A new publication from the National Academy of Medicine identifies eight policy directions as vital to the nation's health and fiscal future, including action priorities and essential infrastructure needs that represent major opportunities to improve health outcomes and increase efficiency and value in the health system, according to the article published online by JAMA.
The U.S. health and health care system is at a critical juncture. Discussions about repeal of the Affordable Care Act (ACA) introduce considerable uncertainty into the health care marketplace and for the 20 million people newly insured during the past six years, but the range of health and health care challenges spans far beyond the coverage provisions of the ACA. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost.
The National Academy of Medicine convened more than 150 of the nation's leading health and policy experts to author 19 articles that addressed pressing policy challenges and opportunities, and offered specific recommendations for achieving progress. Summarized in this publication are the most potentially transformative crosscutting policy directions identified from those assessments, indicated as action priorities and infrastructure needs essential to addressing these priorities. These strategies and priorities are offered to assist the new administration and others leading change throughout health and health care at national, state, local, and institutional levels.
Summary of Findings
The U.S. health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30 percent is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, eight policy directions were identified as vital to the nation's health and fiscal future, including four action priorities and four essential infrastructure needs.
Action Priorities
- Pay for value--deliver better health and better results for all
- Empower people--democratize action for health
- Activate communities--collaborate to mobilize resources for health progress
- Connect care--implement seamless digital interfaces for best care
Essential Infrastructure Needs
- Measure what matters most--use consistent core metrics to sharpen focus and performance
- Modernize skills--train the workforce for 21st-century health care and biomedical science
- Accelerate real-world evidence--derive evidence from each care experience
- Advance science--forge innovation-ready clinical research processes and partnerships
The action priorities recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs were the most commonly cited foundational elements to ensure progress.
"As the new U.S. administration and Congress chart the future of health and health care for the United States, and as health leaders across the country contemplate future directions for their programs and initiatives, their leadership and strategic investment in these priorities will be essential for achieving significant progress," the authors write.
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To read the full article, please visit the For The Media website.
(doi:10.1001/jama.2017.1964)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Related material: The editorial, "Vital Directions and National Will," by Donald M. Berwick, M.D., of the Institute for Healthcare Improvement, Cambridge, Mass., also is available at the For The Media website.
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Journal
JAMA