Harnessing Lean Six Sigma for better healthcare value and outcomes

Healthcare costs keep rising. A new report this month shows that employers expect a 10% rise in healthcare costs in 2026 — surpassing the projected 8% for 2025 that was called the “highest amount in more than a decade” by Business Group on Health.

Businesses across the U.S. drive innovation and efficiency all of the time — so how is this cost trajectory possible after years of trying to promote value and tackle costs in the system? How long is this sustainable?

Employers are used to applying Lean Six Sigma (LSS) ideas to their businesses, improving speed and efficiency and focusing on quality and consistency. When they look at the healthcare they buy, do they demand the same?

LSS follows a structured, data-driven problem-solving method, often summarized by:

1. Define — Identify areas not meeting goals/standards
2. Measure — Collect data to understand the current process
3. Analyze — Focus on root causes and areas for improvement
4. Improve — Design and test solutions
5. Control — Put systems in place to sustain the improvement

Why aren’t employers pushing for these concepts to be applied to the healthcare benefits they provide? Why aren’t they demanding an approach that reduces variation and defects in care and targets services that don’t add value for the patient?  

An outcomes-based focus is completely aligned to the LSS philosophy, and could be applied for better, more cost-effective care backed by data, structured methods, and an empowered system:

• Define: Focus on outcomes, not processes and steps to care that don’t necessarily mean improving health status or care results. Start with unnecessary healthcare events, especially costly hospitalizations, readmissions, complications and emergency department visits.
• Measure: Determine what is within the control of the provider or health plan to manage and set benchmarks based on achievable best performance benchmarks.
• Analyze: Arm the plans and providers with the data so they can see how they perform against targets and their peers. Provide them with risk-adjusted information about their patient population over time so they can see how they manage overall care.
• Improve: Enable providers and plans to find solutions that meet the needs of their patients, set performance targets with incentives for achieving them.
• Control: Track provider and plan performance against benchmarks over time with consistent, tested and transparent measurement tools.

LSS is not just an efficiency program for employers and manufacturers; it is a competitive advantage, and those same ideas can help an employer trying to better manage the health benefits they provide to their valued employees.  

It's time to advocate for measurable cost savings and higher patient satisfaction through improved data utilization and informed decision-making. Employers must foster a culture of healthcare improvement that prioritizes the health of employees and their families, rather than merely meeting regulatory requirements. Healthcare benefits should be held to the same standards of performance and accountability that employers expect from their own business operations.

Megan Carr is the head of the regulatory and payer solutions team at Solventum.