Improving Value in Health Care Through Comprehensive Supply Optimization

JAMA Network October 15, 2019
Cassandra Thiel, PhD; Leora I. Horwitz, MD, MHS

The United States spends nearly twice as much on health care as other high-income countries, yet it achieves some important outcomes that are worse. Historically, high health care spending in the United States was considered to be attributable to disproportionately high utilization. Recent cross-national comparisons, however, show that health care utilization per capita is not appreciably higher than in other high-income countries. Rather, a disproportionately high price per service accounts for the majority of cost differences. Recent efforts to reduce health care costs have focused on avoiding unnecessary or excess care; however, overtreatment accounts for only about 6% of health care costs. Instead, a potentially more effective means of cost reduction may be to focus on reducing the cost of...

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