Insights on bending the healthcare cost curve.
The principles of Value Based Care work for non-profit organizations operating a closed system such as Kaiser. The people who buy Kaiser coverage, buy into the Kaiser way of healthcare. It’s a prevention first organization that promotes healthy living.
Other healthcare systems have had a hard time realizing the same level of success because there is too much variation in the organizational structures and offerings. Researchers have recently discovered that all of the innovative solutions helping to simplify these organizations is actually driving the cost of healthcare up rather than bending the curve.
The cost of innovation is impacting developed countries even more than the aging population. Fortunately, longevity researchers are uncovering insights that can help us bend the cost curve for all.
Healthy Living
Researchers have defined healthy aging to mean “the process of developing and maintaining the functional ability that enables wellbeing in older age.” The functional abilities needed to maintain wellbeing in our later years are also what we need in our younger years.
Five functional abilities for sustained wellbeing
1/ Functional strength for mobility
2/ Opportunities to learn, grow and make decisions.
3/ Financial resources to meet essential needs.
4/ Ability to build and maintain relationships.
5/ Opportunities to contribute to the lives of others.
Bending the healthcare cost curve
People are living longer but they many not be living healthier. The research is not definitive as to why. However, what is clear is that health and wellbeing has comparatively less to do with genetics and clinical care than the other determinants of health.
Determinants of Health
1/ Genes/Biology – 10%
2/ Clinical Care – 10%
3/ Physical Environment – 10%
4/ Health Behavior – 30%
5/ Socio-Economic – 40%
Healthcare in countries around the world is shifting to community care with a focus on prevention and healthy behaviors rather than medical treatment. In the future, hospitals and healthcare systems may get a smaller portion of the spend as payment shifts from service to impact. Researchers have identified five areas of impact based on the expressed capabilities for health and wellbeing.
The five areas of impact include
1/ Locomotion
2/ Cognitive
3/ Sensory
4/ Psychological
5/ Other
Challenges for healthcare systems
Change will not be easy. People have been conditioned to rely on the healthcare system for drugs, treatments and other solutions for many problems that can be solved with better lifestyle practices.
More healthcare leaders need to start talking about the shift to community based care so that people buy in and rely on healthcare systems less. The financial trajectory of the healthcare cost curve is not sustainable for developed countries.
Without behavior change, the financial impact of those that live longer but not healthier lives will eventually hit the bottom lines of healthcare systems hard.
