some of these smaller organizations are succeeding, they do face numerous challenges, and there is a need for both regulatory change as well as greater sharing of peer-based resources and best practices.