New Approaches to Delivering High-Value Healthcare

By Brian Klepper PhD

There are a growing number of providers committed to delivering high-value healthcare and more and more purchasers willing to buy it.

The most consequential healthcare question of our time is whether the iron grip on policy and the marketplace exerted by the industry’s dominant players — a grip that continues to favor volume-based, opaque quality and cost information, widespread information blocking, and little in the way of quality or safety management — can be broken in favor of high-value healthcare. Decades of lobbying on every relevant healthcare law and rule has facilitated the industry’s capture of regulation, formidably favoring incumbents and putting innovators at an equally formidable disadvantage. The fix is depressingly in.

It is also remarkably comprehensive. Every healthcare sector — supply chain, care delivery, finance and information technology — has devised mechanisms that allow it to extract about twice as much as it gets in any other developed country. Because US healthcare has relentlessly pursued the maximized cost promoted by regulatory advantages and fee-for-service unbundling, our care and cost patterns are dramatically different and more inflated than those in other industrialized countries. Our use of high-cost specialist care instead of low-cost primary care…