How can we transform the U.S. healthcare system into one that achieves better population health outcomes for the money spent? Health system redesign and transformation is required. Continuing to deliver more healthcare services in the same way that we have won’t help. Instead, we must create new care delivery models that recognize and address a fuller array of health determinants and risks to health. We must better address the underlying root causes and latent failure modes that lead to avoidable deteriorations in health and functional status, and to the preventable ER visits, hospitalizations and deaths common among higher-risk populations.
Could such a "radical" approach to redesigning care delivery work? Yes. Such care delivery models have already been designed, implemented, rigorously tested and proven to improve the health outcomes of targeted populations. Take, for example, the model of Advanced Preventive Care (APC) developed by Health Quality Partners (HQP), a non-profit organization dedicated to undertaking the research and development needed to create innovative models of care that improve the health of higher-risk populations. APC has been shown in longitudinal randomized controlled trials to reduce hospitalizations (-39%), net costs (-28%) and mortality (by -34% at two years, and -22% at five years) among higher-risk chronically ill older adults compared to those receiving "usual care." (Schore et al. 2011; Zurovac et al. 2014; Brown et al. 2012; Coburn et al. 2012.)
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