Costs for healthcare services in the United States continue to increase faster than inflation. U.S. healthcare spending is not a new topic of discussion. While simple narratives around prices are both potent and easy to understand, the root causes of cost growth are both many and complex. It can be tempting to view healthcare in a simplistic fashion—facility services, doctor visits, or items picked up at the local pharmacy. But this consumer-focused perspective belies the far-ranging and nuanced system of healthcare in the United States.
This report includes a collection of 11 articles from experts across Milliman, exploring a number of the complexities embedded in the system of healthcare delivery and coverage nationwide. We also examine some considerations for stakeholders heading into the future.
The collection covers the following topics.
- Introduction: The shape of the U.S. healthcare landscape
- Healthcare utility: A framework for understanding resource allocation
- Drug pricing in the United States: Background, spending, global comparison, and potential cost mitigation levers
- Genetics vs. geography: The interplay between social determinants of health and health outcomes
- The U.S. chronic disease burden: Cost, comparisons, causes, and choices
- Recalibrating the crisis: Shifting focus from acute care waste to long-term care funding challenges for sustainable end-of-life costs
- Healthcare technology adoption: Costs and barriers
- Malpractice and defensive medicine: How liability concerns drive healthcare costs in the United States
- Suture self: Addressing issues in the physician and nursing workforce requires more than stitches
- Consolidation and vertical integration in healthcare: The impact of mergers and acquisitions
- The great migration from volume to value: Barriers to migration and changing the dynamic