Seemingly conflicting claims are made for the strategies that might successfully address rising health costs and improve value. In addition, many advocates, policymakers and others lack an overarching framework to make sense of the myriad approaches that can be brought to bear.
To help advocates and others navigate healthcare value strategies and the evidence for or against them, we have developed this overarching framework.
We must keep in mind that each target may affect only a portion of overall spending.
Moreover, it is important to recognize that coverage and healthcare value are inseparable, intertwined policy objectives. We need to harmonize these policy spheres if we are to reach our nation’s shared goal of access to quality healthcare for all.
Finally, it is important to have a nuanced understanding of what drives medical spending trends. The evidence is strong that year-over-year increases in unit prices—rather than excess utilization—is a major driver of medical trend. However, many of our current strategies seek to address unnecessary utilization. Faced with such a complex policy problem, experts agree we need to bring multiple strategies to bear but eventually these strategies will also have to address high unit prices.