RISING COST OF HEALTHCARE IN THE UNITED STATES

William Matzner, MD
William Matzner, MD, Simi Valley, California

A recent article in the Wall Street Journal discussed the continued rise of healthcare cost in the US. By 2025 it is projected that healthcare costs will be at 18% of the GDP.  Yet research has shown that among the Organization for Economic Cooperation and Development (OECD) member countries, the US has lower life expectancy at birth and higher mortality for death from respiratory disease, coronary artery disease and diabetes than the OECD average.

A key question becomes how can we decrease the cost of healthcare while simultaneously maintaining or improving the effectiveness of treatment programs? How can an organization health system, ACO, medical group, insurer, government, measure this so as to compare choices?

This is where Cost Effectiveness Analysis (CEA) can provide clear metrics to help determine how differing approaches to healthcare programming and delivery will affect policy change. In chronic diseases such as Diabetes and Coronary Artery Disease, Markov modeling has shown to be an ideal method to determine the cost effectiveness of different treatment approaches over time. One can compare a newer method or medication, or both, to a more standard treatment and see how the cost effectiveness accumulates over time.

Since CEA uses dollars per Quality Adjusted Life Years (QALY), one can quantitatively analyze how effective different treatments or methods are toward the particular disease. This way, policies can be chosen which not only cost less, but can help patients the most over time. It takes a subjective evaluation like effectiveness and turns it into a measurable metric researchers and policy developers can analyze.

The application of CEA using Markov modeling will provide clearer guidance as to how treatment policies should be elucidated, and in the long run can help reduce healthcare costs overall while maintaining and even improving the quality of healthcare delivery and outcomes. It can also be used to quantitatively monitor the effectiveness of new policies once implemented. 

About William L. Matzner, M.D., PhD, FACP 

Dr. William Matzner works in the area of healthcare economics consulting at Healthcare Analytics, LLC, in California. He graduated Phi Beta Kappa from Stanford University. He received his M.D. with Honors from Baylor College of Medicine. In 1988, he was the Solomon Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine. 

Consulting Website: https://healthcareanalytics.biz 
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William Matzner, MD (Simi Valley, California), has been practicing medicine since 1989, Internal Medicine and Reproductive Immunology. M.D. with Honors from Baylor College of Medicine.

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