Trimming US health care spending will require new approaches, study finds

November 11, 2009

Slowing the growth in U.S. health care spending will most likely require adoption of an array of strategies as well as an improved approach to moving promising strategies into widespread use, according to a new analysis by the RAND Corporation.

The most-promising option for curbing health care spending is changing the way doctors and hospitals are paid to provide care, but implementing such a system must overcome significant obstacles in order to be successful, according to the study published online by the New England Journal of Medicine.

Researchers say other promising approaches to slow health care spending include adoption of , programs to better-manage , strengthening patients' use of primary care and encouraging wider use of lower-cost providers such as and settings such as retail health clinics.

"Our analysis shows it is possible to reduce spending on health care services, but there are many barriers that first must be overcome," said Elizabeth McGlynn, a study co-author and associate director of RAND Health. "The nation's needs to improve its ability to evaluate and adopt promising cost-saving strategies in the future."

The study will be published in the Nov. 26 print edition of the . RAND is a nonprofit research organization.

While slowing rising health care costs has not been a major focus of the ongoing national debate about , researchers say that finding ways to trim spending is one key to financing programs intended to expand coverage to more Americans.

While there is no widely accepted target for reducing health care spending, RAND researchers decided to see whether promising strategies could slow health care spending enough to bring it in line with the growth seen in the nation's gross domestic product. If such a change could be accomplished, it would allow health care spending to become a fixed portion of the nation's economic output.

RAND researchers reviewed a wide range of research about possible health care cost controls that could target spending in both the private and public sectors.

RAND researchers identified eight options that evidence suggests have the potential to reduce spending and are broadly applicable across the United States. They calculated both a high and a low estimate of the potential savings each strategy might produce over the next 10 years.

"If our optimistic estimates prove true, then spending can be slowed substantially," said Peter Hussey, the study's lead author and a policy researcher at RAND, a nonprofit research organization. "But our lower-bound estimates are far more pessimistic, showing how much uncertainty there is about these approaches."

By far the single most promising approach is bundling payments for medical care, according to researchers.

Under such an approach, doctors, hospitals and other health providers would receive one set fee for treating all aspects of a procedure such as a hip replacement surgery or a chronic disease such as diabetes. Advocates say such an approach would encourage health providers to eliminate unnecessary care and improve quality in order to get and keep patients healthy.

A similar approach is used by Medicare to pay for hospital care. But simply expanding the approach to pre-admission and post-discharge care for the four major conditions and procedures examined would produce only a small decrease in health spending, according to RAND researchers.

In order to achieve substantial new cost reductions, the payment approach needs to be applied to payments for the treatment of six common chronic diseases, according to the study. Some models of doing so are under development, but they have not yet been tried on a large scale, according to researchers.

Source: RAND Corporation


Rank not rated yet
Relevant PhysicsForums posts

More news stories

Cognitive impairment in older adults often unrecognized in the primary care setting

A new study published in the Journal of the American Geriatrics Society reveals that brief cognitive screenings combined with offering further evaluation increased new diagnoses of cognitive impairment in older veterans two to ...

Medicine & Health / Diseases

created 57 minutes ago | popularity not rated yet | comments 0

Primary care program helps obese teen girls manage weight, improve body image and behavior

Teenage girls gained less weight, improved their body image, ate less fast food, and had more family meals after participating in a 6- month program that involved weekly peer meetings, consultations with primary care providers ...

Medicine & Health / Health

created 47 minutes ago | popularity not rated yet | comments 0

Botox developer rues missing out on billions

Botox developer Alan Scott says he rues the day he handed over rights to the best-selling wrinkle-smoothing drug to a US company for just $4.5 million, saying he might have become a billionaire.

Medicine & Health / Medications

created 1 hour ago | popularity not rated yet | comments 0

Young adults allowed to stay on parents' health insurance have improved access to care

Researchers from Mount Sinai School of Medicine have found that laws permitting children to stay on their parents' health insurance through age 26 result in improved access to health care compared to states without those ...

Medicine & Health / Health

created 1 hour ago | popularity not rated yet | comments 0

Cancer rate 4 times higher in children with juvenile arthritis

New research reports that incident malignancy among children with juvenile idiopathic arthritis (JIA) is four times higher than in those without the disease. Findings now available in Arthritis & Rheumatism, a journal publis ...

Medicine & Health / Diseases

created 1 hour ago | popularity not rated yet | comments 0


Rapunzel, Leonardo and the physics of the ponytail

(PhysOrg.com) -- New research provides the first mathematical understanding of the shape of a ponytail and could have implications for the textile industry, computer animation and personal care products.

AT&T customers surprised by 'unlimited data' limit

(AP) -- Mike Trang likes to use his iPhone 4 as a GPS device, helping him get around in his job. Now and then, his younger cousins get ahold of it, and play some YouTube videos and games.

Climate change causes harmful algal blooms in North Atlantic: study

Warming oceans and increases in windiness could be causing of an abundance of harmful algal blooms in the North Atlantic Ocean and North Sea, according to new research.

Hacker claims porn site users compromised

A hacker claims to have compromised the personal information of more than 350,000 users after breaking into a disused website operated by pornography provider Brazzers.

Integrated pest management recommendations for the southern pine beetle

The southern pine beetle, Dendroctonus frontalis Zimmermann, is a chronic insect pest within pine forests in the southeastern United States. Under favorable environmental and host conditions, it is an agg ...

Scientists discover molecular secrets of 2,000-year-old Chinese herbal remedy

For roughly two thousand years, Chinese herbalists have treated Malaria using a root extract, commonly known as Chang Shan, from a type of hydrangea that grows in Tibet and Nepal. More recent studies suggest that halofuginone, ...