B. Improving coordination to foster health

Care coordination is essential for ensuring health and wellness and for achieving the overall goal of increased value.

In a system with so many moving parts, it can be difficult to coordinate the multiple touchpoints of a patient’s experience within a more coherent approach to create or sustain wellness. Christopher A. Viehbacher, CEO, Sanofi, raised the issue of fragmentation as a way of broadening the context for drug and device development. “I think there has to be a rethinking of healthcare,” he said. “If you think about how healthcare is delivered, it’s on an ad hoc basis. Someone comes into a hospital, someone comes into a pharmacy, someone comes into a doctor. But beyond those touchpoints, the patients are on their own. There’s no real continuity of care.”

Lonny Reisman, MD, Senior Vice President and CMO at Aetna, drew attention to a shift in responsibilities that must be met with a shift in focus from discrete activities to overall results. Reisman noted that not only were healthcare costs rising three times faster than the rate of inflation, but that employees also have been absorbing a greater share of the burden. Since 2007, the annual rate of increased costs for employees has risen 50 percent faster than the rate of costs for employers.

Reisman noted that shifting financial responsibility to the consumer, in itself, fails to address the underlying cause of accelerating health costs: incentives that stimulate a growing volume of care without necessarily contributing to value. “What we cope with as an insurer,” said Reisman, “is the notion of people getting paid more for doing more ‘stuff ’ whether or not that actually contributes to better clinical outcomes.”

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