We focusing on two goals to make the health system deliver more value:
improving the quality of patient care and cutting excessive spending.
The United States has the most expensive health care in the developed world, yet is the worst performing in terms of quality, access to doctors, and health outcomes. Health care is the leading cause of household bankruptcies in the United States. And, rising health care costs threaten the integrity of federal and state budgets and are squeezing out spending on other social needs, such as schools and infrastructure.
The Dartmouth Institute is focusing on two interconnected goals to make the health system deliver more value: improvement in the quality of the care patients receive and cutting excessive spending that contributes nothing to patient health or organizational improvement.
First, our research identifies systems and practices that reinforce low-value care. For example:
How are new, often more expensive, technologies being used?
Is the adoption driven by evidence that the technology really makes people healthier or is it marketing?
Are patient preferences driving clinical decisions or does clinical culture and professional networks influence provider behavior?
Our work on the Choosing Wisely initiative, for example, looks at the use and costs of tests, procedures, and treatments that a physician-led coalition has determined have less benefit to patient health. We look to understand how often and where low-value approaches are being used, what might be the reasons for continued use, and we propose solutions to end the use of low-value care.
Secondly, we are tracking and analyzing the performance of early-adopters of value-based care. We work to understand what innovative organizations are doing to change the status quo—to improve care and reduce low-value actions? For example, if a practice wants to improve communication between primary care and specialty care doctors, how do they do that?
By understanding what promotes better performance in our health care system, and by revealing the gap between what is possible and what is currently the norm, we are confident we can provide the knowledge policy makers, system leaders, and researchers need to accelerate improvement and affordability in the health care system.