Since the U.S. healthcare system still mainly operates under a fee-for-service model, adapting so-called frugal innovations from the rest of the world will be difficult, according to a new study.
Frugal innovations have been defined as " 'good enough,' affordable products that meet the needs of resource-constrained consumers." They can improve quality at the same cost as other solutions or can provide the same quality at lower costs, or both.
In the study, "Global lessons in frugal innovation to improve healthcare delivery in the United States," researchers examined five innovative care models, including India's Narayana Health, which provides low-cost heart surgery, and Singapore's GeriCare, which provides geriatric consultations via telemedicine, saving each facility $9,101 per year.
The study was published in the November issue of Health Affairs.
The five innovations studied all changed who provided the care and where they provided it. For example, BasicNeeds, a program from Kenya, relies on community outreach workers and family members for care management. The innovations also increase efficiency and communication between providers and patients.
These innovations also save money. Though many of these programs come from countries with limited resources, they have great potential in resource-rich areas including the U.S., the authors wrote.
But the U.S. will have a hard time implementing these innovations if it doesn't take them seriously, rethink how care is provided and address regulatory issues, according to the study.
"Perhaps what is most needed to overcome the many barriers is willingness to change combined with openness to learn from unorthodox source of solutions," said Yasser Bhatti, one of the study's authors.
The U.S. tends to focus on improving outcomes regardless of cost, Bhatti said. But that might be becoming unsustainable, given ever-growing healthcare costs in the country, which reached $3.2 trillion in 2016.
"The U.S., and indeed the rest of the world, is increasingly concerned about escalating costs of healthcare, and in order to contain these, they need to be open to learning from new models and from new places that have tried more frugal approaches," Bhatti said.
The best of these approaches, he said, both improve outcomes and reduce inputs. While payers may like cutting costs, lower costs alone won't guarantee adoption. For that to happen, Bhatti said, outcomes for both patients and providers have to improve.
Further studying frugal innovations and how healthcare systems can scale and adapt to them, the study's authors wrote, "can help achieve greater impact at lower cost for better health in the United States and beyond."