National Academy of Medicine

Demanding Value from Our Health Care: Motivating Patient Action to Reduce Waste in Health Care

By Margaret O'Kane, Kathleen Buto, Tanya Alteras, Katherine Baicker, Judith Fifield, Robert Griffin, Jim Hansen, Robert Saunders
July 26, 2012 | Discussion Paper

Health care costs have doubled as a share of the economy over the past three decades (Martin et al., 2012), causing stress on family, employer, and government budgets. Furthermore, these expenses contain substantial waste and often do not improve patient health. One important way to improve this situation is by engaging patients and the public around value. There are numerous challenges to achieving this goal, including several unanswered questions about how best to routinely approach patients on the issue. Yet, some insights are developing. First, the success of value initiatives depends on their understanding of, and connection to, patient goals, motivations, values, and aspirations. To further engage people around value requires that comparative cost and quality information is available and comprehensive enough to support individuals’ care decisions. Finally, value needs to be embedded in all aspects of health care decisions from incentives to benefit design to support patients and consumers as they seek to increase the value they achieve from their care. Given the size of the task, effective change will require coordinated efforts from all stakeholder groups.


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.