Nearly every nation in the world is working to improve their healthcare delivery systems. The United States, in particular, has the most expensive healthcare system in the world with health status indicators that are only average in comparison with less costly health systems of other countries. Chronic illnesses and aging populations have placed a substantial burden on the US healthcare system. Nearly three-quarters of Americans over 65 suffer from chronic illnesses and half of them have more than 1 chronic illness.
There is an enormous pressure for the US to provide a more cost-effective system. The US is now experimenting with new healthcare organizational forms that have the potential to respond to new payment initiatives. The Patient-Centered Medical Home (PCHM), which provides patients with a primary care physician and a team that can deliver personalized, coordinated care across different conditions and settings over time, the Accountable Care Organization (ACO), which is an entity that accepts responsibility for both cost and quality of care provided to a defined population of patients, and the Population Health Management System (PHMS), which sets out to improve the health of populations and reduce the per capita cost of healthcare. These three organizational forms have the most potential for providing more cost-effective disease prevention and management of patients with chronic illnesses. The upcoming decades will further integrate healthcare delivery to reduce the growing burden of chronic illnesses on economic growth, quality of life, and healthcare costs. Experimentations and innovations such those represented by PCHMs, ACOs, and PHMSs will be required so people can enjoy a high quality life at every stage of their lifespan.
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