Costs have traditionally not been taught within medical education. “The reasons for this silence are historical, philosophical, structural, and cultural.”1 In our current political climate, the discussion of how health care should be managed and paid for has been an impassioned one. The cost of medical care has been a subject of bitter debate and frustration for clinicians and patients alike for some time.
Now that we have introduced value-based health care and discussed different ways of measuring outcomes that matter to patients, we will turn our focus to the costs of care. We reviewed data illustrating that, while the United States pays much more per capita on health care than any other country, we do not obtain the outcomes we want. This module will help you to gain an understanding of some of the basics related to medical costs, some of the reasons for these costs, and their effects on our patients and the system as a whole.
Despite the fact that this is clearly a broken model, it is important to understand the basic components of the current system. We will aim to provide a basic overview of the current health care financing and cost accounting systems, but more importantly we will also introduce emerging strategies and tools to create a better system—one that appropriately encourages value-based health care delivery.
If we are to start delivering on the promise of value, then it is necessary that the topic of cost become part of the health care delivery and education dialogue. As we will see throughout this module, it is a complicated topic; but, then again, so is biochemistry, and we took that one on, too.
Reflect on the impact of cost on patient care and the overall value of provided health care.
Define terms used in discussing health care costs.
Evaluate various financial methods used in health care.
Compare the application of traditional and value-based costing methods in the course of a patient’s treatment.
