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.

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.

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. .

Fundamentals of Clinical Data Science
Fundamentals of Clinical Data Science

Author: Pieter Kubben

Publisher: Springer

Published: 2018-12-21

Total Pages: 219

ISBN-13: 3319997130

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This open access book comprehensively covers the fundamentals of clinical data science, focusing on data collection, modelling and clinical applications. Topics covered in the first section on data collection include: data sources, data at scale (big data), data stewardship (FAIR data) and related privacy concerns. Aspects of predictive modelling using techniques such as classification, regression or clustering, and prediction model validation will be covered in the second section. The third section covers aspects of (mobile) clinical decision support systems, operational excellence and value-based healthcare. Fundamentals of Clinical Data Science is an essential resource for healthcare professionals and IT consultants intending to develop and refine their skills in personalized medicine, using solutions based on large datasets from electronic health records or telemonitoring programmes. The book’s promise is “no math, no code”and will explain the topics in a style that is optimized for a healthcare audience.

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.

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.

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.

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 Nursing
The Future of Nursing

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-02-08

Total Pages: 700

ISBN-13: 0309208955

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The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.