Americans deserve a healthcare system that provides high-quality care at a reasonable cost. The current system is failing many people, but especially those who have the greatest health needs and the fewest resources to pay for it.
Many solutions have been proposed to better serve the growing number of high-need patients. Unfortunately, efforts have been largely ineffective and sporadically coordinated with social services, resulting in great variations of outcomes and cost. That variation is cause for concern because the result is an underperforming healthcare system—leading to lower-quality care for people who need it most, and threatening the financial sustainability of the overall healthcare system. At the same time, however, the variation suggests that there may be pockets of excellence where better care is being delivered at a lower cost—and this is our great opportunity.
With 5% of Americans accounting for almost 50% the nation’s healthcare spend, doing better in this key area of healthcare could improve millions of lives and free up wasted resources. To make progress, we need to know more about the people with the most significant healthcare needs and the services they use; identify and validate the care delivery models that generate above-average health outcomes at lower-than-average costs; and transfer the knowledge and know-how to promote their broad adoption so that the models of excellence can become the community standard.