Report: How to introduce productivity, value into U.S. healthcare

Cost trends in U.S. healthcare consistently increase at about 2.5 percentage points faster than the general rate of inflation – clearly an unsustainable rate, according to an April report from the Ewing Marion Kauffman Foundation.

The report, "Valuing Health Care: Improving Productivity and Quality," is based on the recommendations of 31 experts from related fields, whom the Kauffman Foundation convened to reframe thinking around the question, "How can the productivity and value of American healthcare be increased, in both the short-term and long-term?"

Rather than look for a “one-shot-fix” solution, the task force focused on incremental reforms that cumulatively can both reduce costs and enhance the value of healthcare delivered to Americans, regardless of whether and how the Patient Protection and Affordable Care Act is implemented. The underlying thread to the recommendations is leveraging big medical data.

"Using proper safeguards, we need to open the information that is locked in medical offices, hospitals and the files of pharmaceutical and insurance companies," said the report's author John Wilbanks, Kauffman senior fellow. "For example, combining larger datasets on drug response with genomic data on patients could steer therapies to the people they are most likely to help. This could substantially reduce the need for trial-and-error medicine, with all its discomforts, high costs and sometimes tragically wrong guesses."

Specifically, the report recommended:

• Breaking down silos and encouraging data sharing between research centers, medical offices, pharmaceutical companies, insurance firms and others; and that a new corps of data entrepreneurs be incentivized to collect and analyze existing medical data to discover and then disseminate new therapies.
• Funding more translational, cross-cutting research, with larger average grants made available to larger teams, many of them with participants from multiple institutions; and requiring collaboration across research institutions.
• Reforming medical malpractice systems to streamline new drug approvals and remove counter-productive restrictions on health insurance premiums.
• Empowering patients by, among other means, providing unbiased information on treatment options' benefits and drawbacks, and helping them make choices about the relevant lifestyle implications and risk-reward tradeoffs.

The task force concluded healthcare delivery deserves its own national research program, one focused on comparative efficiency research.