title: Combined Regional Investments Could Substantially Enhance Health System Performance And Be Financially Affordable.
abstract: Leaders across the United States face a difficult challenge choosing among possible approaches to transform health system performance in their regions. The ReThink Health Dynamics Model simulates how alternative scenarios could unfold through 2040. This article compares the likely consequences if four interventions were enacted in layered combinations in a prototypical midsize US city. We estimated the effects of efforts to deliver higher-value care; reinvest savings and expand global payment; enable healthier behaviors; and expand socioeconomic opportunities. Results suggest that there may be an effective and affordable way to unlock much greater health and economic potential, ultimately reducing severe illness by 20 percent, lowering health care costs by 14 percent, and improving economic productivity by 9 percent. This would require combined investments in clinical and population-level initiatives, coupled with financial agreements that reduce incentives for costly care and reinvest a share of the savings to ensure adequate long-term financing.
authors: Jack Homer is principal of Homer Consulting, in Barrytown, New York, and a senior modeler at ReThink Health and a research affiliate at the Massachusetts Institute of Technology, both in Cambridge.
authors: Jack
authors: J
authors: Homer
authors: Bobby Milstein (bmilstein@rethinkhealth.org) is director of ReThink Health and a visiting scientist at the Massachusetts Institute of Technology.
authors: Bobby
authors: B
authors: Milstein
authors: Gary B. Hirsch is a consultant and creator of Learning Environments, in Wayland, Massachusetts, and a senior modeler at ReThink Health.
authors: Gary B
authors: GB
authors: Hirsch
authors: Elliott S. Fisher is director of the Dartmouth Institute for Health Policy and Clinical Practice, in Lebanon, New Hampshire, and professor of medicine and of community and family medicine at the Geisel School of Medicine at Dartmouth, in Hanover, New Hampshire.
authors: Elliott S
authors: ES
authors: Fisher
mesh_terms: D017046:Cost Savings; D017048:Health Care Costs; D005102:Health Expenditures; D006282:Health Personnel / Q000191:economics; D006285:Health Planning / Q000458:organization & administration; D006293:Health Promotion; D006801:Humans; D007449:Investments; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D018803:Models, Economic; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States
keywords: Access To Care; Cost of Health Care; Financing Health Care; Health Reform; Organization and Delivery of Care