Searching for the Next Breakthrough in Health Care

By Anne-Marie J. Audet, M.D, M.Sc., S.M.
The Commonwealth Fund, May 5, 2014

It is well documented that health care in the United States is not just expensive; it’s world-class expensive, and unsustainably so. And although many would like to believe that all that spending buys us the safest, most effective care to be found anywhere on the planet, it is equally well documented that our health care system, on many levels, doesn’t measure up on a global scale. We’re simply not getting what we pay for.

Clearly, it’s going to take more than minor tweaks or adjustments to change our course. It’s going to take a real breakthrough.

What do we mean by a breakthrough? Though incremental change is valuable, and The Commonwealth Fund pursues this in many of its other programs, that’s not what we’re looking for here. We mean an idea, a paradigm, a strategy that positively and profoundly disrupts the status quo.

The Commonwealth Fund’s new Breakthrough Health Care Opportunities program aims to discover and vet transformative ideas that have the potential to expand access to care, dramatically simplify the delivery of care, decrease costs, and improve health outcomes.

We’ve set the bar high. Here are our working criteria for a breakthrough:

• How much does it disrupt the status quo? We’re looking for major disruption—a whole new approach that represents a break with what we do now.
• How big a difference will it make? Broad societal impact is the goal, with large numbers of people benefiting nationwide. To gauge impact, we’re using a 20/20 rule for screening breakthroughs: the potential must be at least a 20 percent improvement in health care quality and/or a 20 percent reduction in costs nationally.
• How quickly can it become a reality? The timeframe we envision is up to 10 years to achieve impact.

Our work in exploring breakthrough opportunities is just beginning. We will seek ideas from a broad network of colleagues, and communicating what we find along the way. Please share your thoughts with us here or Tweet them with the hashtag #hcbreakthrus.

http://www.commonwealthfund.org/Blog/2014/May/Searching-for-the-Next-Bre…

Breakthrough Health Care Opportunities: http://www.commonwealthfund.org/Program-Areas/Breakthrough-Health-Care-O…

The Commonwealth Fund’s new Breakthrough Health Care Opportunities program is looking for “major disruption – a whole new approach that represents a break with what we do now.” They aim to “discover and vet transformative ideas that have the potential to expand access to care, dramatically simplify the delivery of care, decrease costs, and improve health outcomes.”

Uh, there is a great idea already out there that would seem to be just what they are looking for – a well designed single payer system. It is highly unlikely that anyone will come up with any other idea that does not yet exist which is a truly disruptive, transformative breakthrough that will achieve their goals. It is much more likely that proposals will be for incremental tweaks or adjustments which they say they are not looking for.

But are they serious? As one example of “the scale and ambition we believe are needed to achieve dramatic improvements in U.S. health care” they suggest “the massive and widespread implementation of financial risk-sharing arrangements to encourage more careful allocation of resources and create incentives to keep patients healthy.” Yikes! We already have introduced that with accountable care organizations and their predecessors, and the results to date indicate that improvements are negligible or worse. A special form of risk sharing – requiring patients to pay more of the costs of the care they obtain – might slow spending very modestly but at a cost of increasing financial hardship and impairing health care access.

Although single payer is not a new concept, it would certainly be a beneficial, disruptive breakthrough for the United States. It will be interesting to see if they are really serious about considering all ideas, or if this will be yet another ABSP proposal. (ABSP – Anything But Single Payer).

Searching for the Next Breakthrough in Health Care

By Anne-Marie J. Audet, M.D, M.Sc., S.M.
The Commonwealth Fund, May 5, 2014

It is well documented that health care in the United States is not just expensive; it’s world-class expensive, and unsustainably so. And although many would like to believe that all that spending buys us the safest, most effective care to be found anywhere on the planet, it is equally well documented that our health care system, on many levels, doesn’t measure up on a global scale. We’re simply not getting what we pay for.

Clearly, it’s going to take more than minor tweaks or adjustments to change our course. It’s going to take a real breakthrough.

What do we mean by a breakthrough? Though incremental change is valuable, and The Commonwealth Fund pursues this in many of its other programs, that’s not what we’re looking for here. We mean an idea, a paradigm, a strategy that positively and profoundly disrupts the status quo.

The Commonwealth Fund’s new Breakthrough Health Care Opportunities program aims to discover and vet transformative ideas that have the potential to expand access to care, dramatically simplify the delivery of care, decrease costs, and improve health outcomes.

We’ve set the bar high. Here are our working criteria for a breakthrough:

• How much does it disrupt the status quo? We’re looking for major disruption—a whole new approach that represents a break with what we do now.
• How big a difference will it make? Broad societal impact is the goal, with large numbers of people benefiting nationwide. To gauge impact, we’re using a 20/20 rule for screening breakthroughs: the potential must be at least a 20 percent improvement in health care quality and/or a 20 percent reduction in costs nationally.
• How quickly can it become a reality? The timeframe we envision is up to 10 years to achieve impact.

Our work in exploring breakthrough opportunities is just beginning. We will seek ideas from a broad network of colleagues, and communicating what we find along the way. Please share your thoughts with us here or Tweet them with the hashtag #hcbreakthrus.

http://www.commonwealthfund.org/Blog/2014/May/Searching-for-the-Next-Breakthrough-in-Health-Care.aspx

Breakthrough Health Care Opportunities: http://www.commonwealthfund.org/Program-Areas/Breakthrough-Health-Care-Opportunities.aspx

Comment:

By Don McCanne, MD

The Commonwealth Fund’s new Breakthrough Health Care Opportunities program is looking for “major disruption – a whole new approach that represents a break with what we do now.” They aim to “discover and vet transformative ideas that have the potential to expand access to care, dramatically simplify the delivery of care, decrease costs, and improve health outcomes.”

Uh, there is a great idea already out there that would seem to be just what they are looking for – a well designed single payer system. It is highly unlikely that anyone will come up with any other idea that does not yet exist which is a truly disruptive, transformative breakthrough that will achieve their goals. It is much more likely that proposals will be for incremental tweaks or adjustments which they say they are not looking for.

But are they serious? As one example of “the scale and ambition we believe are needed to achieve dramatic improvements in U.S. health care” they suggest “the massive and widespread implementation of financial risk-sharing arrangements to encourage more careful allocation of resources and create incentives to keep patients healthy.” Yikes! We already have introduced that with accountable care organizations and their predecessors, and the results to date indicate that improvements are negligible or worse. A special form of risk sharing – requiring patients to pay more of the costs of the care they obtain – might slow spending very modestly but at a cost of increasing financial hardship and impairing health care access.

Although single payer is not a new concept, it would certainly be a beneficial, disruptive breakthrough for the United States. It will be interesting to see if they are really serious about considering all ideas, or if this will be yet another ABSP proposal. (ABSP – Anything But Single Payer).