Tackling the Problem

In Nuna’s first post, our founder Jini Kim shared the story of how her younger brother’s diagnoses sparked her family’s long and difficult path through the U.S. healthcare system and her subsequent founding of Nuna. In this post, we’d like to give you the bigger picture - a bird’s eye view of healthcare in the U.S. and some of the major challenges of this system. These issues reflect the enormity and the complexity of the problem Nuna is helping our healthcare payer partners to tackle.

The Problem

The U.S. spends more per capita than any other developed country on healthcare and yet we frequently fare worse in terms of quality and health outcomes. In short, we have a persistent healthcare cost and quality problem - and it affects everyone.

Cost Challenges

In 2015, nearly 1 in 5 dollars in the U.S. economy was spent on healthcare. This share has grown over time, straining not only government and corporate budgets, but family budgets as well.  

Many US families forego other necessities to be able to pay for their needed healthcare. From 2007 to 2014, middle income households’ spending on healthcare grew by 25%, while spending on food, housing, clothes, and transportation fell.

Those trade-offs can result in individuals not seeking care when they need it. Indeed, a third of U.S. adults say they skip needed healthcare because they can't afford it. This can lead to health conditions worsening and necessitating care in more costly settings, like the emergency room.

Quality Challenges

In a nation where breakthroughs in science and advances in medical technology happen everyday, the quality and experience of care in the U.S. lags, especially relative to the price we pay.  

U.S. patients frequently suffer due to mistakes in the way care is delivered. Estimates show that more than 250,000 deaths per year in the U.S. are due to medical error, making it the third leading cause of death, after heart disease and cancer.

Healthcare services are often provided without regard to clinical need. In 2013, between ¼ and ⅓ of Americans on Medicare received at least one healthcare service that either had little or no clinical benefit, or that carried risk of harm that outweighed its potential benefit.

Our healthcare system does not serve Americans equitably. Low-income individuals and people of color face increased barriers to accessing care, receive poorer quality care, and experience worse health outcomes than other Americans.

What then?

These problems are daunting, but not impossible. The first step is to understand the underlying factors that lead to cost and quality challenges. Nuna helps its government, employer, and health plan partners to bridge the distance between raw healthcare data and the actionable insights that will lead to better care.

Specifically, we help our payer partners break down spending figures to identify areas where improvements in the delivery of care could better serve patients, reduce unnecessary care, and slow the growth of costs. We are busy working to answer questions like:

  • What are the most pressing care needs among a population, and what programs would be best suited to address those needs?

  • How much do payers spend to treat the same condition among different patients, and what’s driving those differences?

  • Which providers have a track record of good outcomes for patients and at a reasonable price?

  • Which providers are regularly seeing new patients, and which ones are not?

  • What makes a patient more likely to see one provider over another?

  • How does provider network design impact outcomes that matter to patients and payers?

Answers to these and other questions can help Nuna’s partners assess and begin to address the challenges in their own populations. Those steps - even small ones - can begin to drive more systemic change, to a healthcare system oriented towards value, in which quality, cost, and patient experience truly matter.

Want to know more about our products? Learn more about our work with government, employers, and health plans.

Nuna Health