"Healthcare is an increasing burden on governments, healthcare systems and employers and in response, innovative approaches are developing to increase value - not just lower costs. These include new models of delivery, payment and purchasing that align providers, employers, insurers, governments and individuals around the patient care continuum."
She said reforms needed to engage a range of players with efforts to develop capacity and investment in community-based care and support.
"There is no one-size-fits-all for achieving efficiency and value - but common guiding principles and goals of improved population health, access and value. Achieving meaningful efficiency requires more than expenditure reduction."
She explained that medical expenditure accounted for a significant and growing proportion of GDP, with some countries spending up to 17% of GDP. There was also a demand for improved outcomes: enhanced patient experience, healthier populations and reduced expenditures.
"The focus is on meeting population healthcare needs with access to care at the right time and place, and engagement by stakeholders in wellness activities. All of these are set in context of competitive healthcare delivery."
The key to achieving value was an integrated delivery system. "The problem is there is often a lack of co-ordination among various professionals involved in treating a patient during a single hospital stay. There is also a lack of co-ordination between different providers that a patient might see for different illnesses. It leads to higher costs and poor quality."
The challenge was to align incentives and coordinate patient care across many entities. She said part of the solution lay in prevention and wellness, providing primary care and promoting employer and community programmes. Solutions need to be organised around initiatives to align incentives and re-orient care delivery, supported by data and information and the right resources.
She emphasised that chronic conditions lead to high healthcare expenditures and employer costs. According to WHO, approximately 63% of deaths worldwide in 2008 were attributable to non-communicable diseases (NCDs) - cardiovascular disease, cancer, diabetes and mental illness - chronic illnesses, which will increase with aging populations. NCDs will cost more than $30 trillion, over next 20 years, or up to 48% of 2010's global gross domestic product.
"The total costs include those that employers pay for absenteeism and 'presenteeism' - employees who come to work too sick to perform. By reducing NCDs and increasing wellness it is possible to reduce costs."
She emphasised that individuals needed to be made more accountable for their health and employers and communities should be centred on preventative care through wellness and the system. Reliable data was also needed to assess the importance of drivers of health issues for communities and to track outcomes.
"We have to reward quality outcomes rather than volume with more consumer cost-sharing, choice, and coverage with new benefit packages," she concluded.
CEO of HASA, Dr Dumisani Bomela, said South Africa's private hospital sector operated in a competitive environment and delivered world-class quality care using the latest technology. "As private hospitals, we are constantly looking for ways to reduce waste, increase the efficiency of health care delivery and allocate resources to improve value in health care."
