The American healthcare system is broken — here’s what we can do to fix it

The American healthcare system is broken

In addition to serving as Chief Clinical Partner for agilon health, Dr. Kevin Spencer is the chairman of Premier Family Physicians in Austin, Texas.

Americans are living longer and consuming more extensive healthcare services than previous generations, which is placing additional strain on an already overburdened healthcare system in the United States. In order to enhance outcomes for our ageing population, which is anticipated to grow to around 84 million people by 2050, primary care access must be improved. Nevertheless, primary care remains grossly underestimated, making up only 5% to 7% of all healthcare spending in the United States.

In a system that favours quantity of services over quality of treatment, primary care doctors are burning out at historic rates. According to a recently released study by the American Medical Association, 63% of doctors would suffer burnout symptoms by the end of 2021, while the Association of American Medical Colleges predicts a shortage of up to 48,000 primary care doctors in the U.S. by 2034.

These startling figures demonstrate one thing: Primary care physicians require a new model that enables them to practise medicine as they were trained to and improves the quality of care for their senior patients if we are to transform the American healthcare system and meet the needs of our ageing population.

I have been a primary care physician for 26 years, and I have seen directly how a value-based care model can empower and enable doctors to provide better care. Instead than focusing on illness, value-based care emphasises wellbeing. Instead than responding to health emergencies, the focus is on prevention. It is the secret to modernising American healthcare, enabling improved health outcomes, cutting waste, bringing down prices, and empowering primary care providers.

A new primary care model requires a shift in perspective regarding how doctors spend their days. 2019 saw the transition of my Austin, Texas, clinic, Premier Family Physicians, to a value-based care model where we took on the full financial burden of our senior patients.

Since then, we have had considerably more substantial influence over their lives. For instance, I had a patient in hospice care who had advanced pancreatic cancer. However, because hospice was unable to treat this patient, they had to keep bringing them to the hospital. He was able to spend the last few months of his life at home with his family rather than in the hospital thanks to the home care team we sent out thanks to our value-based care model.

Doctors may invest in the tools and technology required to direct and coordinate better overall care for their elderly patients, even those who are too ill, underprivileged, or afraid to attend their doctor, thanks to a full risk value-based care model. With the help of this new approach, doctors may expand their practises, identify untapped prospects for better results, and ensure that care is patient-centered and smoothly linked with payers. Less expensive patient interventions (including less time in the ER or hospital), more wellness visits, a stronger emphasis on preventative care, and more specialised support for patients with critical or chronic diseases are the outcomes.

And others are paying attention besides doctors. The CMS and health insurers think the switch to value-based care is the best way to reduce waste, drive down healthcare costs, and enhance patient outcomes. Even more ambitiously, they established a target of converting 30 million Medicare members to a complete care model by 2030. When primary care physicians are given the authority to handle the requirements of their senior patients, everyone involved in the American healthcare system wins. Set value-based care as a top priority to make it a reality. Our doctors and senior citizens expect it of us.

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