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E-raamat: Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model

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, (Numerof & Associates, Inc., St. Louis, Missouri, USA)
  • Formaat: 354 pages
  • Ilmumisaeg: 01-Feb-2016
  • Kirjastus: Productivity Press
  • Keel: eng
  • ISBN-13: 9781498788304
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Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based ModelSuurem pilt
  • Formaat: 354 pages
  • Ilmumisaeg: 01-Feb-2016
  • Kirjastus: Productivity Press
  • Keel: eng
  • ISBN-13: 9781498788304
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The healthcare sector is on the cusp of sweeping disruption. The hallmarks of the old systempricing thats disconnected from outcomes and incentives for treating sickness rather than maintaining healthare no longer sustainable. And yet, after decades of financial success, its difficult for most established industry players to grapple with meaningful changes to their business models.

In their latest book, Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model, Rita Numerof and Michael Abrams lay out the roadmap to a healthcare system that is accountable for delivering optimal patient outcomes at a sustainable cost.

Based on in-depth research and decades of experience consulting with leading hospitals, insurers, and device and drug manufacturers, Numerof and Abrams provide a market-based approach to addressing the ills of the current healthcare system. In addition to highlighting industry challenges and opportunities, the authors also outline the changes required of consumers, employers, and policy makers to move to a patient-centered model characterized by value, accountability, and transparency.

This is the handbook for payer, provider, pharmaceutical, and medical device executives who are seeking to preserve todays profitability while positioning their organizations for success in the very different markets of tomorrow. The books guidance is illuminated by case studies and each chapter concludes with a self-assessment tool and key questions.

Getting to a new future isnt easy. But if it cant be envisioned, it cant be realized. Bringing Value to Healthcare is that critical first step.

Arvustused

"This important work gets to the heart of the debate unfolding across the country and should serve as a blueprint for healthcare companies seeking to remain relevant..." Mark T. Bertolini, Chairman and Chief Executive Officer, Aetna

"lasting change is really a matter of leadership. In this book, Rita and Michael describe the knowledge and actions needed from the board chair to the department head" Joe Mott, Vice President, Population Health, Intermountain Healthcare

"No one can examine, investigate, study, discuss, and research the myriad of forces and role players in the healthcare arena better than the team of Rita Numerof and Michael Abrams. a masterpiece for all stakeholders..." Robert Z. Gussin, PhD, Retired Vice President for Science and Technology, and Chief Scientific Officer, Johnson & Johnson

"Bringing Value to Healthcare presciently describes a future where healthcare is hugely changed and how we are going to get there." George C. Halvorson, Chair, Institute for InterGroup Understanding; Retired Chairman and Chief Executive Officer, Kaiser Permanente

"this book is a must read for C-Suite healthcare executives who want to know how to survive and flourish when the payment models of the past are becoming increasingly obsolete." Paul Howard, PhD, Director and Senior Fellow, Center for Medical Progress, Manhattan Institute for Policy Research

"Open and transparent health care markets are not only possible, but likely. And personal choice and real competition not bureaucracy and regulation will drive that transformation. Health policy experts Rita Numerof and Michael Abrams explain what is happening and why." Robert E. Moffit, PhD, Center for Health Policy Studies, The Heritage Foundation

"Numerof and Abramsilluminate the irresistible market forces that are finally taking the lead

Foreword xxi
Acknowledgments xxv
Introduction xxix
1 A Vision for Tomorrow 1(12)
Vision of a Fundamentally Different Future
1(5)
Seeds of Disruption
6(1)
Healthcare Isn't the First Industry in Transition
7(3)
Where Are We Currently?
10(3)
2 Whose Agenda Controls Your Healthcare? 13(30)
Why a Market-Based Model for Healthcare Is a Good Thing
13(1)
How Did We Get into This Mess?
14(6)
End of the Model Year
20(2)
Understanding Healthcare Reform as Business Model Change
22(2)
Central Role of Payment Reform
24(1)
Unintended Consequences: The Hospital Example
25(5)
Paying for Volume, Not Results
25(1)
Real Impact of CMS on Quality of Care and Costs
26(4)
Unintended Consequences: The Primary Care Example
30(3)
Discouraging the Type of Care That Results in Better Outcomes
31(1)
Creating a Critical Shortage of the "Right" Kinds of Doctors
32(1)
Healthcare Is Big Business
33(2)
Recent Example
34(1)
Creating a Competitive, Functioning Market
35(4)
There Is Little Accountability in the Current System
35(1)
There Is Little Information Available on Which to Base Responsible Care Decisions
36(1)
There Is Already Enough Money in the System
37(2)
There Is a Solution, and It's Closer than Some Think
39(1)
Endnotes
40(3)
3 In the Eye of the Storm: The Role of Consumers and Employers 43(32)
Introduction
43(2)
A Personal Example
45(3)
Shopping for Cancer Care: An Illustration
48(4)
Payer Websites and Information
49(1)
National Marrow Donor Program
49(1)
Provider Websites
49(1)
Mystery Shopping
50(2)
A Glimpse of the Business Model of the Future
52(1)
Future Model
52(1)
Whose Agenda Controls Your Healthcare? Another Look
53(3)
Perversion of the Concept of Insurance
56(3)
New Sources of Competition for the New Consumer Patient
59(3)
Transparency in Healthcare-Coming to Your Health System Soon!
62(6)
What Is Driving Demand for Transparency?
63(4)
Shift to High-Deductible Plans
63(2)
Growth in Reference Pricing
65(1)
Reimbursement Tied to Performance Measures
65(1)
Better Tools to Communicate Quality and Cost
66(1)
Bottom Line: We Have to Have It
67(1)
Where Do Employers Fit into the Equation?
68(1)
What Can Consumers and Employers Do?
68(3)
Demand Transparency and Accountability
69(1)
Move Conversation toward a Continuum of Care
69(1)
Create/Become Informed Consumers
70(1)
Create Incentives for Better Health Behaviors
70(1)
Change Is Never Easy, But It Is Possible
71(1)
Endnotes
72(3)
4 The Role of Data: Creating an Environment for Change 75(16)
Comparative Effectiveness Research: An Overview
75(1)
Drivers of CER
76(2)
Role of Cost Containment
76(1)
Role of Political Expediency
77(1)
Why Is the Federal Government Specifically Involved?
78(2)
Focus of CER
80(9)
Other Considerations for Choosing Priorities
86(1)
CER and the Consumer: Does It Really Matter?
87(1)
Evidence-Based Medicine and the Role of Big Data
88(1)
Endnotes
89(2)
5 Redesigning Healthcare Delivery: Hospitals Were Never Meant to Be Destinations of Choice 91(30)
Introduction
91(2)
Adapting to the Changing Landscape of Healthcare
93(9)
Needed: A Transfusion of Fresh Thinking
95(1)
Capture All the Value in Consolidation
96(1)
Make Better Use of Service Line Organization
96(1)
Rethink Your Competitive Strategy
97(1)
Build Your Management Infrastructure to Support Change
98(1)
Stop the Misuse of IT
99(3)
Shrinking Reimbursement and Pressure for Transparency Are Reshaping Healthcare Delivery
102(1)
Development of Predictive Care Paths
103(7)
Changing Quality Metrics
104(1)
Impact of Comparative Effectiveness Research on Hospital Operations
104(3)
Prudent Responses and Defensive Strategies
107(3)
Accountable Care Is Needed; ACOs Are Not
110(8)
Laudable Goals
112(2)
Any Provider Can Provide More Accountable Care
114(3)
What Are You Waiting For?
117(1)
Endnotes
118(3)
6 The Next
Chapter in Healthcare Delivery		 121(22)
At-Risk Contracting: The Next Step in Improving Quality and Reducing Cost
121(3)
Why Will At-Risk Payment Models Do Any Better?
122(2)
What It Will Take to Deliver Value Tomorrow
124(7)
So How Do We Get There?
127(3)
St. Elsewhere: A Case Study in Bundled Pricing
130(1)
Taking a Proactive Approach to a Market in Transition
131(1)
Competing with a Bundled Price
131(1)
Building the Value Narrative for Consumers, Employers, and Insurers
132(3)
Who (Else) Is Making the Transition?
133(2)
How Should Hospitals and Health Systems Change?
135(1)
How Is Value Defined?
136(2)
The Future of Rural Hospitals: Are They Still Viable?
138(3)
Endnotes
141(2)
7 A Brave New World for Payers 143(24)
Introduction
143(1)
Adapting to the Changing Landscape of Healthcare Insurance
144(3)
Needed Here, Too: A Transfusion of Fresh Thinking
147(1)
Rethinking the Customer
147(2)
Rethinking Products
149(1)
Implications for Healthcare Insurers
150(3)
What Payers Can Do
153(9)
Develop Partnerships with Providers
155(1)
Segment Providers
156(1)
Focus Partnerships on the Prevention of Never Events
157(1)
Require and Pay for Predictive Care Paths
157(2)
Change the Basis for Paying Primary Care Physicians
159(2)
Increase Consumer Engagement and Personal Responsibility, Reducing Abuse of the System by Consumers
161(1)
Reduce Fraud and Abuse by Providers
161(1)
Are You Ready for Disruptive Innovation?
162(2)
Endnotes
164(3)
8 Big Pharma: How to Regain Success 167(34)
Introduction
167(2)
Sovaldi: Spotlight on Pharmaceutical Value
169(2)
Vulnerabilities of the Current Model
171(2)
Market-Driven Business Model
173(7)
Ensuring Stakeholder Value
174(3)
Strategic Marketing and New Commercial Capabilities
177(1)
Innovation Stewardship
178(2)
Pressures on Innovation
180(2)
Role of Comparative Effectiveness in the Pharmaceutical Industry
182(10)
Treatment Guidelines
183(2)
Focus on Cost Effectiveness
185(1)
End of the Placebo-Only Controlled Trial
186(1)
Evidence, Value, and the Emerging Role of Risk-Sharing and Reference Pricing
186(2)
Impact of Comparative Data and Value-Based Payment on Pharmaceutical Operations
188(4)
Prudent Responses and Defensive Strategies
192(5)
Develop Service Wraps
192(1)
Diversify Revenue Streams Away from Payers
193(1)
Adopt a Rolling Blockbuster Approach
194(2)
Real-World Example
196(1)
Looking Ahead
197(1)
Endnotes
198(3)
9 A New Day Is Dawning for Medical Device and Diagnostics Manufacturers 201(36)
Getting Products to Market When Value Is the Focus
201(8)
Implications for the Industry
206(1)
Commercial Challenges
207(2)
Evidence Requirements: The Threat for Medical Devices
209(5)
End of the "Last Version plus 5%" Business Model
209(2)
Increased Pressure to "Rightsize" Functionality
211(1)
Increased Competition with Drugs
212(1)
Restricted Qualification for Devices
213(1)
Healthcare Delivery Pressures: Additional Threats for Medical Devices
214(5)
Growth in Medical Tourism
214(1)
Growth of Risk-Sharing Agreements
215(1)
Transition to Value-Based Payments
216(1)
Use of Reference Pricing
216(1)
Impact of Comparative Effectiveness on Medical Device Operations
217(2)
Prudent Responses and Defensive Strategies for Medical Device Companies
219(3)
Adopt Strategies Suited to the New Environment
219(1)
Focus on Reducing the Cost of the Procedure
220(1)
Develop Service Wraps
220(1)
Embrace the Cost-Functionality Trade-Off
221(1)
Comparative Effectiveness: The Opportunity for Diagnostics
222(5)
Reduced Tolerance for Redundant Testing
222(1)
New Commercial Model
223(1)
Possibility of Mass Screening
224(1)
Personalized Medicine and Companion Diagnostics
225(2)
Prudent Responses and Defensive Strategies for Diagnostics
227(1)
Diversify the Revenue Base
227(1)
Begin to Develop Partnerships for Custom Diagnostics
228(1)
Where Do Medical Device and Diagnostics Companies Go from Here?
228(6)
Hospital-as-Customer Requires a New Sales Model
232(2)
Endnotes
234(3)
10 Putting Value at the Center of Healthcare 237(40)
What Is the Legitimate Role of Policy?
237(4)
Recent Legislative Solutions and Why They Won't Work
241(1)
Accountability for Care Is a Good Concept
242(14)
ACOs: Their Original Purpose
242(1)
Evolving Concept
242(1)
ACOs: Their Role in PPACA
243(2)
Government-Sponsored Payment and Delivery Systems
245(2)
Top-Down Approach to Complex Health Policy Problems
247(1)
ACOs: Key Deficiencies
248(3)
PPACA Does Not Empower Consumers to Be Stakeholders in Their Own Care
249(1)
PPACA Does Not Encourage Provider Accountability
249(1)
PPACA Creates an Unfair Competitive Advantage for Large Organizations
250(1)
PPACA's Pioneers: Lessons from the Field
251(1)
Recommendations for Policy Makers: Healthcare Delivery
252(4)
Enabling Markets to Create Access to Care
256(6)
Creating Access to Affordable Health Coverage
257(1)
Recommendations for Policy Makers: Access to Care
258(4)
Ensure Legitimacy of Participating Businesses
259(1)
Aggressively Prosecute Fraudulent, Negligent, and Abusive Business Practices
259(1)
Remove Legislative Barriers to Competition and Consumer Choice
259(2)
Promote Transparency So That Consumers Know What They're Getting
261(1)
Supporting Innovation: Finding the Right Balance at the Food and Drug Administration
262(8)
Regulation's Impact on Innovation: A Two-Edged Sword
263(5)
Making the Rules Clearer, More Transparent, and Simpler
268(1)
Real-Life Example
269(1)
Patent Life: Shooting Ourselves in the Foot
270(2)
Endnotes
272(5)
11 Creating a Roadmap for Change 277(22)
Revisiting the Challenge of Industry Transition
277(3)
Safety in Size? The Rush to Affiliation
280(4)
Consolidation and the Challenge for Manufacturers
283(1)
Additional Challenges for Manufacturers
284(4)
Creating Collaborations to Develop Lifetime Value
286(2)
Why Now?
288(1)
Reprising the Consumer
288(4)
Power of Choice
289(2)
Increase Perceived Quality
291(1)
Creating and Sustaining a New Business Model
292(1)
Harnessing Consumer Choice and Competition to Ensure Accountability: Final Thoughts for Policy Makers
293(3)
Imagining a New Market
293(3)
End Game
296(1)
Endnote
297(2)
Index 299(18)
About the Authors 317
Rita E. Numerof, PhD, president of Numerof & Associates, is an internationally recognized consultant and author with more than 25 years of experience in the field of strategy development and execution, business model design, and market analysis. Her clients have included Fortune 500 companies such as Johnson & Johnson, Eli Lilly, Pfizer, Westinghouse, AstraZeneca, Merck, Abbott Laboratories, major healthcare institutions, payers, and government agencies. The focus of her consulting addresses the challenges of maintaining competitive advantage in highly dynamic and regulated markets. Dr. Numerof graduated magna cum laude from the Honors College, Syracuse University, and received her MSS and PhD from Bryn Mawr College.

Michael N. Abrams, MA, cofounder and managing partner of Numerof & Associates, has served as an internal and external consultant to Fortune 500 corporations, major pharmaceutical and medical device companies, healthcare delivery institutions, the financial services industry, and government agencies for over 25 years. As an adjunct faculty member of Washington University, St. Louis and LaSalle College, School of Business Administration in Philadelphia, Mr. Abrams has taught MBA courses in strategic management, product planning and evaluation, quantitative decision making, and market analysis. Mr. Abrams completed his doctoral work in business policy at St. Louis University. He received his MA from George Washington University in Washington, DC.
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