The United States spends more on healthcare than any other developed country, yet it has the worst outcomes. Here are the hard numbers: We spend 16.6% of our GDP on healthcare—compared to most developed countries that spend an average of 9.2% of GDP. Despite that, the U.S. performs worse than average on 77% of health status indicators, including life expectancy and limb amputations as a result of diabetes, according to the Organization for Economic Cooperation and Development.

“We’re paying a lot of money for a really fragmented, impersonal system that’s not working for most people,” says Dr. Asaf Bitton, executive director of Boston-based health innovation center Ariadne Labs and an associate professor at Harvard Medical School.

He notes that the root cause is that the U.S. healthcare system doesn’t focus on prevention. Instead, it is oriented toward a system of specialists who look at individual problems. Most conditions are only treated when they become emergencies, which is bad for individuals and the system. “We’re good at acute sick care, but less good at building longitudinal relationships that maintain and improve health,” says Bitton.

Many of the companies recognized this year as the most innovative companies in healthcare are stepping forward to pick up the pieces. Digital health company Egnite, for instance, wants to reimagine heart disease care. It uses AI-powered data analysis to screen patients for early symptoms of stroke and heart failure before they become life-threatening.

CopilotIQ is trying to improve healthcare for older Americans by providing a more holistic view of their health with tailored suggestions. It provides remote healthcare monitoring and collects 1,000 times more data on patient health than a traditional doctor’s office. Patients also get weekly calls from nurses who offer coaching based on their results.

Children’s Health, based in Texas, is training primary care providers to diagnose and treat mental health conditions in order to address the youth mental health crisis. The average waitlist for visiting a psychologist is three months or longer, if a psychologist is taking new patients at all. Children’s Health’s program aims to get children preventive mental health care before they reach crisis point.

The other side of the coin is making healthcare more affordable. “Cost, equity, and access challenges are the quiet rumbling train that keep on moving throughout healthcare,” Bitton says. Included Health works with employers to help them get better health outcomes for every dollar they spend on employees, by partnering with high-quality healthcare providers. It’s shaved 11% off of the total cost of care for Walmart, and reduced hospital readmissions by 26%. Galileo offers affordable healthcare for small employers, at $19 a month per employee instead of about $700, which is industry standard.

“If you don’t have a strong primary care system that coordinates and integrates care, you pay for a very top-heavy system that prioritizes expensive technological procedures,” Bitton says, noting that the U.S. spends far less on primary care than other countries. “There’s a real opportunity here for companies that can figure out how to scale and support improved primary care outcomes across the system.”

Explore the full 2024 list of Fast Company’s Most Innovative Companies, 606 organizations that are reshaping industries and culture. We’ve selected the firms making the biggest impact across 58 categories, including advertising, artificial intelligence, design, sustainability, and more.

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