Reinventing healthcare in 2023

aAfter a year defined by record inflation and double-digit health care premium increases, I’m hopeful that with a few years down the road, we can finally look back on 2023 as the year that ignited change in health care in the United States and ushered in a new order for future generations to be proud of. with it.

I will do everything I can to make it happen.

When I think about reinventing health care, I see two separate problems that need to be addressed: How can a system be created that is more sustainable over the long term? How can cost barriers be removed and patients come first?


Not sustainable at all

Do the math and it’s easy to see that a realignment of health care incentives in the United States is inevitable.

the Average family insurance premium It was $6,348 in 2000. By 2020, that amount has swelled to $21,342, an average increase of 6.25% annually. the average wage In 2000 it was $30,846, which increased to $58,130 by 2020, or an average increase of 3.22% annually. In other words, health insurance premiums in the United States have increased at nearly twice the rate of wages.


If nothing is done and health premiums continue to increase at the same rate, the median household premium will exceed $100,000 by 2046. If premiums and wages continue to increase at the same rates, the median household premium will exceed the median wage in 2055 At just over 30, a family will need a full adult income to pay for health insurance. Imagine the suffocating effect it would have on the economy and American life.

Reinventing healthcare for the long term

Here’s a simple question for the leader of every healthcare organization: Are you serving the patient’s best interests? Naturally, each of them will answer, “Of course!” But this is not true unless what people have to pay for care is part of how the organization thinks about patients’ best interests.

Health care is unaffordable for many Americans and medical debt is The main reason for personal bankruptcy. More initiatives need to directly address this. An individual can receive the best clinical care, but if the cost of that care is too high, there will still be a person — and a family — who suffers.

I am a healthcare entrepreneur, so I honestly acknowledge that healthcare organizations need to be profitable. But not at the cost of patients’ financial ruin. A fraction of a healthcare giant’s annual earnings (choose a major insurer or pharmacy benefits manager) could wipe out most medical debt in the United States.

As this finally becomes a focus, Americans and their employers will increasingly seek healthcare partners that are committed to financial well-being. Companies that make every human-health interaction accessible, affordable, and seamless will win the future of healthcare.

Re-invent now

To refocus the healthcare industry on a fair cost of care, employers and workers can take several steps to immediately reduce costs. When solutions like these are widely recognized and implemented, they will begin to turn the tide on ever-increasing healthcare costs.

Expanded use of Healthcare Advantage Navigators. To the surprise of many, the cost of care Not an indicator of quality. It may cost the same procedure with the same surgeon many times The hospital is more of an ambulatory surgery center. People don’t realize that they can pay $16,000 in one place for $4,000 in another with the same provider. How will they know this? Employers can provide Healthcare Advantage Navigators On top of the health benefits, so that their employees can make cost-effective care decisions.

Make hospital financial assistance more readily available. Non-profit hospitals are required To provide free and discounted care based on an income scale that often falls to the middle class. But these programs tend to lurk in the shadows. People who qualify for financial aid are often unaware of the existence of these programs and do not apply for them, leaving them vulnerable to medical debt. Surprisingly, it is more cost effective for hospitals Providing charitable care Chasing bad debts. No one who qualifies for this assistance should miss it.

Self-insured business development. Self-insurance or self-financing previously only made sense for companies with more than 1,000 employees. Things have now reached a tipping point where small businesses like 25 Factor can pay their claims, protect themselves from risk with stop loss insurance and cost containment programs, and generate savings for their organization and team. Goodroot, a company of 87, took the self-insurance route on January 1 and has dramatically reduced the costs of our business and our employees, while improving their benefits.

Adopt affordable drug prices. The high cost of medicines contributes to expensive healthcare. With new treatments entering the market and price tags in the millions, now is the time to rethink how we price and pay for medicines. There should be fewer steps – and fewer companies making profits – between the manufacturer and the people who take the drugs. There is an opportunity for a new generation of healthcare innovators to design a better way.

Let’s make 2023 the year of new ideas in healthcare. Even though the industry is very profitable, it cannot continue on the path that it is on. Things must change, and those who see that now will have the honor — and reward — of creating the new order.

Michael Waterbury is the CEO of Goodroot, a group of companies that is reinventing one healthcare system at a time. Goodroot companies operate in some of the areas described in this article.

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