The cost of health care is unsustainable. By 2020, with approximately 50 percent of adults predicted to have one chronic disease and 25 percent to have multiple diseases, an estimated 19 percent of the United States gross domestic product will be devoted to health care. Additional burdens on the system are expected from an aging population, with Americans aged 65 years or older projected to reach $55 million by 2020 and $72 million by 2030. As a consequence, Medicare spending (Part A, B and D) is expected to be $542 billion in deficit by 2025.1

Surgical care, in particular, accounts for half of hospital admission expenses, with the rate expected to increase as the population ages. However, the majority of this spending comes from a smaller proportion of the population. For example, it is estimated that 32 percent of the U.S. population aged 65 years or older undergoes surgery in the year before their death. That fact, taken together with knowledge that the average cost of a surgical complication is approximately $12,000 per event,2  is cause for alarm. The opportunities to alter this cost trajectory and add value to the health care system are enormous.