Culture of Health Blog

With the right data to inform priorities, and a powerful commitment to equity, places like Tulsa, Okla., are making progress to close health gaps.

Recent advancements in payment reform have been massive and exciting. It's time to sustain the momentum and transform how we pay for and deliver care.

Want to know one of health care’s dirty little secrets? While we know how much the country spends on care each year, we have little understanding of what it actually costs to provide care.

Think, for example, about an appendectomy. What does it really “cost” the health care system to perform that procedure? The answer is complex, and of course it includes everyone’s time—from the surgeon to housekeeping staff—and it also includes the drugs, equipment, space, and overhead associated with your stay.

The cost of your visit will also depend on who is delivering your care. A consult with a registered nurse (RN) is less costly to the hospital than one with a physician.

Then, consider insurance. If the price your carrier pays for that RN consult is $85, but the price another carrier pays is only $65, what does it actually cost the hospital—and how do those variances affect what you pay both out-of-pocket and for insurance premiums? Moreover, health care providers are currently not trained to think about the costs of the care they provide—and often have no incentive or means to even consider those costs.

These complexities have made it difficult to reform the way we purchase and pay for health care.

It’s not always easy to think in statistics.

While that statement might seem obvious, applying that knowledge when it comes to health and health care is anything but.

Think, for example, about your last visit to the doctor. (Doctors, put on your patient hats and bear with us.) In the first couple of minutes, you (we hope) had your blood pressure, weight, and other vital signs checked. You might have also talked about changes you could make—like exercising more or quitting smoking—and how they might decrease your risk of developing a chronic disease or help you live longer.

As a patient, all of this information is valuable, but it is not often meaningful or actionable: what does a systolic blood pressure of 175 actually mean? Exercising regularly might bring my risk for diabetes down, but by how much? And what does that difference translate to for me?

There are lots of ways to answer these questions, but up until recently there hasn’t been much clarity at all when it comes to how to communicate those answers effectively. That’s why we’re so excited to announce the launch of our newest project, Visualizing Health.

The thin, paper-like hospital gown. Open. Exposing. Awkward. The perfect symbol for what health care in America represents for most of us.

As a bit of context, last week I spent three days with a group of amazing women from across the health care industry at an RWJF-sponsored forum hosted by the Association of American Medical Colleges. At that meeting, a key part of the discussion centered on where the opportunity for meaningful, collective, action might lie to catalyze dramatic system transformation. More than once, the hospital gown metaphor came up.

To me, though, this symbol represents much more than a call for system transformation—I see it as a battle cry for empowerment.

Let me explain.