A Review of the Formation of Accountable Health Partnerships and Integrated Health Care Delivery Systems
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Published: 1995
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The Future of the Public's Health in the 21st Century
Author: Institute of Medicine
Publisher: National Academies Press
Published: 2003-02-01
Total Pages: 536
ISBN-13: 0309133181
DOWNLOAD EBOOKThe anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Operational Structures Forming Complex Feedback Loops in Health System/accountable Care Partnerships
Author: Richard J. Pro
Publisher:
Published: 2022
Total Pages: 434
ISBN-13:
DOWNLOAD EBOOKThe Patient Protection and Affordable Care Act of 2010 introduced accountable care organizations as a critical component in the transformation of the United States healthcare industry to a value-based care model. It also triggered an ongoing series of health system consolidations consistent with the theory of transaction cost economics. Consolidations included the alignment of health systems with accountable care organizations despite the assertions of some researchers that competing economic models rendered such partnerships financially unviable. The academic literature is silent on this issue, without any published studies of the effects of health system / accountable care organization interactions. The purpose of this qualitative study was to document the nature of health system / accountable care organization interactions to support the future construction of a system dynamics model. The research uncovered five themes demonstrating the absence of consideration for the effects of inter-organizational interactions among healthcare expert participants due to a lack of awareness of the presence of feedback loops and nonlinearity. The results of the research study demonstrated for the first time the presence of feedback loops in health system / accountable care organization interactions, the necessary presence of nonlinear behaviors governing those interactions, and the requirement to employ system dynamics models to accurately project future firm performance in health system / accountable care organization partnerships.
Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
Published: 2001-07-19
Total Pages: 359
ISBN-13: 0309132967
DOWNLOAD EBOOKSecond in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
The Healthcare Imperative
Author: Institute of Medicine
Publisher: National Academies Press
Published: 2011-01-17
Total Pages: 852
ISBN-13: 0309144337
DOWNLOAD EBOOKThe United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Accountable Care Organizations as a Model of Integrated Care
Author: Daniel P. DelVecchio
Publisher: Nova Science Publishers
Published: 2012
Total Pages: 0
ISBN-13: 9781621001201
DOWNLOAD EBOOKThe provision of health care in the United States has been described as fragmented, with patients seeing multiple providers. Fragmented care has been found to be, among other things, both costly, since provider payments are not linked to performance or outcomes and services can be duplicative, and of lower quality, since providers lack financial incentives to coordinate care. This book examines ACOs as a model of integrated care with a focus on delivery systems such as the Mayo Clinic, Geisinger Health System, Kaiser Permanente and Intermountain Healthcare. While ACOs can be designed with varying features, most models put primary care physicians at the core, along with other providers, and emphasize simultaneously reducing costs and improving quality.
Primary Care and Public Health
Author: Institute of Medicine
Publisher: National Academies Press
Published: 2012-07-19
Total Pages: 212
ISBN-13: 0309255201
DOWNLOAD EBOOKEnsuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.
Integrating Social Care into the Delivery of Health Care
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Published: 2020-01-30
Total Pages: 195
ISBN-13: 0309493439
DOWNLOAD EBOOKIntegrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
Health Professions Education
Author: Institute of Medicine
Publisher: National Academies Press
Published: 2003-07-01
Total Pages: 191
ISBN-13: 030913319X
DOWNLOAD EBOOKThe Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Engineering a Learning Healthcare System
Author: National Academy of Engineering
Publisher: National Academies Press
Published: 2011-07-14
Total Pages: 340
ISBN-13: 0309120640
DOWNLOAD EBOOKImproving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.
