It is a beautiful time of the year.
Family, football, and feasting - these three words perfectly describe the charm of Thanksgiving. The evening is incomplete without dinner table discussions on issues from sports to movies.
I often think that out of all other blessings, healthcare in itself is no less. In fact, 80% of Americans rate the quality of healthcare received as either “excellent” or “good.” Make no mistake, there are challenges that need addressing. We are yet to become the “best healthcare system in the world.” However, not everything is in bad shape. We have come a long way - something that is worth taking stock of.
Source: Gallup, Most Americans Still Rate Their Healthcare Quite Positively
Here’s my list of 11 things we should be thankful for this Thanksgiving:
1. Comprehensive coverage
Government and private coverage have been the backbone of our healthcare system for years. While Medicare and Medicaid combined account for 37% of coverage expenses, private health insurers contribute to another 34%. The fact that we have been able to cover the vast majority of our population spread across various geographies is commendable. Various policies by federal and state governments, along with employers and private payers, are further aimed at ensuring that each American is covered, and things are moving rapidly in this direction.
2. Right intent and support from all quarters
One of the most underrated attributes of our healthcare system is the right intent demonstrated by each stakeholder from ensuring quality care delivery to solving existing problems. Initiatives such as “Partnership for Patients,” aimed at improving care quality, safety, and affordability, is a classical example of how federal agencies and private organizations are partnering to make healthcare more efficient. In fact, multiple federal initiatives such as the ACO Investment Model, Comprehensive ESRD Care Model, Kidney Care Choices (KCC) Model, and BPCI Advanced, are not only wide-ranging but also showing an upward and positive trajectory. Apart from such initiatives, many private organizations are partnering to advance their mission of providing value-based care and remain financially viable.
3. Rapid access to care
98% of Americans have access to an ED within 60 minutes, and 87.6% of people have a usual place to go for medical care. Right from top specialty care facilities to Critical Access Hospitals (CAHs), one can easily get diagnosed and treated rapidly. Additionally, we are also improving on critical fronts such as access to care for children, people with a specific source of ongoing care, and many others.
Fig: Number and percentage of access measures for which measures were improving, 2000 through 2016 or 2017, 2018 National Healthcare Quality and Disparities Report
4. Advanced chronic care management
According to the Centers for Disease Control and Prevention, 60% of adults in the US have at least one chronic disease. However, the effectiveness of care management has improved in the last couple of decades through emerging disease management techniques, case management, preventive care, use of evidence-based guidelines, and patient engagement. Centers for Medicare and Medicaid Services (CMS) is working aggressively to ensure better chronic care management through initiatives such as Chronic Care Management (CCM) Program by listening to provider communities and adjusting its payment models accordingly. Leading payer and provider organizations are also providing technology-assisted care management programs to ensure that care delivery does not end inside the four walls for their facilities.
5. Focus on research and development (R&D)
We have world-class centers of excellence for improving on existing treatment methodologies, analyzing and identifying solutions to complex diseases, and developing highly effective drugs. We are slowly moving towards a culture of wellness, and the vast amount of research that goes into realizing this dream cannot be undermined. Health and medical R&D expenditures are constantly increasing - growing a whopping 27% from 2013 to 2017. Academic and research institutions, foundations, state and local governments, voluntary health associations, and other sectors have also increased their healthcare R&D investment during that time period. Not only federal and other government agencies, but private organizations are also investing heavily in R&D.
Fig: Estimated U.S. Medical and Health Research Expenditures ($ in millions) and Annual Percentage Change, 2013-2017, Research America, U.S. Investments in Medical and Health Research and Development, 2013-2017
6. High standards of clinical education
Our highly advanced and quality healthcare system convinces a large number of medical tourists to travel to the United States each year. Undeniably, we produce the best doctors and other healthcare professionals. According to the U.S. News & World Report, 8 out of the top 10 medical universities in the world are in the United States. We also attract top medical talent from across the globe. More than 247,000 doctors educated in other countries, the majority of them foreign-born, practice in the United States.
7. Healthcare IT advancements
The shift towards imparting value-based care (VBC) has substantially increased the relevance of healthcare IT technologies. By 2017, certified health IT was used by 96% of non-federal acute care hospitals. Healthcare data is rapidly becoming the focal point of the revolution towards more transparency and cost-effectiveness. Organizations are integrating and analyzing data from disparate sources to obtain contextual insights into the health of their population. Healthcare professionals are looking beyond conventional information sources and leveraging factors such as Social Determinants of Health, social media, survey data, among others, and creating more customized care delivery plans for each patient. Further, healthcare providers are now leveraging cutting-edge technologies such as Artificial Intelligence and Machine Learning to enable quality population health management and preventive care strategies. More than 50% of healthcare professionals expect widespread AI adoption in healthcare in the next five years.
Fig: A HIMSS Media Research survey analyzed the criticality of AI in the current healthcare landscape
8. Quality infrastructure and comfortable hospitals
America is blessed with quality healthcare infrastructure from sophisticated equipment to highly advanced EDs and other care facilities. For instance, the number of magnetic resonance imaging (MRI) units per million stands at 38, unparalleled by most other developed countries. Without saying, we have a long way to go in terms of making our hospitals even more comfortable and patient-centered, but the progress that we have made over the years should be readily acknowledged.
9. Wearables and mobile apps
Many health IT organizations are leading the way with a fresh perspective on long-standing problems. Additionally, smartphone apps are allowing each healthcare stakeholder to stay on top of patient needs. Right from the ability to send heartbeat rates to your doctors in real-time to point-of-care diagnostic tools that can transmit your data from the lab to your specialist in no time - innovations in healthcare are enabling breakthrough performances.
10. Patient engagement and empowerment
Patients are involved in their care journeys today more than ever before. They are asking all the right questions, following up regularly with providers, and are more current than ever on prevailing health issues and potential risks. 80% of patients who have access to their health data use that information to assist care teams in making medical decisions. Patient engagement is not just a buzzword, and we couldn’t be happier.
11. We stand a chance to improve on statistics
The number of uninsured Americans dropped from 48.6 million in 2010 to 28.5 million in 2017. Mortality rates for colorectal, cervical, and breast cancer in the United States are lower than in comparable countries. The mortality rate for circulatory system diseases has gone down in a manner similar to comparable countries in the last three decades. If we can improve on these measures, why not aim for improving in other areas as well? Inefficiencies may exist, but we have the capacity to change and improve.
Fig: Age-standardized mortality rate per 100,000 population for malignant neoplasms of colorectal, breast, and cervix, 2015, KFF Analysis of OECD Health Statistics
The road ahead
As I said, we still have a very long way to go, and the great performance in one area cannot compensate for poor performance in another. As we approach the 2020s, collaborative approaches will likely be the key to further advances in cost and quality.
How much time would it take to make a dream healthcare system? This question should make up for a good dinner table discussion!