Rob Abbott Of ISPOR On 5 Things We Must Do To Improve the US Healthcare System

As a part of our series about 5 Things We Must Do To Improve The US Healthcare System, we had the pleasure of interviewing Rob Abbott, ISPOR.

Rob Abbott is Chief Executive Officer of ISPOR — The Professional Society for Health Economics and Outcomes Research (HEOR), the leading global professional society in the field of HEOR. He is responsible for the Society’s global strategic direction and leadership. Mr Abbott is a highly accomplished, visionary leader with more than 20 years’ experience providing executive-level strategic and operational leadership in businesses, nongovernmental organizations (NGOs), government environments, as well as professional societies and associations. Most recently, he served as executive director and CEO of Health Technology Assessment International, a global nonprofit society focused on health technology assessment (HTA). He is recognized for his knowledge in HTA, strategy, and stakeholder relations. He has successfully guided a number of organizations through their transformation and growth. He is also a pioneering social responsibility thinker and advisor who has authored 2 books and numerous articles on the nature of business and society. Mr Abbott holds an undergraduate honors degree from the University of Victoria and graduate degrees from the University of Toronto. Additionally, he holds professional designations as both a management consultant and an ICF-accredited coach.

Thank you so much for joining us! Can you tell us a story about what brought you to this specific career path?

I grew up in a small town where the local pulp and paper mill was the dominant employer and the government of the day referred to the pollution from the mill as the “smell of money”. That sparked something in me and I’ve dedicated my life to understanding human-environment interactions, the human health effects arising from pollution, and how to improve human welfare.

Can you share the most interesting story that happened to you since you began your career?

Early in my career I was investigating soil and water contamination on an indigenous community in Canada. The site had been cleaned up but the cost was far in excess of what was initially budgeted. I was tasked with finding out why. I remember the Chief of the community — a well-educated and well-travelled man — using the famous Mona Lisa painting in the Louvre in Paris as a talking point. He said: Rob, if someone splashed paint on the Mona Lisa, would you only clean part of it off? His point was that as the Chief of his community, he lobbied for all of the pollution on his people’s site to be cleaned up. It cost more, but he felt his people’s health was worth it.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I’m not sure how funny it is, but on one of my first large consulting projects many years ago I wanted to impress my client and my boss by investigating every possible data point associated with the problem I was trying to solve. Talk about going down a proverbial rabbit hole! I got so buried in data that I lost sight of the bigger picture. As a result, I became much more alert to knowing how much data is needed to tell the story we need to tell — without getting lost in unnecessary detail.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

I’ve been a student of Henry David Thoreau for many years and have always been inspired by his quote: “Go confidently in the direction of your dreams. Live the life you’ve imagined.” Among other things, this provided a certain fuel for me to write a book about the relevance of Thoreau’s ideas to modern business (Uncommon Sense: Thoreau and the Nature of Business, 2007). More generally, I believe that nothing great ever happens without first a dream. So we need to dream — and dream big. I regularly tell my team this. And on a personal level, life is short and goes by very fast so we should truly live out our dreams to the best of our ability.

How would you define an “excellent healthcare provider”?

I think about excellence in healthcare as being truly centered on the patient and the patient’s experience or journey through the healthcare system. As such, for me it is about patients getting access to the care they need, when they need it, at a price that is affordable. If providers can do this then I think they are providing excellent care. It’s also why ISPOR’s vision is: A world in which healthcare is accessible, effective efficient and affordable for all.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I’ve always been a voracious reader and some of the more recent books that have inspired me to be a better man — and a better healthcare leader as well — include Jordan Peterson’s 12 Rules for Life; Simon Sinek’s Start with Why; and Richard Slotkin’s A Great Disorder. Peterson’s book is about knowing what it means to be present and grounded, and equally, when it’s necessary to step onto the frontier that is in front of you. Sinek’s book is about how we frame problems and opportunities and how we communicate to inspire those around us. Slotkin’s book is a magisterial exploration of the defining myths that underpin American culture. Unless we understand these myths we miss the context that is critical to any change action — in health or any other aspect of life — we might want to undertake.

Are you working on any exciting new projects now? How do you think that will help people?

I’m fortunate to be engaged in several exciting projects, but perhaps the most exciting is the launch of the ISPOR Institute for Healthcare Transformation, which officially begins on January 1, 2026. This institute complements the work of ISPOR by translating the science of health economics and outcomes research (HEOR) into “insights” that are relatable to policy and decision-making individuals and organizations. My hope is that the institute catalyzes a step change in awareness, understanding and use of HEOR to improve healthcare decisions around the world.

Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us a few reasons why you think the US is ranked so poorly?

The U.S. healthcare system is a paradox: world-leading in spending per capita, technology development and specialized care, yet lacking in life expectancy, equity and affordability. The market-based principles that underpin the U.S. system — prioritizing private ownership and competition — allow for consumer choice among providers, but they also increase costs and ultimately result in lower quality care. The status quo exacerbates economic, racial, and gender inequities, as access to essential services is tied to financial means. This is especially true in the U.S. where most hospitals and medical practices are privately owned and operated, and the profit motive is paramount. When healthcare becomes a private good, direct payment for services creates financial barriers, making it difficult for low-income individuals to access necessary care. The result is 29 million Americans who are uninsured and many others with health insurance who face unpredictable and unaffordable out-of-pocket costs as copayments and deductibles rachet up. This forces many into impossible choices such as delaying treatment or taking on debt, rationing medication or skipping checkups.

As a “healthcare insider”, if you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

ISPOR’s vision is a world where healthcare is accessible, effective, efficient and affordable for all. This is an audacious vision and if achieved it would completely transform U.S. healthcare (and healthcare around the world). What this vision means is that people have access to the care they need when they need it. That care is effective — it makes them better and has minimal to zero side effects. That care is also efficient in its use of public and private dollars. And most importantly, that care is affordable to all — there are no barriers based on financial means. To make this vision a reality it will be necessary to take a “whole systems” view of healthcare, understand some of the underlying assumptions that inform the status quo (see my comment above about private interests) and rearticulate the system from the ground up. This should also include a meaningful conversation about making investments in prevention. At present we underinvest in things that would put more Americans on a trajectory of healthy living and overinvest in expensive treatments after someone becomes sick.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

As a global, multistakeholder professional society, ISPOR has many of the right players in the tent, so to speak, and we are actively engaged in a conversation about two related and critically important things: (1) what does value mean in health and how do we focus on value versus private profits? And (2) how do we broaden the definition of value to include the emerging idea of “whole health”? Whole health is the idea that a person’s health transcends the physical to include social, economic, spiritual and other dimensions. It also acknowledges that health is shaped by many other factors such as access to affordable housing, access to nutritious food, employment, social networks and connection and so on. As such, we need individuals, corporations, communities and leaders to join our ongoing work to deepen our understanding of value and communicate that to policy makers and decision makers.

How do you think we can address the problem of physician shortages?

This is a truly systemic problem — and one that the U.S. has been struggling with for a long time. The shortage, especially in rural areas and certain specialties such as emergency medicine and geriatrics can be traced to several causes including limited medical school and residency capacity, burnout (see my response below) uneven geographic distribution, and an aging population. Some potential short-term fixes include expanding the physician training pipeline; broadening the clinical workforce; reducing barriers for international medical graduates; and leveraging technology and workflow design. On the longer term we need to rethink health system design and get away from an overreliance on physicians for all aspects of care delivery. Equally, we need structural reforms such as expanding U.S. medical school capacity; modernizing medical education; and aligning reimbursement and incentives to ensure that primary care and preventive medicine are financially attractive career options.

How do you think we can address the issue of physician and nurse burnout?

This is related to my response above. We know that in some specialty areas physician and nurse burnout rates exceed 50%. To address this, we need to reduce the administrative burden on nurses especially and reform billing systems that currently incentivize volume over value. We also need to promote flexible scheduling such as part-time options. Mental health support is also critical, as is what I might describe as leadership and culture change in the clinical environment. We know that hospitals and clinics that invest in physician and nurse well-being experience lower turnover and burnout. Ultimately, and consistent with my call for “whole system” change in U.S. healthcare mentioned above, we need to move towards value-based payment models that reward outcomes (mental health, teamwork, preventive care) over throughput.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I’m especially interested in the economics of prevention to drive change in health and healthcare — both in the United States and globally. I want to see more awareness and understanding at a young age about the benefits — health, economic and other — of getting to good health early and staying there as long as possible. We should be making significant investments in prevention to mitigate at least some of the risk of obesity, type II diabetes and so on. There will always be a need to treat people who become sick, but we should “swim upstream” and do everything we can to prevent as many people as possible from becoming sick. This requires a fundamentally new mental model in how we think about and see health and healthcare, but that is the movement I want to inspire and my organization has the tools and techniques to help us all understand the economics that inform it.

How can our readers further follow your work online?

I post regularly on LinkedIn and readers can also follow my regular appearances on podcasts related to health and healthcare decision making (Pharmaverse podcast, The Business of Biotech podcast and others).

Thank you for your time and for sharing your valuable insights!