Three Crucial Reforms Could Save the World's Developed Nations Almost 15 Percent of Their Healthcare Spending

The world’s developed nations could reduce their healthcare spending by almost 15 percent by adopting three key reforms according to analysis conducted by the Health & Life Sciences practice of Oliver Wyman released today at the 2014 World Economic Forum Annual Meeting in Davos, Switzerland.

“Healthcare costs are rising rapidly all over the world,” says Dr. Jim Bonnette, Oliver Wyman’s Chief Medical Officer. “Many healthcare systems are trying to keep them down through reducing what they pay for a given procedure or through rationing, an approach in the long run that forces trade-offs between quality, access, and sustainability. But there is another way.”

To identify a more sustainable approach, Oliver Wyman modeled the impact of three basic care models on healthcare costs in the 34 nations of the Organization for Economic Cooperation and Development (OECD). The models were chosen based on Oliver Wyman’s work with innovators in the United States and the United Kingdom and are described as: an Advanced Primary Care model aimed at providing preventive care to the relatively healthy efficiently and inexpensively; an Intensive Outpatient Care Program (IOCP) for patients with late stage or multiple chronic diseases; and an “Extensivist” program designed to coordinate and simplify the care of the sickest, most complex patients. The team adjusted for demographics, country-by-country health status, and existing reforms.

Their conclusions:

• The three innovations together could save the nations of the OECD $440 billion dollars, or approximately 13 percent of total healthcare costs.
• Roughly half of the impact came from IOCP, which accounted for $209 billion in savings. The Extensivist program (which treats a much smaller number of patients with much higher costs) followed close behind at $177 billion.
• The United States had the largest potential savings: $253 billion, or 14.4 percent of total healthcare spend. The non-U.S., non-U.K. OECD nations had the lowest potential savings as a percent of healthcare spend: 12 percent, or $170 billion.

“By most estimates, 40 percent of what the developed world spends on healthcare is wasted,” says Bonnette. “The 14 percent savings from these three reforms would give us a good start on eliminating waste and put us in the enviable situation of spending less to get better care. We shouldn’t stop there though,” Bonnette adds. “Our research finds that surgical factory models and other advances can make inroads on the remaining 26 percent of waste while improving outcomes.”

Three key components underlie the successful ability of these models to deliver high-quality, cost-effective care:

• Coordination of care to ensure that patients actually receive the care they need and to eliminate waste and duplication.
• Standardized care to drive consistency and high quality while leveraging incentive systems that encourage physicians to find the most cost-effective solutions to patient needs.
• Matching patient needs with the right care model and physician skills. “We often act as if medical care is a commodity,” says Bonnette. “It’s not. Patients with chronic diseases need a different kind of care than patients with injuries or simple episodic diseases.” This philosophy of directing patients into the right care model or delivery channel applies to physicians as well. Bonnette adds, “Just as patients need to be segmented, so do physicians. That way their skills are lined up with what’s best for the patient.”

In the end, each of these components requires doctors to be trained to leverage new technology, processes, and team-based approaches. “Across geographies, we’ve spent decades training doctors to deliver care in a way that actually does not meet patient needs and at the same time costs more, which is why the problems are universal,” notes Dr. Bonnette. “If the medical profession and their funding source embraced coordinated, evidenced-based, and population-focused care systemically, national healthcare costs would drop dramatically and patients would be much better off.”

The full data release, including methodology, is available here. Media inquiries for Dr. Bonnette while he is in Davos or thereafter can be directed to Patrick Clinton.

About Oliver Wyman

Oliver Wyman is a global leader in management consulting. With offices in 50+ cities across 25 countries, Oliver Wyman combines deep industry knowledge with specialized expertise in strategy, operations, risk management, and organization transformation. The firm's 3,000 professionals help clients optimize their business, improve their operations and risk profile, and accelerate their organizational performance to seize the most attractive opportunities. Oliver Wyman is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC). For more information, visit www.oliverwyman.com. Follow Oliver Wyman on Twitter @OliverWyman.