Today we’re in the midst of a monumental effort to develop and assess alternative means of providing and paying for health care. Accountable care organizations, value-based care (and insurance design), medical homes, competition, bundled payments, integration across service providers, prescription drug and treatment adherence, preventive and wellness services, electronic health records, narrow provider networks, consumer-driven health plans, telemedicine, and a host of other initiatives are all being tested; this experimentation has encouraged much optimism that the quality of care can be significantly improved while also restraining cost growth.
The ultimate success (or failure) of these innovations in restraining cost growth will be reflected in the impartial data on national health expenditures. I’m optimistic that at least some of these efforts will prove successful — but I’m also mindful that few of them would affect the primary drivers of health care cost growth. A series of one-time reductions in the level of health care costs would be welcome, of course, but they would not represent a long-term reduction in the health care cost growth rate. Moreover, a look at one of the key drivers of growth—namely new medical technology—suggests that there are major “growth clouds” on the horizon.
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