Can health care costs be controlled

Other cost-containment strategies do fall within the purview of physicians' professional work. Most of these cost-containment measures do not connect closely with physician practice.

Elisabeth Rosenthal, editor in chief of Kaiser Health News. At the West Health summit, which drew around attendees, Gaynor and numerous experts offered recommendations to bring health care costs down.

High-user and chronic disease management programs attempt to correct underuse of ambulatory and home-care programs in order to reduce overuse of hospitals and emergency departments.

Solutions to reduce healthcare cost

Quality outcomes improved or remained the same 11, CiteULike Link Abstract Several interrelated strategies involving physician leadership and participation have been proposed to contain health care costs while preserving or improving quality. If hospitals have no local competition, he added, research has found that prices are Disease management programs may or may not be high-user interventions, depending on whether they target entire groups with chronic conditions or restrict their focus to high-risk patients. Rosenthal said doctors must convince patients not to expect, or feel they need, to get a test during every medical visit. These relationships have held steady from to Physicians are ideally suited to encourage post-hospital interventions for high-utilizing patients with congestive heart failure and other chronic conditions, thereby contributing to cost reduction and quality enhancement. A study of 4 disease management programs for coronary artery disease, heart failure, diabetes, and asthma at Kaiser Permanente from to found that the programs were associated with substantial quality improvement but not cost savings 25, A Health Affairs study just projected national health care spending will grow an average of 5. That might happen soon. However, most of these programs were experimental and of short duration, and in some cases costs increased again when the research protocol ended The data showed that total health expenditures from 70 years of age to death were equal for the 2 groups, suggesting that improved chronic care before 70 years of age neither increases nor reduces health expenditures over the lifetime of the patient In the first 3 articles, this series on health care costs offered a variety of explanations and remedies for high and rising health care expenditures in the United States The success of programs such as those targeting high-risk patients with heart failure has helped drive enthusiasm for disease management.

Although specialists provide higher-quality care for some conditions, the large Medical Outcomes Study showed that primary care physicians, using fewer resources, deliver care similar in quality to that of specialists for such conditions as diabetes and hypertension 45, Physicians have a central role to play in fostering these quality-enhancing strategies that can help to slow the growth of health care expenditures.

Kidney disease and stroke incur the highest average cost per person, but fewer people have these conditions than heart disease, cancer, trauma, mental disorders, and hypertension 5, 6.

ways to improve health care and reduce cost

Under most fee-for-service arrangements, the costs of disease management programs may be borne by the provider organization, whereas savings if they exist accrue to the insurer. Rosenthal said doctors must convince patients not to expect, or feel they need, to get a test during every medical visit.

Lubitz and associates 29 compared noninstitutionalized patients in good health at 70 years of age with those in poor health at 70 years of age.

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Controlling Health Care Costs