Journal article
Vital Directions for Health and Health Care Priorities From a National Academy of Medicine Initiative
JAMA : the journal of the American Medical Association, v 317(14), pp 1461-1470
11 Apr 2017
PMID: 28324029
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
IMPORTANCE Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost.
OBJECTIVES To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity.
EVIDENCE REVIEW Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings.
FINDINGS The US health system faces major challenges. Health care costs remain high at $ 3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient-and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress.
CONCLUSIONS AND RELEVANCE The action priorities and essential infrastructure needs represent major opportunities to improve health outcomes and increase efficiency and value in the health system. As the new US administration and Congress chart the future of health and health care for the United States, and as health leaders across the country contemplate future directions for their programs and initiatives, their leadership and strategic investment in these priorities will be essential for achieving significant progress.
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Details
- Title
- Vital Directions for Health and Health Care Priorities From a National Academy of Medicine Initiative
- Creators
- Victor J. Dzau - National Academy of Medicine, Washington DCMark B. McClellan - Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DCMichael McGinnis - Natl Acad Med, 500 Fifth St NW, Washington, DC 20001 USASheila P. Burke - Malcolm Wiener Center for Social Policy, John F. Kennedy School of Government, Harvard University, Cambridge, MassachusettsMolly J. Coye - AVIA, Chicago, IllinoisAngela Diaz - Icahn School of Medicine at Mount SinaiThomas A. Daschle - The Daschle Group, Washington, DCWilliam H. Frist - Vanderbilt UniversityMartha Gaines - University of Wisconsin–MadisonMargaret A. Hamburg - National Academy of Medicine, Washington DCJane E. Henney - National Academy of Medicine, Washington DCShiriki Kumanyika - University of PennsylvaniaMichael O. Leavitt - Leavitt PartnersRuth M. Parker - Emory UniversityLewis G. Sandy - UnitedHealth GroupLeonard D. Schaeffer - University of Southern CaliforniaGlenn D. Steele - xG Health Solutions, Columbus, MarylandPamela Thompson - American Organization of Nurse Executives, Chicago, IllinoisElias Zerhouni - Sanofi
- Publication Details
- JAMA : the journal of the American Medical Association, v 317(14), pp 1461-1470
- Publisher
- Amer Medical Assoc
- Number of pages
- 10
- Grant note
- Commonwealth Fund California Health Care Foundation Gordon and Betty Moore Foundation RobertWood Johnson Foundation; Robert Wood Johnson Foundation (RWJF) National Academy of Medicine's Harvey V. Fineberg Impact Fund John A. Hartford Foundation Josiah Macy Jr. Foundation
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Dana and David Dornsife School of Public Health
- Web of Science ID
- WOS:000398901200020
- Scopus ID
- 2-s2.0-85017514168
- Other Identifier
- 991019312611204721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Medicine, General & Internal