Dr. Sai Balasubramanian, M.D., J.D.

How can we leverage Patient Experiences to Drive Health and Care Outcomes? What is "Authentic" Value-Based Care? In our recent Health Data Management article, Rachel Biblow and I discuss transforming health and care delivery by prioritizing “authentic” value, which emphasizes patient experiences and health outcomes (in relationship to financial results). This approach requires healthcare providers to focus on what matters most to patients. Read the full article: https://lnkd.in/e7fQihgw Initial Steps to Drive Authentic Value: 🌟 Adopt a human-centered culture by prioritizing individual health needs and goals >> Partner with individuals across the health and care continuum to support progress toward achieving goals. Operationalize experiences that enable better outcomes. 🌟 Develop an integrated data strategy and utilization plan >> Implement tools to capture patient perspectives on health status and healthcare experiences, ensuring that care aligns with patient needs. Integrate data for continuous improvement through collection, analysis, and intentional change to transform experience and health outcomes. 🌟 Leverage technology innovations >> Adopt relevant digital tools, including, AI for personalized care, improved communication, and operational efficiency. Determine pragmatic applications of technology that enable outcomes that matter to patients. By focusing on these elements, health and care organizations can earn trust, strengthen partnerships, enhance health outcomes, and achieve a more sustainable system. ************ SIGN-UP: Free monthly digest:  “Transforming Health and Care Experiences with Research and Actionable-Insights" https://lnkd.in/eWG5XSEd ************ ATTEND: Patient Experience Symposium, Boston, Sept 16-18, 2024 https://lnkd.in/eNKSpJ8G ************ PUBLISH: in the Special Collection on "Exploring the Relationship between Patient Experience, Health Outcomes, and Value-based Care" https://lnkd.in/ew4gEgz7 (A Collaboration between Journal of Patient Experience and International Consortium for Health Outcomes Measurement (ICHOM) ************ #PatientExperience #PatientReportedOutcomes #PatientEngagement #HealthCareExperience #ClinicianEngagement #PREMs #PROMs #VBC #VBHC #ValueBasedHealthCare #ValueBasedCare

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Been reading a fair bit this week about the entrances of exits of large organizations in the healthcare technology sectors. To me, it keeps coming back to how healthcare is truly different from the typical private investment model of business and why those of us that have been in healthcare for decades keep saying that healthcare math "is different." Millions . . . no BILLIONS of dollars are being invested and lost in healthcare. Buildings built and empty. People hired and laid off. Companies stood up and folded. Service lines expanded, then shelved. All in search of the next big ROI. In the end - we care for people. Yes, we need to be capitalists and there is no mission without margin. But we need to keep patients and caregivers in the forefront of our decisions. Not profit and loss. Pick a service. Do it exceptionally well. Double and triple down on consumer, physician, and employee experience, be strategic and relentless in contracting for reimbursement for that service, and own that space. You will make money. You will make a difference.

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Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • athenahealth released Ambient Notes, a fully integrated AI ambient scribe for ambulatory practices, which also supports switching between AI models based on context and individual preference. • Abridge is partnering with OpenNotes to evaluate AI-generated visit summaries. 📞 AI Contact Center • healow health released Genie, a phone-, text-, and chat-based AI conversational chat solution for appointment scheduling, prescription refills, and more. 🏥 AI Facility Management • Kontakt.io released a security app that allows staff to page security personnel with location information, and a Kio Nurse app for locating items with a live map view. 📈 Data & Analytics • Alameda County selected Innovaccer to unify and analyze the data in its Social Health Information Exchange.    • Cornerstone AI announced an additional $5M investment, bringing its total funding to $10M. • emtelligent released their Clinical Workflows solution, which offers both clinical and business users across healthcare organizations an interface experience to interact with their existing LLM and NLP engine. 💼 Provider & Practice Administration • Axuall announced two new health system partnerships—VA-based Inova Health System and IN-based Community Health Network—and a partnership with PayrHealth, which helps providers negotiate contracts and reimbursements. 🔁 RCM • SmarterDx released an AI denials solution that creates AI-generated appeals letters.    • Inovalon hosted its Empower 2024 summit and announced a host of new solutions and updates, including an eligibility verification solution for provider organizations and several other tools for health plans and research organizations. • XiFin, Inc. added two new payers to its Payor Rate Transparency Monitor—Humana and Blue Shield of California—and launched Payor Intelligence Hub to help providers better understand payer policies and behaviors. ⚙️ Clinical Operations • Oracle hosted its Oracle Health Summit and announced a number of new features and product updates, including an AI-native EHR, patient admin tools, and plans to become a QHIN. • eClinicalWorks hosted its National Conference and released AI RCM tools, VBC scorecards, and patient engagement updates. • Altera Digital Health released a new EHR, Paragon Denali—natively deployed in Microsoft Azure —intended for rural, critical access, and community hospitals. 🤝 Staffing, Consults, and Referrals: • Tennr raised a $37M Series B. • Cottage Hospital partnered with ShiftMed to add more flexible per diem options for acute care staff. 🧑‍💻 Virtual & At-Home Care • Brook Health is partnering with Linus Health to provide treatment plans and ongoing remote clinical care for cognitive care patients. --- Want the latest healthcare tech news delivered to your inbox each week? Sign up here 📬 👉 https://lnkd.in/e2UJ3ckP

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I’ve been given advice that the fastest way to monetize HER Heard without charging the end user (woman) is trackers and selling data. Instead, I’d like to build something more trustworthy. I don’t want to be in a headline like this. If you are not paying, then you are the product (you/your data are being sold). There are newer ways to deindentify data or even to aggregate things women search for that can be of interest to various stakeholders. In theory that could be okay to sell, but in a post-Roe world with laws encouraging bounty hunting, I am vetting the choices ahead. I am all for moving fast, without breaking things.

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CMS' new model promises healthcare reform, but there may be challenges ahead States may face significant hurdles in implementing the AHEAD model, such as: 1️⃣ 𝗛𝗼𝘀𝗽𝗶𝘁𝗮𝗹 𝗥𝗲𝘀𝗶𝘀𝘁𝗮𝗻𝗰𝗲: Convincing hospitals to adopt global budgets over FFS models 2️⃣ 𝗙𝗶𝗻𝗮𝗻𝗰𝗶𝗮𝗹 𝗦𝘂𝘀𝘁𝗮𝗶𝗻𝗮𝗯𝗶𝗹𝗶𝘁𝘆: Developing long-term funding plans beyond CMS' initial support 3️⃣ 𝗗𝗮𝘁𝗮 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁: Meeting extensive data collection and reporting requirements across multiple stakeholders 4️⃣ 𝗣𝗿𝗼𝘃𝗶𝗱𝗲𝗿 𝗘𝗻𝗴𝗮𝗴𝗲𝗺𝗲𝗻𝘁: Coordinating diverse payers including Medicaid, Medicare, and private carriers 5️⃣ 𝗠𝘂𝗹𝘁𝗶-𝗣𝗮𝘆𝗲𝗿 𝗔𝗹𝗶𝗴𝗻𝗺𝗲𝗻𝘁: Coordinating diverse payers including Medicaid, Medicare, and private carriers 6️⃣ 𝗥𝗲𝗴𝘂𝗹𝗮𝘁𝗼𝗿𝘆 𝗢𝘃𝗲𝗿𝗵𝗮𝘂𝗹: Creating new legislation or regulations to support the model 7️⃣ 𝗘𝗾𝘂𝗶𝘁𝘆 𝗣𝗹𝗮𝗻𝗻𝗶𝗻𝗴: Developing and implementing effective health equity strategies 8️⃣ 𝗖𝗼𝘀𝘁 𝗖𝗼𝗻𝘁𝗿𝗼𝗹: Managing overall healthcare cost growth across the entire system 9️⃣ 𝗣𝗲𝗿𝗳𝗼𝗿𝗺𝗮𝗻𝗰𝗲 𝗧𝗮𝗿𝗴𝗲𝘁𝘀: Meeting CMS' quality, equity, and cost benchmarks 🔟 𝗦𝘁𝗮𝗸𝗲𝗵𝗼𝗹𝗱𝗲𝗿 𝗕𝗮𝗹𝗮𝗻𝗰𝗲: Navigating competing interests of hospitals, payers, providers, and patients 💡 These challenges underscore the complexity of healthcare transformation. States will need careful planning, robust stakeholder engagement, and innovative solutions to succeed. 𝗪𝗵𝗮𝘁 𝗼𝘁𝗵𝗲𝗿 𝗼𝗯𝘀𝘁𝗮𝗰𝗹𝗲𝘀 𝗱𝗼 𝘆𝗼𝘂 𝗳𝗼𝗿𝗲𝘀𝗲𝗲 𝗶𝗻 𝗶𝗺𝗽𝗹𝗲𝗺𝗲𝗻𝘁𝗶𝗻𝗴 𝘀𝘂𝗰𝗵 𝗮 𝗰𝗼𝗺𝗽𝗿𝗲𝗵𝗲𝗻𝘀𝗶𝘃𝗲 𝗵𝗲𝗮𝗹𝘁𝗵𝗰𝗮𝗿𝗲 𝗺𝗼𝗱𝗲𝗹? #healthequity #CMS #populationhealth #patientoutcomes #SDoH #holistic #comprehensivecare #totalcostofcare #AHEADmodel #healthcare #innovation ------------------------------------------------------------------------------------------ PS: Hey there! I'm Jess, a market research consultant specializing in the healthcare and animal health industries. I help clients navigate market complexities and capitalize on growth opportunities through customized research and analysis. If you're interested in discussing how current and emerging trends could impact your business or strategy, let's connect!

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Healthcare technology is in trouble. After the relative boom time we experienced through during the pandemic, the fervor to innovate in health systems and payers seems to have dried up. While organizations continue to post stellar earnings, they also continue to lay off experienced health technology people en masse. Why? I think it's time for a bit of honest reflection. 70% of all enterprise healthcare technology projects fail. 17% of of all large scale IT projects go so badly that they threaten the very existence of the company itself. Bridging Business & IT, LLC For projects with a total price tag of over $1MM, that failure rate jumps to over 90%. And the ever prescient Clayton Christensen believed that the failure rate for all new product introductions is 95%. This is not new information. What is new is the most recent E&Y Pulse Survey that has health system CIOs believing that 7 in 10 of their healthcare IT projects have had no discernible #ROI. None. And this is for the projects that didn't fail. https://lnkd.in/gRgVt_Xs This is an existential crisis that health technology must face honestly and soberly. Lack of planning and poor communication are the core culprits. Clunky and outdated Waterfall project methodologies can be blamed for many of these failures. And frankly Agile disciples could use a bit more planning before they start iterating so they know what they're building. There are, however, some problem actors and business models that need to be called out. The historically biggest culprits, in my humble opinion, are large, institutional, enterprise software vendors and their server-based architectures. For decades they feasted on seven figure licensing deals, sometimes humble-bragging to potential implementation partners about 5:1 or 7:1 implementation cost to license cost ratios. Companies just went along with it, because no one gets fired for buying IBM, right? But the failures in this segment are legendary. And many have indeed been a key cause in the parent company failure. As for the ROI, there was a bright spot in the E&Y Pulse Survey. Despite not having established a demonstrable ROI, 96% of them still wanted to move forward with the projects, believed the investment was worth it. So the issue isn't necessarily that the projects aren't generating value, the issue is that the organizations (and their vendors) didn't do a good job up front validating agreed upon ROI metrics and measures. They don’t fully understand the value it is (or isn't) creating. This is our collective job to be better at this. So what can we do to reduce the failure rate and get health systems and payers back into investing in #innovation? #ROI #startups #valueengineering #goldenpath #LCNC #opensource

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In our latest #economic lens our guest contributor Nicholas Hicks FRCP FRCGP FFPH shares some observations about  the nature of outcomes in health care and health systems and the attribution of outcomes to inputs and process.  He also puts forward six key questions about health outcomes that decision makers in healthcare may want to consider whenever they encounter health economic analyses. Read his article here: https://lnkd.in/g4UMyeTP      #healtheconomist #healthcareeconomicanalyses #healthcareoutcomes #healthsystem

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To meet CMS’ commitment to have all #Medicare beneficiaries in value-based payments (VBP) by 2030, payers have to dig deeper into #VBP design flaws and explore new strategies like: •Creating a coordinated set of VBP model designs to cut wasteful or inefficient spending without asking one participant to forgo all the revenue. •Introducing real savings requirements for shared savings, or implementing a risk-score growth cap to encourage better care practices. •Leaning into mandatory participation in new VBP programs to help ALL types of Medicare beneficiaries – not just larger-scale organizations. Read more about how these solutions can help accelerate VBP adoption in a recent Health Affairs article I wrote with Amol S Navathe and Daniel Shenfeld (linked in comments) #HealthcareonLinkedIn

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Very interesting, insightful study. Flare Capital Partners AI in healthcare is hype. Most AI stories for healthcare are tech advancements. Not real clinical advancements or fitting into their workflows, bearing few. MedTech Innovators face these paradox. 1.Adoption requires Evidence. But evidence comes only from adoption. Clinical data can not be synthetic data for good AI. 2.Regulatory, validation requires money. But investors require regulatory, validation. 3.MedTech need faster adoption, but healthcare is slower among every profession, a cut-throat industry. They won't use it, if it is more than 2-3 mouse clicks. https://lnkd.in/gUh8sDHe

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How can we partner with patients and leverage digital innovations? Why should life-science, provider, and payer organizations invest in patient partnerships? The featured Deloitte Digital report "Transforming the Patient Experience" focuses on the evolution of patient-centric approaches in the life sciences and healthcare sectors. The report discusses the importance of integrating patient feedback in the development of medical treatments and technologies, the role of digital innovations in enhancing patient engagement. The report emphasizes the need for a comprehensive partnership between patients and healthcare providers to improve health outcomes. It also highlights various case studies and strategies for creating a more patient-centered healthcare system. Highlights: PATIENT-CENTRIC INNOVATIONS: 💙 Digital technologies and telemedicine became widely adopted, allowing for more patient engagement and data-driven insights. CO-CREATION WITH PATIENTS: 💙Patient-centricity involves patients as equal partners in decision-making processes. 💙Co-creation with patients should span from the initial brainstorming to product launch, integrating their feedback continuously. INTEGRATING ENGAGEMENT: 💙Full partnership with patients includes understanding their preferences, skills, and needs. 💙Effective engagement requires early involvement and adequate compensation for patients' time and input. DIGITAL SOLUTIONS: 💙Digital health technologies empower patients to monitor and manage their health, improving medication management and access to therapies. 💙AI and advanced analytics provide personalized patient experiences, improving engagement and outcomes. HOLISTIC PATIENT SERVICES: 💙Life sciences companies are moving towards in-house patient services, focusing on a comprehensive approach that includes financial, clinical, engagement, education, and therapy access. 💙Partnerships within the ecosystem are essential for creating unified patient experiences. Share your research and perspectives with Journal of Patient Experience Special Collection on Technology and Digital Innovations in Patient Experience https://lnkd.in/gZJKXy8V Attend Patient Experience Symposium Boston September 16-18, 2024 https://lnkd.in/eNKSpJ8G The Symposium features expert speakers and research on Patient Experience, Engagement, and opportunities to leverage technology. #DigitalHealth #PatientCentered #PatientExperience #ArtificialIntelligence #AI #PatientEngagement #PatientReportedOutcomes Deloitte article https://lnkd.in/eHS6gWq6 Phil Ripperger

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✅ We are entering a new era of federal vs. state powers with the rise of AI in healthcare. 🧠 Come read my first opinion piece on substack. If you are a paid subscriber, you can read the entire thing. If you are a free subscriber, you can read a portion.

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DRG Downgrades DRG downgrades are becoming more pervasive as payers find this activity to be quite lucrative, hiring their own staff as well as "cost containment" companies such as Cotiviti, Gainwell Technologies, and Performant Recovery to audit inpatient encounters and dispute the coding. Granted oversights in coding by coders are made and not intentional in nature. While coders must follow official coding guidelines and Coding Clinic advice, often there are medical record inpatient encounters that do not lend themselves to black-and-white scenarios for coding. DRG downgrades can be categorized as follows: 1- egregious determination by the payers and their contractors, obviously not following official coding guidelines, misinterpreting coding guidelines to fit the scenario to meet their objective of recouping or denying payment 2- Incorrect coding as explained above 3- CDI issuing queries for diagnoses to capture a CC/MCC or principal diagnosis that may not be well-supported by the physician documentation, including issuing a query where the query is the only place in the record where the diagnosis appears. Coders then code the record with the diagnosis, leading to an ultimate DRG downgrade due to a lack of consistency in documentation 4- CDI attempting to optimize the DRG without understanding and being able to apply official coding guidelines. Keep in mind that CDI are not coders, despite the earning of the CCSD designation. This does make the CDI a coder. I submit to all CDI professionals that by focusing our efforts on the medical record as a communication tool versus a reimbursement tool, there would be far more costly DRG downgrades and clinical validation denials. A great starting point is to explore the website timeofcare.com, a treasure chest of information on how best to document and chart in the medical record. CDI can be facilitators of documentation and communication, helping physicians become better documentarians. The profession owes it to the patient, the physicians and the final health of our hospital employers. #CDI, #cdidowngrades, #betterCDI, #reinventCDI https://lnkd.in/eAn7ScPF

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AI is good and growing fast but we are still in the developmental stages. Companies need to be careful with the claims they make. Texas Strikes Settlement with Dallas AI Firm Over Misleading Healthcare Tech Claims 📢 Issue: The State of Texas, through its Attorney General, filed a petition for the approval and entry of an Assurance of Voluntary Compliance (AVC) with Pieces Technologies, Inc. The key issue involves whether Pieces Technologies, Inc. engaged in deceptive practices under the Texas Deceptive Trade Practices - Consumer Protection Act (DTPA) by making false or misleading representations about the accuracy of its artificial intelligence (AI) products used in healthcare. 📢 Rule: The Texas Deceptive Trade Practices Act (DTPA) prohibits false, misleading, or deceptive practices in the advertising and sale of goods or services (Tex. Bus. & Com. Code §§ 17.41-.63). Specifically, Section 17.47 allows the Consumer Protection Division of the Attorney General’s office to investigate and take action on violations. 📢 Application: Allegations by the State of Texas: Pieces Technologies developed and marketed AI products intended to assist healthcare providers in treating patients. It claimed its products had very low error rates (referred to as "hallucination rates") in creating outputs like clinical notes. The state alleged these claims were false or misleading, violating the DTPA, since the AI could produce incorrect or misleading outputs. Response by Pieces Technologies: The company denied any wrongdoing or liability, stating that its claims about the AI’s accuracy were accurate and did not violate any laws. Assurance of Voluntary Compliance: To settle the matter without prolonged litigation, Pieces Technologies agreed to a series of actions, including: Providing clear and conspicuous disclosures in all marketing materials regarding the accuracy and metrics of its AI products. Prohibiting misleading or unsubstantiated representations about the accuracy or testing of its AI products. Ensuring transparency with customers about the potential risks and limitations of its products. Complying with the AVC terms for five years and implementing internal processes to monitor compliance. 📢 Conclusion: Pieces Technologies agreed to settle the matter by entering into the AVC, which does not constitute an admission of liability. The company agreed to specific practices and disclosures to comply with Texas law, as outlined in the AVC, and the court’s approval was sought for the AVC. --------------- Sanjay Juneja, M.D. Douglas Flora, MD, LSSBB, FACCC Nixon Gwilt Law Sean Weiss Ronald Chapman II, Esq. LLM Michael Crocker Rebecca E. Gwilt David Penberthy, MD MBA FACCC VMG Health ECG Management Consultants Etyon HLTH Inc. Aashish Shah ------ https://lnkd.in/enduqyDe.

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Going live this afternoon with Murali Gandhirajan at the Dallas-Fort Worth Hospital Council (DFWHC) on how organizations are accelerating clinical research. We'll be covering OHDSI OMOP, i2b2, PCORnet, TREs, GenAI, and more. This is open to all levels of folks interested in the processes or deep in the weeds of research. Bring your questions! #clinicalresearch #academicmedicalcenters Snowflake #snowflake #datacloud #aidatacloud #genAI #healthdata #research

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Key trends and takeaways from HLTH 2024: 1. AI's Evolving Role: AI dominated discussions, with executives acknowledging its potential while also recognizing challenges in accuracy and clinician trust. There's a shift towards focusing on the practical applications of AI, with a call for partnerships to ensure reliable testing and implementation. 2. Infrastructure Focus: Beyond the glitzy AI tools, there's a growing emphasis on the "picks and shovels" needed for healthcare data accessibility, including infrastructure, compliance, and interoperability. Executives believe that improving data flow will facilitate the effective use of AI. 3. Middlemen Under Scrutiny: Pharmacy benefits managers (PBMs) faced criticism for their role in rising drug costs, with discussions highlighting misaligned incentives and the need for transparency in healthcare pricing. 4. Women's Health Spotlight: Women's health initiatives gained attention, particularly following government funding announcements and personal stories shared by advocates. However, investment in women's health remains minimal compared to overall healthcare funding. 5. Interest in Psychedelic Medicine: The potential of psychedelics for treating mental health conditions garnered significant interest, with discussions about funding and research moving forward, especially within the Veterans Affairs system. Executive Takeaways: Leaders from various sectors emphasized the importance of consumer-focused strategies, collaboration, and the need for responsible AI usage. There was a consensus on the critical role of addressing healthcare accessibility, improving patient experiences, and fostering innovations that genuinely enhance care delivery.

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The healthcare industry continues to see significant funding activity as companies prioritize innovation in analytics and benefit management solutions. These investments reflect the growing opportunities in healthcare data management and benefits innovation. Merative, the data and analytics company formed from IBM's Watson Health assets, secured $25M from Morgan Health. This funding will help scale its products and expand offerings for self-insured employers, focusing on enhanced data-driven insights. Meanwhile, Soda Health raised $50M in a Series B round to advance its work in managing Medicare Advantage supplemental benefits, simplifying administration, and improving member engagement for health plans.

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The U.S. and Indian healthcare systems offer a stark contrast, shaped by their distinct economic landscapes and healthcare priorities. Spending and Costs: The U.S. healthcare system spends $12,742 per capita, making it the highest spender among OECD countries. This figure is nearly double the average spending of $6,850 per person seen in other wealthy nations​. Despite this, healthcare outcomes in the U.S. lag behind, with life expectancy at 77.3 years—lower than the OECD average of 81 years. In contrast, India spends approximately $60 per capita on healthcare, reflecting its economic constraints, yet it manages to achieve outcomes in some areas that rival more developed nations. Access and Infrastructure: In the U.S., about 8.6% of the population remains uninsured, which limits access to care despite the country’s advanced healthcare infrastructure​. Conversely, India has made significant strides in expanding healthcare access, particularly through public health initiatives like Ayushman Bharat, which aims to cover 500 million people with health insurance​ . However, only 30% of rural Indians have access to adequate healthcare facilities, highlighting a significant gap in infrastructure​. Public vs. Private Sector: The U.S. healthcare system is predominantly private, with private insurance accounting for 66% of health coverage​. This drives high costs and contributes to the disparity in access. India’s healthcare system, while heavily supported by the government in rural areas, sees the private sector handling about 70% of urban healthcare services. This mix of public and private has led to variable quality and accessibility across regions​ Health Outcomes: Despite spending far less, India has managed to reduce its infant mortality rate to 28 per 1,000 live births, down from 57 in 2006. However, the U.S., with all its spending, still faces an infant mortality rate of 5.6 per 1,000 live births, which is higher than many other developed countries​. Additionally, the U.S. struggles with managing chronic conditions like diabetes, where 10% of adults have diabetes compared to 8.7% in India​ Conclusion: The U.S. healthcare system, while advanced, struggles with high costs and unequal access, which are not always justified by better outcomes. India, with far fewer resources, has prioritized expanding access but faces challenges in ensuring consistent quality and infrastructure. Both nations could learn from each other—India could benefit from the U.S.’s technological advancements, while the U.S. could learn from India’s cost-effective healthcare delivery models.

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