Healthcare Economic Reform: How and Why Physicians Must Lead Change Within Our Evolving Healthcare Economy

Healthcare Economic Reform: How and Why Physicians Must Lead Change Within Our Evolving Healthcare Economy PDF

Author: Ellis M. Knight

Publisher: American Association for Physician Leadership

Published: 2021-11-30

Total Pages: 162

ISBN-13: 9780984831197

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This book not only provides a review of how the healthcare system operates, but also arms physician leaders with actionable information to reform the healthcare economy and satisfy their own motivations for entering the field of medicine.

Evidence-Based Medicine and the Changing Nature of Health Care

Evidence-Based Medicine and the Changing Nature of Health Care PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2008-09-06

Total Pages: 202

ISBN-13: 0309113695

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Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Understanding Healthcare Economics

Understanding Healthcare Economics PDF

Author: Jeanne Wendel, PHD

Publisher: Taylor & Francis

Published: 2017-11-22

Total Pages: 190

ISBN-13: 135175761X

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Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation’s healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today’s healthcare system. The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes. Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed. The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change – and some of the changes – on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.

Paradox and Imperatives in Health Care

Paradox and Imperatives in Health Care PDF

Author: Jeffrey C. Bauer

Publisher: CRC Press

Published: 2014-08-25

Total Pages: 164

ISBN-13: 1466593245

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The Paradox: Americans are not as healthy as people in dozens of comparable countries that spend 30 percent less on health care, and our medical marketplace overall is plagued by persistent problems of cost, quality, and access. Yet, the world’s best individual health systems are located in the U.S.—each a unique result of visionary leadership and private initiative, not government-driven health reform. The Imperatives: Due to powerful new forces explained in this book, medical spending has stopped growing. Purchasers, payers, and patients are no longer willing or able to keep paying more. To stay in business and improve population health, providers and their business partners must eliminate the shameful waste generated by inefficient and ineffective production processes. The Solution: Simply repairing or repealing the Affordable Care Act will not get us where we want to go. The fundamental roadblock is a wasteful system, not uninsured Americans. Reform needs to be immediately redirected to creating the best health care system that 17 percent of GDP can buy. Money saved by taking the new path to reform can then be used to improve population health through access for all. Paradox and Imperatives in Health Care is the roadmap for getting there. Supplies updated perspectives on health care’s problems and solutions Details the reasons why government-driven reform does not solve problems Provides a justification for regulatory relief tied to performance improvement Suggests specific new policies for a better approach to desired outcomes Presents content written expressly for busy executives and policy makers

An Introduction to Health Policy

An Introduction to Health Policy PDF

Author: Manish K. Sethi

Publisher: Springer

Published: 2013-09-14

Total Pages: 259

ISBN-13: 9781461477365

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Based on the current climate of our nation’s finances and healthcare spending, it is clear that young doctors and medical students are likely to see a dramatic transformation of the manner in which America offers medical care to its citizens over the course of their careers. As such, it is pivotal that the next generation of America’s leaders on the front lines of medicine develop a sense of where healthcare has evolved from and future potential directions of change. An Introduction to Health Policy: A Primer for Physicians and Medical Students is the first of its kind: a book written by doctors for doctors in order to allow busy physicians and medical students to quickly develop an understanding of the key issues facing American healthcare. This book seeks to efficiently and effectively educate physicians and medical students in a clinical context that they can understand on the past, present, and potential future issues in healthcare policy and the evolution of American healthcare. The reader will walk away from the book with the ability to discuss the fundamental issues in American healthcare with ease.

The Economic Evolution of American Health Care

The Economic Evolution of American Health Care PDF

Author: David Dranove

Publisher: Princeton University Press

Published: 2009-01-10

Total Pages: 224

ISBN-13: 1400824680

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The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.

Leading Health Care Transformation

Leading Health Care Transformation PDF

Author: Maulik Joshi, Dr.P.H.

Publisher: CRC Press

Published: 2023-10-20

Total Pages: 259

ISBN-13: 1000983498

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"Readers should go broad and go deep with this book. Readers who do both will find this book a valuable framework for approaching the complexities of leading health care organizations today...it will provide a framework for approaching the work, and that framework is one likely to lead to business success and personal satisfaction." —From the Foreword by Thomas H. Lee, MD, Chief Medical Officer, Press Ganey and Senior Physician, Brigham and Women’s Hospital The U.S. health care system continues to undergo transformation, with a rate of change that has accelerated in recent years. This rapidly evolving field requires a new level of astute clinical leadership. The bottom line is that physician leadership will be the key ingredient for any dramatic change in our health care system and a fundamental driver of outcomes for patients and communities. Leading Heath Care Transformation prepares physician leaders with the evidence, tools, and ideas to make and lead systemic improvement. This second edition provides fresh insights, new evidence, and modern topics with revised and updated chapters. Each chapter is complete with contemporary evidence, pragmatic case studies, lessons learned, and action steps for physician leaders. This second edition of Leading Health Care Transformation is a succinct and practical primer on 16 key topics in health care transformation. Physician leadership is critical to transform care; this book will help guide the way.

Healthcare Disrupted

Healthcare Disrupted PDF

Author: Jeff Elton

Publisher: John Wiley & Sons

Published: 2016-02-08

Total Pages: 292

ISBN-13: 111917189X

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“During a time of tremendous change and uncertainty, Healthcare Disrupted gives executives a framework and language to determine how they will evolve their products, services, and strategies to flourish in a increasingly value-based healthcare system. Using a powerful mix of real world examples and unanswered questions, Elton and O’Riordan lead you to see that ‘no action’ is not an option—and push you to answer the most important question: ‘What is your role in this digitally driven change and how can your firm can gain competitive advantage and lead?’”—David Epstein, Division Head, Novartis Pharmaceuticals “Healthcare Disrupted is an inspirational call-to-action for everyone associated with healthcare, especially the innovators who will develop the next generation of therapeutics, diagnostics, and devices.”—Bob Horvitz, Ph.D., David H. Koch Professor of Biology, MIT; Nobel Prize in Physiology or Medicine “In a time of dizzying change across all fronts: from biology, to delivery, to the use of big data, Health Disrupted captures the impact of these forces and thoughtfully develops new approaches to value creation in the healthcare industry. A must-read for those who strive to capitalize on change and reinvent the industry.”—Deborah Dunsire, M.D., president and CEO, FORUM Pharmaceuticals Healthcare at a Crossroad: Seismic Shifts, New Business Models for Success Healthcare Disrupted is an in-depth look at the disruptive forces driving change in the the healthcare industry and provides guide for defining new operating and business models in response to these profound changes. Based on original research conducted by Accenture and years of experience working with the most successful companies in the industry, healthcare experts Jeff Elton and Anne O’Riordan provide an informed, insightful view of the state of the industry, what's to come, and new emerging business models for life sciences companies play a different role from the past in to driving superior outcomes for patients and playing a bigger role in creating greater value for healthcare overall. Their book explains how critical global healthcare trends are challenging legacy strategies and business models, and examines why historical leaders in the industy must evolve, to stay relevant and compete with new entrants. Healthcare Disrupted captures this pivotal point in time to give executives and senior managers across pharmaceutical, biopharmaceutical, medical device, medical diagnostics, digital technology, and health services companies an opportunity to step back and consider the changing landscape. This book gives companies options for how to adapt and stay relevant and outlines four new business models that can drive sustainable growth and performance. It demonstrates how real-world data (from Electronic Medical Records, health wearables, Internet of Things, digital media, social media, and other sources) is combining with scalable technologies and advanced analytics to fundamentally change how and where healthcare is delivered, bridging to the health of populations, and broadening the resposibility for both. It reveals how this shift in healthcare delivery will significantly improve patient outcomes and the value health systems realize.

Healthcare at a Turning Point

Healthcare at a Turning Point PDF

Author: Rita E. Numerof

Publisher: CRC Press

Published: 2012-08-16

Total Pages: 280

ISBN-13: 146656153X

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If the furious debate around the state of healthcare in the US has led to any consensus, its that the system should be delivering better quality for less cost than it does. The truth is that our healthcare system is a sprawling mix of competing interests in which those of the patient are valued least. Too much discussion has devolved to simplistic

How Physicians Can Change the Future of Health Care

How Physicians Can Change the Future of Health Care PDF

Author: Michael E. Porter

Publisher:

Published: 2009

Total Pages: 0

ISBN-13:

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Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something only medical teams can do. The right kind of competition - competition to improve results - will drive dramatic improvement. With such positive-sum competition, patients will receive better care, physicians will be rewarded for excellence, and costs will be contained. Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care. Three principles should guide this change: (1) the goal is value for patients, (2) medical practice should be organized around medical conditions and care cycles, and (3) results - risk-adjusted outcomes and costs - must be measured. Following these principles, professional satisfaction will increase and current pressures on physicians will decrease. If physicians fail to lead these changes, they will inevitably face ever-increasing administrative control of medicine. Improving health and health care value for patients is the only real solution. Value-based competition on results provides a path for reform that recognizes the role of health professionals at the heart of the system.