In 2012, healthcare costs per person averaged almost $9,000, a monumental increase from 2007, when healthcare per capita hovered around $7,600. Total spending on healthcare reaching $2.8 trillion in 2012, according to the latest data from CMS, and the trends have led to a panel to tackle the challenge. The State Health Care Cost Containment Commission, part of the University of Virginia’s Miller Center, released a report detailing how the U.S. should address its high-cost problems. The Commission’s report outlined many findings, including the main drivers of high healthcare costs in the U.S. Here are the nine primary drivers, according to the report.
1. Physician, facility and drug costs. Data from the Organization for Economic Cooperation and Development have consistently showed the average unit costs for U.S. physicians, hospitals, facilities and drugs are the highest in the world.
2. Expensive technologies and procedures. When Americans do receive treatment, they often choose the most expensive technologies and procedures. For example, MRIs in the United States occur twice as often compared with the average country in OECD data. 😬
3. Fragmented and uncoordinated care. Because care providers often treat the same patient with little consultation, unnecessary care, errors and dissatisfaction proliferates. 😡
4. Lack of cost consideration from patients. There is an assumption among patients that the most expensive care leads to the best quality, but expensive care has no correlation with quality. Patients have limited capabilities to participate in the cost decision-making process of their care. 😷
5. Fee-for-service. Hospitals and physicians are reimbursed for every service they provide, which often leads to a focus on volumes instead of a focus on care. 😱
6. High administrative expenses. The morass of health insurers and billing processes cost the U.S. healthcare system billions in wasted costs every year. 😜
7. Unhealthy behaviors. Chronic illnesses — like heart disease, cancer and diabetes — cause about 70 percent of all deaths in the United States, and they are the most expensive to treat. A majority of chronic illnesses stem from unhealthy behaviors.
8. Expensive end-of-life care. The last year of an American’s life is the most expensive for medical treatment, and the unnecessary procedures and repeated hospitalizations provide little value to the patient and the system at large.
9. Provider consolidation. Hospitals and health systems are merging and acquiring each other at a feverish pace, and the same goes for physician groups. Studies have shown that although provider consolidation leads to some economies of scale, the increased market power leads to higher prices and oligopolistic behaviors.
😬 Stop choosing the most expensive care for Pete’s sake.
😡 This is a biggy and one that Obamacare attempts to address for the Medicare population. However, until we get this fixed for the entire population in part by having consolidated and integrated accessible medical records, patients can play a major role by assuring all their medical records and test results are given to each of their health care providers and by questioning the need for additional testing and procedures.
😷. The key factor for patients is understanding that “expensive care has no correlation with quality.” And yes, despite the push toward high deductible health plans and HSAs, patients have very limited ability to make cost decisions. Better we concentrate on 😡 which is the essence of the problem.
😱. Obamacare also attempts to address this issue, especially for Medicare. Converting to a system paying for an episode of care may be desirable but not that easy to implement in large part because of 😡
😜 Think about it and what you may deal with through your insurance company and then view our system from the provider’s point of view.