And that removes the incentive to do the “right thing” in the year in question. Healthcare economics for health plans are driven by decisions that offset costs for any given year because there is little guarantee that the member in question will be on the same insurance plan next year. c These rapidly escalating costs for drugs are disheartening when one considers that medication compliance has been shown to help reduce overall healthcare costs in the long-run-particularly in the management of chronic disease. Moreover, annual drug costs have increased at a rate of at least two times the rest of health care over the past five years. And the average cost of a cancer drug has increased tenfold since 2000. And in this example, it is hard to see any impact from improved compliance on reducing costs.įor example, in 222 generic drug groups, costs increased by 100 percent between 20. Even if patients can afford medicines, they still experience the impact of increasing cost, given that the cost of pharmaceuticals is increasing at an even higher rate than general healthcare spending. From a practical standpoint, however, achieving such medication adherence among all patients is not so easy.Īffordability of medicine is a real concern, particularly among patient members on fixed incomes. This assertion is as true for hypertensive patients as it is for patients with diabetes. It improves health, helps prevent adverse events, minimizes complications associated with disease, and reduces the likelihood of hospital admission. Getting individuals with chronic disease to consistently adhere to their prescribed medications is widely shown to be beneficial. To understand why it is so difficult to improve quality while driving down cost in our nation’s healthcare system, consider a simple example of the competing effects in health care. industry sectors have not been replicated in the healthcare sector, where spending has far outpaced the growth of the overall economy. Unfortunately, the efficiency trends observed in other U.S. This reality contradicts the underlying premise of the Triple Aim: that improvements in quality can ultimately reduce costs-a premise that has been borne out in other industries, where improving process controls has led to dramatic increases in quality in concert with tremendous increases in profitability and plummeting prices for consumers. Indeed, even as annual healthcare spending has surpassed $3 trillion, the average life expectancy for Americans has plateaued, and it continues to fall short of the life expectancies seen in many other high-income nations that spend far less on health care. Yet the reality is that the rising costs of care in the United States have not correlated with improved quality. One could argue that this effect is to be expected-that high-quality care comes at a cost. Although healthcare providers conceivably could improve the patient experience by simultaneously improving the quality of care and delivering better access to care for all Americans, there is much evidence that improving access actually drives up costs. The problem is that realizing all these elements together has proven elusive. Reduce the per capita cost of health care.At face value, the basic elements of the Triple Aim seem straightforward: In some ways, the Institute of Healthcare Improvement’s oft-cited Triple Aim can be likened to a mythical beast-clearly defined in the imagination yet never seen and only vaguely hinted at by what can be found in the real world. healthcare system is ever to achieve the Triple Aim. Engagement of rising-risk patients in their own care through self-reporting will be necessary if the U.S.
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