Dean Shortell targets five areas to control health care costs in JAMA viewpoint

In a viewpoint for the Journal of the American Medical Association (JAMA), published in the October 10 issue, Dean Stephen Shortell and Dr. Arnold Milstein point out opportunities to use innovations in care delivery to slow the growth of U.S. health care spending.

“The United States needs to slow its rate of growth in inflation-adjusted per capita health spending by 2.5 percentage points annually without sacrificing health or slowing biomedical technology advances,” they write. “The consequences of failure may include shifting funding away from resources for elementary and high school education, infrastructure (such as highways), and basic science research.”

The article covers five areas that are ripe for controlling costs in the U.S. health care system: preventing costly health crises among medically fragile patients, enabling patients in late stages of serious illness to avoid dying in a hospital, increasing patient flow through hospitals, reducing hospital readmissions, and accelerating the diffusion and creation of high-value care delivery innovations.

Shortell and Milstein caution that, while substantial, known care delivery innovations that lower spending represent a finite savings opportunity, estimated at 20 to 35 percent of current U.S. health spending. Once these avenues are exhausted, they recommend prioritizing interprofessional training in order to spawn cost-moderating care delivery innovations more rapidly. “Prioritization would expand the tiny current pipeline of young professionals explicitly trained to help patients attain their health goals more efficiently,” they conclude.

Read JAMA viewpoint

Linda Anderberg