This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox.
Every day, I see a new example of inefficiency in the American health care system. Lagging medical research. Siloed data with unclear applications. A tedious revenue cycle. Too few providers despite climbing demand.
If you’re reading this newsletter, I’m sure you can relate—you likely have your own library of personal and professional moments that made you ask, “Surely this isn’t the best we can do?”
We usually groan about the daily slowdowns, but it can be tough to translate anecdotes into action. That’s why this study, published July 15 in The Lancet Global Health, was so intriguing to me. It actually puts a number on our inefficient health care system and gives us something to measure ourselves against.
Researchers from the Institute for Health Metrics and Evaluation (IHME), based at the University of Washington in Seattle, measured health spending inefficiency for 201 countries from 1995 to 2022. They compared each country’s health adjusted-life expectancy to its level of health care spending, and estimated the cost of one additional year of healthy life to determine inefficiency scores.
“When we talk about inefficiency in this work, what we’re describing is a gap between the best possible outcome and then the actual observed outcome,” Dr. Amy Lastuka, lead research scientist at the IHME, told me.
Previous research has established that the U.S. has the highest per capita health care spending of its peers, but the IHME determined that we have an inefficiency gap of 6.2 healthy years in our life expectancies. In other words, Americans could—and should—be getting 6.2 more years of bang for our bucks.
Even after accounting for high levels of behavioral and metabolic risks in our population, we fell short of the best possible health outcomes for the amount that we spend.
China, on the other hand, appears to have cracked the spending code. They achieved zero inefficiency in 2022. The good news is that there is a better way; the bad news is that our way is not meeting that gold standard, while our international competitors are.
I asked Lastuka why we’re lagging—and although the IHME didn’t investigate specific drivers of U.S. health outcomes, she did share some global patterns they observed. Higher vaccination rates and higher use of prenatal care were associated with more efficient systems, as were higher investments in preventative care.
A higher percentage of government health care spending, as opposed to private insurance or out-of-pocket payments, was also linked to more favorable outcomes. And governance structures are “really important” to health systems’ success, Lastuka said. Government corruption was associated with less efficient health care spending.
“It does seem to be the case that there are countries that are getting more healthy life years for less money,” Lastuka said. “We certainly don’t have all the answers in this paper, but I would hope that policy makers and [health care] stakeholders look at who is really performing the best according to this analysis, and try to dig deeper into what they’re doing in those locations so we can learn from them.”
What’s the biggest bog to the U.S. health care system right now? Let me know your thoughts at [email protected].
Essential Reading
- City of Hope recently launched its own generative AI model: HopeLLM. The tool can assist with patient onboarding, summarizing vast medical records in seconds. It also works to match patients with clinical trials and pull relevant data for research. HopeLLM has been a hit with providers and has also attracted interest from the pharmaceutical industry, according to Simon Nazarian, City of Hope’s chief digital and technology officer. Read more deployment insights from our exclusive interview here. And read on to the Pulse Check section for a slice of my recent conversation with CEO Robert Stone.
- HHS proceeded with thousands of layoffs after receiving a green light from the Supreme Court, The New York Times reported on Tuesday. Employees who dealt with communications, public records, medical research contracts and travel coordination for overseas drug inspection were included in the terminations. Health Secretary Robert F. Kennedy Jr. also laid off his chief of staff and deputy chief of staff for policy this week. Kennedy “lost confidence” in these individuals after only a few months on the job, a source told CNN, which broke the news. But it remains unclear what particular event (if any) sparked the firings.
- Large employers are preparing to scale back health care benefits next year amid rising costs from weight loss and specialty drugs, per a Wednesday report from the consulting firm Mercer, shared with Newsweek. Of the surveyed companies, 51 percent shared plans to increase cost-sharing in 2026—a 45 percent increase from the same survey in 2025. More than three-quarters of employers told Mercer that the rising cost of GLP-1 weight loss drugs was a top issue. This has the potential to make a bad situation worse for employees. KFF released new poll results this week, revealing that 1 in 5 American adults have not filled a prescription because of cost. Plus, patients with employer-sponsored insurance continue to rate their insurance more negatively than those with Medicare or Medicaid, reporting a negative view of their monthly premiums, out-of-pocket costs and prescription co-pays.
- The Hospital of the University of Pennsylvania is set to pay $207.6 million in a record-breaking medical malpractice verdict for the state. This week, an appellate court upheld a lower court’s finding that the hospital delayed a cesarean section—causing the child to be born with severe brain injuries including cerebral palsy. Courts ruled that the 2018 procedure deviated from standards of care. The mother had an infection in her uterus, and the C-section was delayed by 45 minutes. The hospital tried to appeal the case, arguing that it relied on an unlawful “team liability theory,” asking jurors to find the collective care team responsible without naming a specific individual. Their appeal was ultimately rejected, but the hospital intends to continue its challenge of the “legally flawed verdict,” according to recent statements.
Pulse Check
For this week’s Pulse Check, I connected with Robert Stone, CEO of City of Hope, one of the nation’s largest cancer research and treatment organizations. Its hospitals are pillars in some of the largest American cities, including Los Angeles, Chicago, Phoenix and Atlanta.
But the health system aims to reach beyond the hubs, bringing top-notch cancer care to all corners of the country. Whether through novel AI developments, groundbreaking genomic research or brick-and-mortar expansion, access is a major priority, Stone told me.
It’s only fitting that I share his thoughts in this aptly named newsletter—find a portion of our interview below.
Improving access to cancer care is a major focus for your organization. How, specifically, do you envision large cancer centers like City of Hope bridging those gaps?
There is a gap between the innovation taking place at academic cancer centers and the people who can actually access these breakthroughs. That’s why we’re bringing optimal cancer care closer to where people live and work. We’ve grown tremendously over the last 10 years, and that includes becoming this national system. We opened and acquired hospitals across the country so that now 86 million people live within a short driving distance of one of our hospitals. There is an aspect of having facilities in the communities where people live, putting your own experts and treatments in those communities. Beyond our long-time campus in Los Angeles, we have just opened a new cancer center and will open a new hospital at the end of the year in Irvine, California, [and we have facilities] just outside of Phoenix, Chicago and Atlanta.
Part of the answer though is, really, if you’re going to put patients first, if they can stay in their communities to be treated, that’s the best answer for them. Their support system is there. Their lives are there. They’re most comfortable. And so we’ve taken a lot of effort to partner with health providers in different communities. We have a subsidiary that we formed five or six years ago called Access Hope, and the purpose of Access Hope was to partner with the treating physician of cancer patients and get our expertise to them, rather than find a way to drive that those patients to one of our facilities. We invited a number of other leading cancer centers to join us in that effort, because if you’re putting patients first, it’s not about any one center. So Dana Farber, Northwestern, Emory, Fred Hutchinson, UT Southwestern, Johns Hopkins are all partners in servicing and making sure patients across the country get the right diagnosis and the right treatment plan, even without us providing that care. That’s part of the solution.
Continuing to use technology in new ways to partner with others is also part of the solution. I think the bottom line is cancer represents hundreds of diseases and there’s no one-size-fits-all approach. The common denominator is putting patients at the center and figuring out how you’re going to get the latest discoveries to them as fast as possible.
What’s one innovation in the oncology space that you believe will have a significant impact on public health beyond cancer care?
A lot of the genomic work that we’ve seen and that we’ve applied to cancer has applicability to other rare diseases and rare childhood diseases.
Thanks to genetics, we now know that cancer is not one disease but hundreds—unique variants that can be targeted for treatment. Unlocking the human genome has provided an unimaginable amount of information on the human body. If you typed out a sequence in 12-point font at 60 words per minute and for eight hours a day, it would take 50 years to type just one human genome. And that stack of papers would be as tall as the Statue of Liberty.
Today, the relative low cost and quick turnaround time has exponentially expanded the use of genomic data to fuel our incredible progress. Things like accurate genomic testing, where we can ensure the correct diagnosis, or precision medicine, with tailored treatment plans designed around specific variants of cancer to greatly improve outcomes and the patient experience. With precision medicine, I think you’re going to see patient populations get smaller and smaller over time, because we’ll understand that targeted therapies–whether you’re talking about cancer, or other therapies or other diseases–you’ll have smaller patient populations to apply it to. And I think that that’s really important.
I’ll give you an example in oncology. If we were in a room with 200 people and we all had lung cancer, maybe three of us would have the same type of lung cancer. And so the innovation that allows you to focus on smaller and smaller patient population sets, that approach is going to happen throughout medicine in general.
What about the health system status quo needs to change in order for genomics research and innovation to reach its full potential?
I think health systems need to embrace change, right? Technology and innovation are going to lead to a changing environment. I tell people that the days of 10-plus-year strategic plans, to me, are over. We have to accomplish 10 years’ worth of work in five years because the environment changes so, so quickly.
I think the key is focusing on what’s good for the patient. If you approach it through that lens, you realize speed is of the essence and that cancer is a challenge greater than any one entity can tackle. It represents a team sport, which makes partnerships and collaborations so important. Historically, thinking has been siloed. Your collaboration tends not to happen at the same level as it should, and you’ve got to think of cancer care as a team sport. You’ve got to be able to operate with speed, mobility, agility. You have to be flat and fast. You’ve got to see change as an opportunity and then create value through differentiation. Those are things that I think health care is waking up to.
C-Suite Shuffles
- Dr. Phillip Chang is the new system SVP and chief medical and quality officer for CommonSpirit Health, tasked with overseeing clinician, quality and safety leaders across more than 2,200 care sites in 24 states.
- UnitedHealth Group named Mike Cotton its CEO for Medicaid, a role that has been vacant since May. The Medicaid division was previously led by Bobby Hunter, who will now oversee both the Medicare and Medicaid divisions in a streamlined role.
- Aledade, the nation’s largest network of independent primary care providers, tapped Dr. Lalith Vadlamannati to serve as its chief technology officer. He most recently held the same title at the digital joint and muscle clinic Hinge Health, and previously worked as VP of engineering at Amazon, leading international expansion for its eCommerce business.
Executive Edge
Last week, I sat down with Dr. Stacey Rosen, who was recently named volunteer president of the American Heart Association. She’s also the executive director of Northwell Health’s Katz Institute for Women’s Health in New York—and will be speaking at Newsweek’s upcoming Women’s Global Impact Summit.
We discussed her upbringing and the “mythical” qualities of the heart that compelled her to study it. And, in preparation for the Summit on August 5, we discussed the long history of neglect for women’s health in medical research and cardiology: a wrong that Rosen has dedicated her career to righting.
I asked her to give her best advice for women health care leaders, but I think parts of her answer will resonate regardless of sex:
- “Decide what’s important to you. Identify your vision, priorities, integrity, mission, and make that always your North Star. Stick to your true values, work hard and keep at it.
- “There have been a lot of times in my career that [I’ve gotten] frustrated. Things don’t go as you want. Your grant doesn’t get supported, or ‘women’s health’ becomes a term you’re not supposed to use. If it’s important to use, you’ve gotta stick with it.
- “My advice to women is to decide what’s important to you when it comes to how you are perceived at the workplace. Don’t make assumptions about things, but also, don’t sit quietly in the corner of the room. There are times that it’s hard, and times that you have to decide when you ignore a comment and when you don’t ignore a comment…I tell women who are often frustrated as the only, or one of few [women in the room] to decide what’s important and to keep working at it.”
Register here to see Rosen speak live at Newsweek’s Women’s Global Impact Summit in New York City on August 5.
This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox.
Read the full article here
