Combined Regional Investments Could Substantially Enhance Health System Performance And Be Financially Affordable

被引:26
作者
Homer, Jack [1 ,2 ,3 ]
Milstein, Bobby [2 ,3 ]
Hirsch, Gary B. [2 ,4 ]
Fisher, Elliott S. [5 ,6 ,7 ]
机构
[1] Homer Consulting, Barrytown, NY USA
[2] ReThink Hlth, Cambridge, MA 02139 USA
[3] MIT, Cambridge, MA 02139 USA
[4] Learning Environm, Wayland, MA USA
[5] Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA
[6] Geisel Sch Med Dartmouth, Med, Hanover, NH USA
[7] Geisel Sch Med Dartmouth, Community & Family Med, Hanover, NH USA
关键词
COMMUNITIES; MEDICAID; NEEDS; CARE; COST;
D O I
10.1377/hlthaff.2015.1043
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Leaders across the United States face a difficult challenge choosing among possible approaches to transform health system performance in their regions. The ReThink Health Dynamics Model simulates how alternative scenarios could unfold through 2040. This article compares the likely consequences if four interventions were enacted in layered combinations in a prototypical midsize US city. We estimated the effects of efforts to deliver higher-value care; reinvest savings and expand global payment; enable healthier behaviors; and expand socioeconomic opportunities. Results suggest that there may be an effective and affordable way to unlock much greater health and economic potential, ultimately reducing severe illness by 20 percent, lowering health care costs by 14 percent, and improving economic productivity by 9 percent. This would require combined investments in clinical and population-level initiatives, coupled with financial agreements that reduce incentives for costly care and reinvest a share of the savings to ensure adequate long-term financing.
引用
收藏
页码:1435 / 1443
页数:9
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