Healthcare is embedded in all of our lives. From getting our first check-up as runny-nosed kids anxious to get rewarded with a lollipop, to depending on prescriptions to ensure a decent quality of life, it’s a constant. I have personally depended on our healthcare system more than many my age. When I was fifteen, I was diagnosed with early stage cancer. Due to early detection, I was able to have an operation that spared me (and my parents) the suffering that comes with chemotherapy. Because of this defining moment in my life, I have always felt a deep appreciation for modern medicine—and I have an intimate understanding of how it can make a difference between life and death.
Yet as we’re inundated with news of people protesting mask usage or vaccines, it’s clear that some don’t share this same sentiment. I can appreciate their perspective. For years, the traditional fee-for-service model (where healthcare providers are reimbursed on the basis of the number of services they provide or the procedures they conduct) has led to financial growth for two key industry stakeholders—payers and providers. But who is left to foot the bill? The patients.
Since the turn of the century, the cost of hospital services has outpaced inflation by almost 3.5% per year. The average family in the U.S. spends more than $20,000 per year on health insurance and, as a country, we spend more than 17% of our GDP on healthcare. Although it’s true that we lead the world in many new and innovative ways to combat disease, many Americans have had a less-than-positive experience with healthcare. A 2017 Johns Hopkins study found that physicians estimated that a whopping 21% of medical procedures that were conducted were, in fact, unnecessary. So, it should not come as a surprise that the public trust in medicine has waned over the years.
Just as I have been surprised by how “behind-the-times” the industry can be, I have been equally impressed by the commitment and energy of the people who surround me.
There was once a certain reverence for the medical community. For example, Jonas Salk gave away the polio vaccine for the betterment of humanity rather than selling the patent. But now, many Americans associate medicine with rising premiums and the misinformation crossfire that was brought about by the COVID-19 pandemic. As a 20-year-old who is still on his parents’ insurance plan, I have been shielded from some of the outrageous costs associated with medical care; but that’s not the case for everyone. Approximately one in five people in the U.S. is currently being pursued by a collection agency due to debt associated with healthcare costs.
I’d hazard a guess that most of my peers have not thought about what they’ll do for coverage when that oh-so-important 26th birthday arrives, and many of them may not have to. For the lucky ones, their employers will take on the roles of mom and dad, and those peers won’t miss a beat. But for those who are left between the gaps, the story is a bit more complicated.
During my internship at Apervita, I’ve had the opportunity to see firsthand how innovative pricing models like value-based contracting can help dramatically shift current payer-provider incentives and realign them to better serve the patient. Not only does a value-based approach empower organizations to reduce patient costs, but it also improves patient outcomes. I’ve also learned that Apervita’s Quality Measurement Solutions help push stakeholders, like providers, in the right direction to ensure transparency in healthcare delivery. These advanced solutions illustrate a hopeful future for medicine, which leaves me optimistic. Many will go through life blissfully unaware of how the healthcare system works. And, perhaps I would have too, without the opportunity to work at Apervita. In the sea of industry challenges (slow progress, collaboration barriers , etc.), there are pockets of incredible innovation and disruptive thinking that I have been exposed to over the past year. As an outsider, I would not have been able to otherwise grasp the slow pace at which the healthcare industry moves. Just as I have been surprised by how “behind-the-times” the industry can be, I have been equally impressed by the commitment and energy of the people who surround me. There’s rarely a meeting that doesn’t conclude with a list of action items. While daunting at times, I find this fast-paced culture not only exciting, but a testament to the passion required to make a meaningful difference. When my internship ends, I will be able to look back and know that I—in some small way—contributed to making the health system stronger and more equitable. And that’s a good feeling.