The United States spends more than 17% of its GDP on health care,
while other developed countries throughout the world average 8.7%
of GDP on healthcare expenditures. By 2028, that percentage in the
United States is projected to be 19.7% of GDP. Yet all this
spending apparently doesn't equate to value, quality, or
performance. Among 11 high-income countries the United States
healthcare industry ranked last during the past seven years in four
key performance categories: administrative efficiency, access to
care, equity, and healthcare outcomes. This book presents the
implantable medical device (IMD) supply chain ecosystem as a
microcosm of how these challenges of affordability and healthcare
outcomes are created and are allowed to fester. The IMD Spiderweb,
as the authors call it, is exposed as an example of how a wide
range of participants-including physicians, health system CEOs,
group purchasing organizations, health insurance companies and
supply chain executives-become ensnared in a web designed to
benefit only one player. The book also details the affordability
challenges in the industry caused by the past and current IMD
ecosystem and presents a model for meeting those challenges. The
result is that the true cost of IMDs is hidden, while hospitals and
health systems in the United States pay as much as six times more
for some IMDs as their counterparts do in Europe, and prices for
the same model of a particular IMD vary wildly even among different
U.S. hospitals. While there is a fascination with the latest and
greatest device there is also a shroud around visibility into how
these products-which include cardiac rhythm management devices such
as pacemakers and orthopedic implants such as knees and hips-have
performed and are likely to perform in patients. The costs continue
to rise not only in healthcare expenditures, but also in death and
disability. The IMD spiderweb is presented as a prime lesson in the
challenges in healthcare affordability and outcomes that occur
throughout the entire healthcare industry. It is also put forward
as an opportunity. The story behind how these challenges arose and
are deepened by the ecosystem provides a foundation for solutions.
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