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Preoperative Risk Management in Perioperative Medicine and Value-based Care: What the United States Needs to Understand, What the United Kingdom Knows

In the United States, the economics of health has caused us to recognize that a national strategy is needed to quickly and effectively bend the cost curve of a system that is globally noncompetitive with respect to value and is unsustainable in its current form as a health care delivery model. Heretofore, US national policy and health care reform efforts have principally focused on addressing gaps in coverage. Going forward in the United States the drivers of value for health care will most likely come from re-engineering the delivery system itself. In the setting of perioperative medicine, these value gaps maybe unrecognized and underappreciated.