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

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.

Value Driven Healthcare and Geriatric Medicine
Value Driven Healthcare and Geriatric Medicine

Author: James S. Powers

Publisher: Springer

Published: 2018-05-04

Total Pages: 160

ISBN-13: 3319770578

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Value driven healthcare is the lasting legacy of the Affordable Care Act, which had three goals: to improve access to healthcare by increasing healthcare insurance coverage, to improve the patient’s experience and quality of care, and to slow the rate of increase in healthcare costs. Regardless of changes to the financing of healthcare or changes in policy, value-based purchasing for healthcare is to remain a constant feature of the healthcare horizon. Value-based purchasing is a demand side strategy to reward quality in health care delivery. Value-based purchasing involves cost considerations and includes the actions of employers, the public sector, health plans, and individual consumers in making healthcare decisions. Effective health care services and high performing health care providers are incentivized to provide quality outcomes and to control cost. Value-based purchasing drives quality metrics which are publicly reported and serve as important levers for changes in healthcare delivery. Geriatric patients consume a disproportionate share of healthcare resources, so CMS directs Medicare and drives geriatric healthcare models. All other insurers generally model CMS/Medicare guidelines. Innovative geriatric care models which demonstrate improved outcomes and cost moderation are scaled and lessons learned used to create new healthcare models. The best data for broader value driven healthcare comes from the geriatric models, which currently have the best data available. This book traces the origins of value-based purchasing and current geriatric care models and synthesizes their implications for today's changing health system. It also discusses healthcare accountability and risk sharing. The audience includes geriatric healthcare professionals, but also a wider audience interested in broader healthcare models and value driven healthcare from a policy, economic, and ethical perspective. These include primary care physicians, specialists who work with aging patients, hospital administrators, healthcare educators, healthcare organizations, and all medical professionals working with aging patients and patients affected by healthcare reform.

Understanding Value Based Healthcare
Understanding Value Based Healthcare

Author: Vineet Arora

Publisher: McGraw Hill Professional

Published: 2015-04-03

Total Pages: 417

ISBN-13: 007181700X

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Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .

Redefining Health Care
Redefining Health Care

Author: Michael E. Porter

Publisher: Harvard Business Press

Published: 2006-04-24

Total Pages: 540

ISBN-13: 1422133362

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The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.

Rewarding Provider Performance
Rewarding Provider Performance

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2007-02-17

Total Pages: 273

ISBN-13: 0309102162

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The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.

HBR's 10 Must Reads on Strategy for Healthcare (featuring articles by Michael E. Porter and Thomas H. Lee, MD)
HBR's 10 Must Reads on Strategy for Healthcare (featuring articles by Michael E. Porter and Thomas H. Lee, MD)

Author: Harvard Business Review

Publisher: Harvard Business Press

Published: 2018-05-15

Total Pages: 207

ISBN-13: 1633694313

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Prepare for an uncertain future with a solid vision and innovative practices. Is your healthcare organization spending too much time on strategy--with too little to show for it? If you read nothing else on strategy, read these 10 articles. We've combed through hundreds of Harvard Business Review articles and selected the most important ones for healthcare professionals to help you catalyze your organization’s strategy development and execution. Leading strategy experts, such as Michael E. Porter, Jim Collins, W. Chan Kim, and Renee Mauborgne, provide the insights and advice you need to: Understand how the rules of corporate competition translate to the healthcare sector Craft a vision for an uncertain future Segment your market to better serve diverse patient populations Achieve the best health outcomes--at the lowest cost Learn what disruptive innovation means for healthcare Use the Balanced Scorecard to measure your progress This collection of articles includes "What Is Strategy?" by Michael E. Porter; "The Five Competitive Forces That Shape Strategy," by Michael E. Porter; "Health Care Needs Real Competition," by Leemore S. Dafny and Thomas H. Lee; "Building Your Company's Vision," by Jim Collins and Jerry I. Porras; "Reinventing Your Business Model," by Mark W. Johnson, Clayton M. Christensen, and Henning Kagermann; "Will Disruptive Innovations Cure Health Care?" by Clayton M. Christensen, Richard Bohmer, and John Kenagy; "Blue Ocean Strategy," by W. Chan Kim and Renee Mauborgne; "Rediscovering Market Segmentation," by Daniel Yankelovich and David Meer; "The Office of Strategy Management," by Robert S. Kaplan and David P. Norton; and "The Strategy That Will Fix Health Care," by Michael E. Porter and Thomas H. Lee.

Integrating Social Care into the Delivery of Health Care
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

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Integrating 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.

Retooling for an Aging America
Retooling for an Aging America

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2008-08-27

Total Pages: 316

ISBN-13: 0309131952

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As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

The Future of the Public's Health in the 21st Century
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

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The 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.

Best Care at Lower Cost
Best Care at Lower Cost

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2013-05-10

Total Pages: 437

ISBN-13: 0309282810

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America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.