A Nation in Need of Resuscitation. Like a person suffering from a debilitating disease, healthcare delivery in the United States is ailing. The U.S. spends significantly more per capita and a higher percentage of GDP on healthcare than other developed nations, yet our patient outcomes (e.g., mortality, safety, access to medical care) are disparate and inconsistent. Moreover, the rapidly rising costs of healthcare delivery are making medical care increasingly unaffordable to the average citizen and threaten our national financial viability. How did we get here? Although unhealthy lifestyles and the growing and aging population are undoubtedly contributing to the rise in healthcare costs, two key factors must not be underestimated: a) advances in medical technology and b) powerful system incentives that inadvertently advance unchecked utilization throughout the healthcare delivery system. So what can we do? In this publication, Denis A. Cortese, MD and Robert K. Smoldt, MBA draw on nearly 80 years of combined experience in healthcare delivery, to help U.S. citizens and leaders understand the concepts and options for improving healthcare delivery, and outline a roadmap for a high-value healthcare delivery system, where value is defined as patient outcomes divided by total cost per patient over time. While providing a comprehensive set of recommendations, Cortese and Smoldt really zero in on the need to change existing healthcare provider financial incentives toward "pay for value" as a key stepping stone toward high-value healthcare delivery. Healthcare professionals, policy-makers, and concerned citizens will all benefit from considering their point of view.
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Denis A. Cortese, MD is a Foundation Professor at Arizona State University (ASU), Director of ASU's Healthcare Delivery and Policy Program, and President of the non-profit Healthcare Transformation Institute based in Phoenix, AZ. He is an Emeritus President and CEO of the Mayo Clinic. Robert K. Smoldt, MBA is the Associate Director of Arizona State University’s Healthcare Delivery and Policy Program, and Senior Policy Advisor at the Healthcare Transformation Institute. He is an Emeritus Vice President and Chief Administrative Officer of the Mayo Clinic.
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