A report recently published in JAMA Internal Medicine shows how spending more on individual physicians doesn't necessarily lead to better outcomes; a report in the Harvard Business Review examined why.
Americans spent $2.3 trillion on healthcare in the U.S. in 2013, accounting for 17 percent of gross domestic product, nearly twice as much as other countries spend on healthcare. However, outcomes aren't necessarily better and in many cases they're worse, according to the report.
Here are five key notes:
1. There is evidence suggesting around 20 percent of healthcare spending could be reduced by eliminating patient harms. HBR examined a sample of 500,000 hospitalizations treated by 20,000 hospitalist physicians in 3,000 hospitals and found that when similar patients were treated at hospitals, spending varied dramatically.
2. The spending between hospitals varied, but there was also a difference in spending among individual physicians within each hospital. Approximately 8.4 percent of the variation in spending was explained by difference between hospitalist physicians, compared to 7 percent due to the difference in hospitals.
3. The physicians with the highest spend spent 40 percent more than physicians with the lowest spend in the same hospital for similar patients. However, the physicians in the higher spending group didn't report lower mortality or readmission rates than the physicians in the low spending group.
4. The study authors weren't able to assess the reason for some physicians spending more, but those reasons could help eliminate excess spending in healthcare.
5. The study authors concluded, "Ultimately, we need to experiment with physician-focused strategies for improving healthcare efficiency."