How Improved Health and Longer Lives Drive Global Prosperity

Panel Overview & Objective

• The session, hosted by Cece Connolly (PwC Health Research Institute), examined the link between healthcare innovation and economic growth, aiming to debunk myths surrounding cost and quality.
• The panel comprised experts from the CDC, Heritage Provider Network, Georgetown University/RAND, GE Health Care, and the University of Cincinnati.
• The central thesis posited that moving from a "sick care" fee-for-service model to an accountable care model improves population health while reducing long-term costs.

Economic Impact & Innovation Examples

• Immunization ROI: Dr. Thomas Frieden (CDC) cited a 10-to-1 return on investment for immunizations, generating $70 billion in societal savings annually from $14 billion in spending.
  • Immunizations prevent approximately 20 million disease cases and save 42,000 lives yearly.
  • The benefit-to-cost ratio is 3-to-1 for direct medical costs and 10-to-1 for total societal costs.
• Accountable Care Models: Jonathan Gluck (Heritage Provider Network) highlighted a 30-year track record of using budget-based care (capitation/medical homes) to reduce costs.
  • This model relies on the premise that preventing illness is cheaper than treating it after onset.
  • The industry is shifting toward this model via the Affordable Care Act and CMS Center for Medicare and Medicaid Innovation (CMMI).
• Telehealth & Diabetes Management: Carol Roan (Georgetown/RAND) noted a CMMI pilot in Hawaii using remote foot imaging to prevent amputations in low-income diabetics.
  • The device takes daily foot photos to detect neuropathy early, preventing ulcers.
  • Medicare is currently funding this pilot, signaling potential broader adoption.
• Imaging Efficiency Savings: Mike Harsh (GE Health Care) estimated that the shift from exploratory surgery to diagnostic imaging saved nearly $14 billion annually over the last 20 years.
  • Exploratory surgeries have declined by approximately 60% due to advanced imaging technologies like CT, MRI, and PET.
  • GE developed a handheld ultrasound device ($50k+ annual savings potential) described as a "21st-century stethoscope" for point-of-care cardiac diagnostics.
• Systematic Care Standardization: Dr. Peter Margolis (UCincinnati) reported that the "Improved Care Now" network increased remission rates for pediatric IBD (Crohn's/Colitis) from 60% to 77% without new medications.
  • This network involves 52 centers, 15,000 patients, and 1,000 clinicians sharing standardized data.
  • Current practice gaps show only 25% probability of patients receiving indicated care due to provider/patient adherence failures.

Incentives, Data, and Big Data Strategy

• Prize Challenges: Heritage Provider Network utilizes prize challenges to crowdsource solutions, leveraging the fact that "most smart people work for somebody else."
  • The "Bundles for Babies" prize aims to find payment models for Medicaid providers to prevent premature birth complications.
  • The "Heritage Health Prize" seeks algorithms to predict hospital admissions to prevent $40 billion in unnecessary hospital care annually.
• Data Silos & Interoperability: Speakers noted that while the U.S. has enough healthcare data to fill 500,000 Library of Congress volumes, data is trapped in silos.
  • Geolocation of data varies drastically; e.g., Whitman Walker Health in DC uses integrated EMRs, while many private practices in the same district do not.
  • Interoperability is required to eliminate redundant care, though progress is currently "in its infancy" compared to sectors like finance.
• Industrialization of Healthcare: GE Health Care advocates for "industrializing" healthcare to reduce clinical variation.
  • Eliminating just 1% of clinical diagnostic variation could yield $60–63 billion in annual savings.
  • The strategy requires moving from "data rich, information poor" to actionable insights for providers.
• Information vs. Incentives: Dr. Frieden emphasized that public reporting of provider performance often motivates physicians more than patients, as doctors are sensitive to ranking.
  • Controlling high blood pressure is a high-impact intervention; 47% of Americans are currently controlled, whereas high-performing systems reach 75-85%.

Barriers, Future Outlook, & Myths

• Timeframe for Savings: Dr. Roan noted a trade-off where short-term health IT implementation and preventive care increases utilization costs before long-term savings materialize.
• Payment Reform: The consensus is that reimbursement must shift from "paying for volume" to "paying for value," a transition driven initially by public payers and trickling to private insurers.
• Myth: Innovation Requires High Tech: Panelists debunked the idea that innovation must be high-tech, citing low-tech solutions like checklists and task-shifting to nurses as highly effective.
• Political vs. Intellectual Barriers: Jonathan Gluck identified the primary hurdle as political (addressing end-of-life discussions, payment reform) rather than intellectual.
• Economic Growth & Insurance: Carol Roan argued that universal insurance access fosters entrepreneurship by freeing individuals from "job lock."
• Patient Engagement: Dr. Margolis highlighted that patients are an underutilized resource; involving them in collaborative networks (e.g., via IP lawyers or filmmakers) accelerates innovation.