The U.S. healthcare system: a massive, dangerous beast devouring our economy

Leora Heathcote

Hot

21 mins

Sep 06, 2022 12:07

The U.S. healthcare system is a massive and dangerous beast that devours a huge chunk of our economy. 20% of GDP is a staggering amount, and yet it doesn't seem to be enough for this insatiable system. For all the money it costs, we don't seem to [...]

This is Part 1 of a two-part series on innovation in primary care. This article covers the importance of primary care and reasons for increasing investment in the space, while Part 2 covers who the players are, how they compete, and who is likely to win. Part 1 of this series is essential reading for anyone looking to understand the current state of primary care and the challenges faced by those working in the field.

It's no secret that Amazon has been making big moves in the healthcare space recently. One of its latest acquisitions is One Medical, a primary care provider with a national network of clinics. There are a few possible reasons behind this purchase.

For much of humanity, we have had no reliable way to pass on our wisdom to the next generation. Then cave paintings appeared, and writing followed around 3200 BC. Previously, wisdom was passed down in the form of stories about the world, and various terrifying creatures began appearing in these stories, to serve as allegories. With the advent of writing, humanity suddenly had a way to record and preserve wisdom for future generations. This was a turning point in our history, and has allowed us to slowly build up a vast store of knowledge over the millennia. Today, we continue to rely on writing to communicate our ideas and thoughts to the world.

The world is full of strange and dangerous creatures, but there is nothing more feared than the undead. Zombies are relentless, soulless creatures that feast on the living, and they have been the stuff of nightmares for centuries.

There is no danger in the real world from mythical creatures.

The current state of the U.S. healthcare system is unsustainable and dangerous. It is consuming an ever-increasing share of our GDP while delivering poor results by international standards. This is a crisis that must be addressed urgently.

Although the parties have different solutions, they both realize that, as the leviathan grows as a portion of the federal budget, it eats away at our country’s future.

In a time of political turmoil and economic uncertainty, it is heartening to see that primary care may be able to step in and provide some much-needed stability. This vital sector of the healthcare industry is often overlooked, but it plays a vital role in keeping communities healthy.

The recent history of primary care does not suggest that it is a logical place to start trying to tame the $4 trillion healthcare leviathan. Indeed, the data and trends seem to suggest quite the opposite.

There is a crisis in primary care in the United States. Fewer and fewer Americans have a primary care physician, and those who do are often paid less than half of what specialists make. This is having a profound impact on the health care system, as patients with chronic conditions are less likely to get the care they need.

The healthcare industry is facing a major threat to the traditional doctor-patient relationship. With new investments in telehealth and direct-to-consumer companies, patients are becoming more fragmented and physicians are struggling to keep up. This could have a major impact on the quality of care patients receive.

There is no doubt that primary care is going through a tough time. But even in these difficult times, primary care is innovating. In fact, primary care is reporting some of the most encouraging data in terms of patient satisfaction, reduced costs, and improved outcomes. And some of the most innovative companies – from technology-enabled startups to Fortune 100 incumbents to health systems – are investing heavily because they see the opportunity to do well by doing good.

There is no doubt that primary care is essential to our healthcare system. However, the question remains as to whether or not primary care physicians are the best positioned to be the gatekeepers of care. In the past, Health Maintenance Organizations have tried (and failed) to make this happen. So, what is different now? And which of the innovative approaches is most likely to succeed? Only time will tell.

The leviathan, a powerful and seemingly invincible force, may be defeated by something that is innately human: the desire to form deep, meaningful, and lasting relationships. This desire is what drives us to seek out primary care, and it is also why investors believe that now is the time to bet on primary care. In this two-part article, we will explore (i) the importance of primary care and (ii) why investors believe now is the time to bet on primary care. By understanding the role that primary care plays in our lives, we may be able to defeat the leviathan and create a more meaningful existence.

The future of primary care is shrouded in uncertainty. Part Two of this series addresses the different players in the primary care arena and how they compete with one another. It also delves into the question of who is likely to win in this competition. The role of the primary care physician is also discussed. In the end, it is still unclear whether primary care can slay the healthcare leviathan.

The importance of primary care cannot be understated. It is the first line of defense against illness and disease, and plays a vital role in keeping people healthy.

It's time for a change in the way we think about healthcare. For too long, we have been focused on treating patients when they are sick, and this has led to skyrocketing costs and lower quality of care. Moving "upstream" to focus on prevention and wellness will help us improve the overall health of our population and bring down costs in the long run. Jaewon Ryu, MD, JD, president and CEO of Geisinger Health System, is leading the charge in this effort, and we are behind him all the way.

Policymakers want a healthcare system that provides equitable access to medical care for a population, improving health outcomes over time, and satisfactory patient experiences. Most doctors are trained to provide care that meets these objectives. However, achieving all of these goals at a reasonable cost is a challenge.

The training and education system for doctors tends to reward specialization, which has led to the rise of specialties and subspecialties among physicians. This system focuses on developing highly technical and specialized knowledge of medicine, mechanisms of action, and treatment for individuals. The more specialized and technically challenging the type of problem or area of focus, the more training required and ultimately, the more highly reimbursed.

The healthcare system in the United States is in a state of crisis. One of the major problems facing the system is the problem of specialization. This problem is exacerbated by the fact that policymakers have historically hoped for one thing but paid for another. The type of healthcare system that policymakers want requires organization, coordination, and management of groups of patients; meanwhile, the payment system that policymakers developed (in the form of Medicare) financially incentivizes doctors and hospitals to bill for services provided, not to care for the well-being of patients. This is a major problem that needs to be addressed in order to improve the healthcare system in the United States.

As someone who works in the medical field, I believe that fixing this issue requires a medical specialty that can serve as the entry point to the healthcare system for patients. This specialty should be able to build trusting and lasting relationships with patients, guide them toward healthy behaviors and habits, and help them navigate the system when they require attention.

The type of healthcare system policymakers want requires organization, coordination, and management of groups of patients.

There is no one-size-fits-all definition of primary care, but in general, it refers to a clinician or team of clinicians who take responsibility for a person's overall health. Primary care providers may be family physicians, pediatricians, nurse practitioners, or other types of providers. The importance of primary care is that it can help prevent health problems before they start, or catch them early when they are more easily treated. Primary care providers can also help coordinate care if someone has a chronic or complex health condition. Making primary care more accessible and affordable is an important goal for many health care systems. By improving access to primary care, we can improve the overall health of our population.

There is a wealth of evidence indicating that investing in primary care is associated with better health outcomes, lower healthcare spend, higher quality of care, and more equitable outcomes. This is due in large part to recent research suggesting that non-medical factors such as social determinants of health and modifiable individual behaviors account for up to 80% of medical spend and the majority of outcomes. Primary care is uniquely positioned to help address these issues. By building trusted relationships over time with patients, primary care providers can discover and potentially help address the underlying social determinants of health and modifiable individual behaviors that are barriers to a healthier life.

As the U.S. healthcare system undergoes a shift to value-based care, it is more important than ever to invest in primary care. Unfortunately, the U.S. has historically underinvested in primary care, spending only 6% to 8% of its healthcare budget on primary care services. This is only about half of what experts suggest it should be, and is far less than what peer OECD countries spend on primary care. However, as more payers embrace value-based payment systems, more money is likely to flow to primary care. This could help improve access to primary care services and improve the overall quality of care in the U.S.

Some people believe that the transition to a green economy won't happen overnight. However, there is a growing movement of people who are committed to making this transition happen as quickly as possible.

We need to invest in primary care in order to improve our overall health care system. We can't just shift the way we pay for primary care and expect things to get better. We need to invest in primary care so that patients can get the care they need and deserve.

There is reason to believe that the shift from primary care to specialty care is already underway. Greiner's point may be true at a macro level, but individual primary care practices are already making changes to specialty care. This shift will continue as primary care practices become more specialized and focused on specific areas of care.

There are a number of reasons why investors are putting more and more money into primary care. One is that the Affordable Care Act has put a greater emphasis on preventive care, which is typically provided by primary care physicians.

The past few months have seen a growing recognition of the importance of primary care.

• Steward Health System's announcement of a partnership with CareMax is a positive step forward for the healthcare industry. This transition will allow Steward to focus on its value-based programs and provide patients with access to quality primary care. This partnership is a win-win for both organizations and will ultimately benefit patients the most.
• I see a future where more and more people are opting for virtual-first care plans that offer team-based care. I believe that this trend will continue as people become more comfortable with using technology to access healthcare services. I think that virtual care will become increasingly popular as it offers convenience, flexibility, and often, lower costs.
• CVS Health's expansion into primary care is a welcome development that could help improve access to care for many people. The company's new "virtual primary care" offering could help make primary care more convenient and affordable for many people. This is a positive development that could help improve the health of our communities.

It's no secret that primary care is one of the lowest-paid medical specialties. But that hasn't stopped investors from betting big on the sector. According to a recent report from Bloomberg, primary care health investors raised a whopping $16 billion in 2021 alone. That's a lot of money being pumped into an area of medicine that is often overlooked. So why the sudden interest in primary care? Investors are betting that primary care will be a key part of the healthcare system in the future. With the aging population and the rise of chronic diseases, there is a growing need for primary care services. And it looks like their bet is paying off. Primary care is slowly but surely gaining more attention from policymakers and the general public. With more money being invested in the sector, we can expect to see even more progress in the years to come.

What's driving the investment? For years, experts have been predicting that the world economy would eventually shift away from its reliance on fossil fuels.

Kameron Matthews, Chief Health Officer at Cityblock Health, sees the pandemic as a healthcare touchstone. "The COVID-19 pandemic demonstrated the many inequities and systemic barriers to accessing high-quality preventative care, especially for underserved communities," says Matthews, a family physician and attorney. Matthews sees changes occurring at a systemic level as a result of the pandemic, accelerating the shift to value-based payment models that are highly aligned to the role that primary care plays.

The states that have been struggling to manage their budgets during the past decade are now starting to see the benefits of primary care spending. Oregon is one example of a state that has enacted legislation requiring health plans to spend at least 12% of their healthcare expenditures on primary care services by 2023. This policy change is likely to have a positive impact on the state's budget and on the health of its residents.

I'm bullish on Cityblock Health. I think the company is well-positioned to take advantage of the growing demand for primary care services for Medicaid populations. I was pleased to see that the company raised $400M in November to expand its geographic footprint. I believe the company has a bright future and can become a national player in the healthcare industry.

There is no denying that primary care is a crucial and essential part of our healthcare system. And, if recent trends are any indicator, it looks like investing in primary care is a smart financial move. Cityblock, a company that provides care to Medicaid recipients, has seen success in recent years and attributes much of its growth to the Covid-19 pandemic. Others in the industry agree that investing in primary care is a wise decision, and Elation Health, a technology company that supports independent primary care practices, has just raised $50 million to support its own growth. With the importance of primary care in mind, it seems like now is the time to invest in this vital part of our healthcare system.

I believe that the wave of investment into primary care makes a lot of sense. As Fong and others have noted, primary care is an important part of our healthcare system and it is crucial that we invest in it.

• There is a shift happening in how the government is paying for healthcare services. Instead of paying providers to provide services, they are now paying them to keep populations healthy. This is a positive change that will incentivize providers to focus on preventive care and keeping their patients healthy. Oak Street Health is one primary care company that is leading the way in this new model of care.
• The rise of Medicare Advantage plans is shifting the financial risk away from the traditional Medicare program and onto commercial health insurers. These plans now cover 42% of all Medicare beneficiaries, and the trend is likely to continue as more and more insurers contract with CMS to administer these privately-run health plans. This shift could have major implications for the overall cost and quality of care for Medicare beneficiaries.
• As burnout among clinicians reaches epidemic levels, primary care startups may be a safe haven for primary care physicians. These startups allow physicians to focus on clinical care and take care of administrative overhead, providing a much-needed respite from the stresses of modern medicine. With more and more physicians experiencing burnout, these startups could be a lifeline for the primary care system.
• As healthcare costs continue to rise, consumers are increasingly being exposed to the costs of care. This is leading many people to be more judicious with their use of healthcare services. There is an opportunity for primary care providers to help patients navigate to more cost-effective care options.
• In the face of talent shortages and an increasingly competitive job market, many employers are turning to primary care as a way to improve recruitment and retention. By offering healthcare benefits and programs, companies are able to attract and retain the best employees. This trend is likely to continue as the benefits of primary care become more widely recognized.
• As healthcare costs continue to rise, employers are searching for ways to reduce their expenses. One way they are doing so is by implementing direct primary care, which is hoped to reduce low value and high cost care. While this may help to reduce expenses in the short term, it is important to ensure that employees still have access to quality care.
• The healthcare industry is on the cusp of a major transformation, driven by technology, data and analytics. Electronic health records (EHRs) are being adopted by more and more physicians and hospitals, close to 90%. This, combined with the fact that more than 300 million Americans own smartphones, means that there is great potential for care coordination and information sharing. Telehealth has also seen a dramatic increase in uptake during the pandemic, as both providers and patients have become more comfortable with the technology. This is just the beginning – the healthcare industry is poised for a major shift that will improve patient care and outcomes.

I believe that the time is now for primary care. I think that there are many new and incumbent players in this market, and that they are all competing for the same thing: market share. I think that the primary care player who is most likely to win in this market is the one who is able to offer the best value to their customers.