Estimates show that by 2017, almost 20 percent of the United States economy more than $4 trillion will be spent on health care.

"In 2008, the cost of health care increased two times the rate of inflation, and it is expected to increase at similar rates for the next decade unless something is done," added Dr. Bozic. "Whatever measures are taken to rein in Medicare costs will ultimately benefit patients as well as physicians," he concluded.

Among a few solutions, Bozic and his co-authors suggest:

• Preventing costly, unnecessary hospital readmissions. Elderly individuals with osteoporosis, back problems or arthritis use the emergency department and hospital at a higher than average rate compared with those without such problems. Sixty-four percent of Medicare patients hospitalized for a hip fracture wind up back in hospital within thirty days.
• Enhance communication among health-care providers, patients and family caregivers. In a recent AARP study of older adults with chronic conditions, nearly 20 percent said their health had suffered because of poor communication.
• Realigning the physician payment system to reward good perfo
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