So how can we create a substantive dialog on the real factors pushing healthcare cost growth? Rather than looking to the politically paralyzed federal government for solutions, Moses says healthcare executives and clinicians must take the lead, particularly on issues such as improving care processes.
A good starting point, Moses says, is to press for adding more primary care physicians into the healthcare system to direct wellness regimens and coordinate treatment when patients become ill. His study notes that while 4% of healthcare spending goes to biomedical research, only 0.1% goes to improving the process of care.
"The innovation that has to occur here to solve any of these problems in my view, personally, should come from the private sector," Moses says. "The private sector has largely not been a participant in care process innovation. There are very few appropriations for it. The question is 'will innovations in health services occur by virtue of investment by health systems?' The Mayo Clinic, Geisinger Health System, [and] my own institution at Johns Hopkins have historically, for decades, invested in care process innovation. However it has not been widespread. It must be now."