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News and Notes   |    
News & Notes
Psychiatric Services 2014; doi: 10.1176/appi.ps.651News
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Copyright © 2014 by the American Psychiatric Association

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Explaining the high costs of U.S. health care: The United States spends more on health care than any other country—$2.9 trillion every year, or $9,200 per person. Yet it also tops the list for deaths that are considered to be preventable with appropriate treatment. Is it possible to provide better care at a lower cost? An issue brief from the Commonwealth Fund addresses this question by examining the sources of high costs, obstacles to controlling them, and efforts under way to obtain better value. In addition to the fee-for-service reimbursement system, the high prices for many types of care, and avoidable hospital readmissions, a key driver of costs is poorly coordinated care, particularly for patients with complex, chronic conditions. As noted in the issue brief, just 5% of the U.S. population accounts for nearly half of total health care spending, and 20% accounts for four-fifths. The brief describes efforts to lower costs, such as accountable care organizations and bundled or “episode-based” payments that provide incentives for keeping patients with complex conditions healthy. Throughout the online document, hyperlinks take users to pages with more detailed information. Research cited in the brief shows that if U.S. health care spending had been the same for the past 30 years as the second-highest-spending country, the savings would equal $15.5 trillion—enough to transform the federal debt into a surplus and to send more than 175 million students to a four-year college. The brief is available on the Commonwealth Fund Web site at www.commonwealthfund.org/Publications.

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