As a leading medical institution in the United States, the Cleveland Clinic operates at the center of the country’s raging debate over health care. Like many peers, the clinic finds itself fighting to hold the line on costs while maintaining quality, attracting the most qualified staff, and providing access to affordable health care. But its efforts don’t stop there. Established in 1921 as a nonprofit group practice with a mission that links patient care, research, and education, the clinic has long been a crucible for experimentation and innovation.

And innovate it has, though not always without controversy. With more than 37,000 employees and annual revenues in excess of $4.4 billion, the Cleveland Clinic is leading a charge to lower the burden of disease on the country’s health care system while improving quality and patient experience. Cafeterias in the clinic’s many facilities no longer serve foods containing trans fats. Cleaning supplies have been replaced with nontoxic alternatives. What’s more, starting last September new employees aren’t allowed to smoke. Applicants are tested for nicotine, and those who test positive are provided with free smoking-cessation assistance but are not offered employment.

Fonte: www.mckinseyquarterly.com

Five characteristics can help ensure that a disease-management program achieves its clinical and financial goals.

Health systems around the world are under increasing strain because of the rising prevalence of chronic conditions, including diabetes, heart disease, and asthma. For more than 15 years, disease-management programs (DMPs) have been promoted as a solution to this problem. By carefully coordinating the delivery of high-quality care to patients with chronic conditions, the programs are supposed to enhance the patients’ health, reduce hospitalization rates, and lower treatment costs.

Unfortunately, initial experience with DMPs was often disappointing. Many of them produced, at best, only modest improvements in health outcomes, and few were able to decrease health care spending. Thus, many payor, provider, and health system executives have questioned whether the programs are worth their cost.

More recently, however, some DMPs have produced much better results. Germany’s diabetes program, for example, has reduced the incidence of some complications and has lowered the overall cost of care by 13 percent. Germany is also achieving good results with its programs for coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). Several other countries have also begun to achieve good results with DMPs.

october 2010 • Stefan Brandt, PhD; Jan Hartmann, MD; and Steffen Hehner, PhD
Source: Healthcare Payor and Provider Practice
Fonte: www.mckinseyquarterly.com

Demand for health services is rising steadily. At current growth rates, we estimate that most Organisation for Economic Co-operation and Development (OECD) countries will spend more than 20 percent of GDP on health care by 2050.1 Two important contributors to this growth—the increasing prevalence of largely preventable chronic conditions and the suboptimal use of health care resources—are strongly influenced by the behavioral choices consumers make. For example, obesity, which is largely preventable, significantly raises the risk of diabetes, heart disease, stroke, and some cancers. And because most health systems have not encouraged patients to take appropriate control of their care, consumers often seek the wrong type of treatment for many conditions. Misuse of the health care system only intensifies the cost burden imposed by the increased prevalence of chronic illness.

As the principal bearers of health risks and costs, payors—both governmental agencies and private insurers—have an interest in helping consumers adopt healthier lifestyles and in promoting more value-conscious health care consumption. By encouraging their members to make better choices, payors can prevent or control many chronic diseases, ensure that health care resources are used more wisely, and—in many cases—reduce costs. Recognizing this, a growing number of payors have made consumer engagement a priority, employing strategies with different degrees of effectiveness. In this article, we discuss three increasingly common approaches: educating consumers about health and preventive care, encouraging them to be more proactive in making choices about health services, and creating incentives for behavioral change. We review how these approaches are being used and what impact they are having. We also suggest ways they can be used more effectively.

Fonte:/www.mckinseyquarterly.com

Throughout the world, leaders of government health agencies, heads of health care companies, and even patients—collectively, the shapers of the modern health care system—behold the growth of health care spending with alarm. For almost 50 years, spending has grown by 2 percentage points in excess of GDP growth across all Organisation for Economic Co-operation and Development (OECD) countries. As a result, health care has become a much bigger part of most of these economies.

It is set to become bigger still. If current trends persist to 2050, most OECD countries will spend more than a fifth of GDP on health care. By 2080 Switzerland and the United States will devote more than half of GDP to it—and by 2100 most other OECD countries will reach this level of spending. While such a scenario is difficult to conceive, observers in 1960 would have viewed as far-fetched any forecast that in 40 years Western Europe would spend about 9 percent of GDP on health care. Of course, that prediction came true.

Fonte:www.mckinseyquarterly.com