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Meet 21st Century Healthcare Challenges

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Collaborative care: An Economic imperative

Cost pressures, new payment models, and demographic trends are creating a global economic crisis as health systems struggle to care for an aging population of sicker patients. Funds available for healthcare are constrained, and they’re being wasted by inefficient, uncoordinated healthcare services.

Across the nations of the OECD, health expenditures consume an average of 9 percent of gross domestic product (GDP), and real per capita healthcare expenditures grew more than 4 percent annually during 1997-2007. In the UK, the NHS wastes GBP 330 annually by treating patients as emergency hospital admissions when they could be seen by their GP.

An oft-cited study shows that in the U.S. in 2003-2004, almost one in five hospitalizations of Medicare fee-for-service patients resulted in a readmission within 30 days of discharge; three-quarters of these could have been prevented by better coordinated care, and the cost to Medicare for these readmissions was USD 15 billion. Even traditional fee-for-service practitioners are under financial duress, with the U.S. Small Business Administration reporting that SBA-backed loans to physicians’ offices grew more than tenfold from 2000 to 2011.

Controlling costs starts with better management of patients with multiple chronic diseases, and it puts a premium on coordination and collaboration. Medicare patients with multiple chronic illnesses see an average of 13 different physicians in the course of a year, and their full treatment team can easily include another dozen professionals and paraprofessionals. Reflecting the importance of collaboration in caring for patients with chronic conditions, nearly 80 percent of the scoring criteria for the National Committee for Quality Assurance’s (NCQA) Recognition Program for Physician Practice Connections (PPC) Patient-Centered Medical Home (PCMH) relate to information- sharing and teamwork.

New payment models are forcing delivery networks to share the risks and potential cost savings of caring for these patients.