Health care in the United States is long overdue for an upheaval. The mismatch between costs, by far the highest in the world, and health outcomes, among the worst in the high‐income world, has long been glaring. Perhaps the good news is that the time for such an upheaval has come. At least 4 forces have been gathering steam, each promising to change the nature of health care and, in so doing, influence population health.
First, precision medicine promises a future in which genetic and molecular targeting can provide us all with specific treatments for our particular ailments and even preventive approaches to keep us from getting sick in the first place.
Second, the digital revolution has made yottabytes (10 to the 24th power) of “big data” available to describe individuals and populations, promising to illuminate how we behave so that we may both predict what interventions can make us healthier and anticipate our health needs before symptoms or more conventional diagnostic approaches could do so.
Third, the Affordable Care Act was only the first piece in a decade of regulatory change that included the 21st Century Cures Act, European Union changes in medical device regulation, and growing global concern about data privacy. These changes together are contributing to an evolving—and in some ways uncertain—regulatory framework that will shape health care innovation.
Fourth, corporate efforts to reshape health care delivery are evolving at an extraordinarily fast pace. Proposed and executed mergers, including the CVS purchase of Aetna and Cigna's purchase of Express Scripts, are creating new providers that combine pharmacy benefit managers with health insurers, potentially creating comprehensive payer systems that can choose what services to insure and how to price them.
Read full piece at The Milbank Quarterly.