Susan Dentzer, editor in chief of Health Affairs, reviewed the literature on the causes of rising costs and suggested solutions. According to Dentzer, why are costs rising?

• advances in medical technology
• poor health status, especially obesity
• poor productivity
• no competition on prices
• Fee for service penalizes those who re-engineer their practice
• NOT: aging population, or malpractice costs

Solutions? Dentzer explored two approaches – from the Commonwealth Fund, and the Center for Studying Health System Change. These include:

• expanding health IT
• employment comparative effective studies
• patients sharing in decision making
• disease prevention
• realigning incentives
• correcting price signals, such as re-setting Medicare Advantage rates, and permitting negotiation of Medicare prescription drug prices
• payment reform – fee for service is toxic to health care

• Listen to Dentzer’s presentation. (Length: 36:45) (This will open your computer's default media player in a new window)
• Download from iTunes
• View Dentzer’s slides.

Filed under: State of the State of Health Care Conference: 2008