COMMENTARY

How to Control Healthcare Costs: Take a Walk on the Supply Side

Karen Davis, PhD

Disclosures

March 25, 2005

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The federal government says that healthcare spending will double to $3.6 trillion in the next 10 years.[1] There are as many expert opinions about what to do about that as there are experts. So, let me add mine.

Here's my "Top 10 List" of approaches that show promise for reducing healthcare costs and improving quality at the same time:

  1. Prevent hospitalization by having nurses monitor patients with serious conditions at home[2];

  2. Reduce variation in charges for patients with similar conditions;

  3. Encourage shared decision making by informed patients;

  4. Stop paying for medical errors and poor care[3];

  5. Negotiate pharmaceutical prices[4];

  6. Standardize insurance products to reduce administrative costs;

  7. Use evidence-based clinical guidelines to determine when a given test or procedure should be done[5];

  8. See that every patient has a regular physician responsible for prevention, management of chronic conditions, and coordinating care[6];

  9. Reduce waste and duplication of care; and

  10. Implement modern information technology.

Combined, these efforts could generate substantial savings. None would force patients to forgo effective care or pay more out of pocket. The savings should be redeployed to help cover the uninsured, improve prevention and quality, reduce disparities in care for minority patients, and invest in modern information systems.

The result? A health system that commits fewer errors, improves health, and is accessible to all.[7] And that's worth paying for.

That's my opinion. I'm Karen Davis, President of The Commonwealth Fund. Note: For a more detailed rendition on this topic, please see The Commonwealth Fund , to contact the author kd@cmwf.org .

Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed for the editor's eye only or for possible publication via email: glundberg@medscape.net .

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