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E-raamat: Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary

  • Formaat: 852 pages
  • Ilmumisaeg: 17-Dec-2010
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309144346
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  • Formaat: 852 pages
  • Ilmumisaeg: 17-Dec-2010
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309144346
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"From the perspective of an employer and that of an innovative health product company, the need is clear to understand the sources of waste in health care and to focus attention and incentives on the right care for each patient. The IOM has performed an important service in bringing together different perspectives, which, not individually but collectively, offer possible solutions to lowering health care costs, while improving outcomes and fostering valued innovation."---David R. Brennan Chief Executive Officer, AstraZeneca PLC

"With the first phase of comprehensive health care reform, addressing access, now completed, the Institute of Medicine has turned its attention to the remaining challenges---how to improve quality while constraining costs. This report provides a compelling case for not only the necessily for further reform, but clearly outlines feasible strategies for success."---John W. Rowe, M.D. Former Chairman and CEO, Aetna, Inc. Professor, Columbia University Mailman School of Public Health

"The insights gathered by the Institute of Medicine capture the importance of engaging patients in the health care conversation. It is only with patient involvement that we will identify the right mix of strategies to create a value-based delivery system that addresses the major cost drivers of health care, and improves the quality of health care and individual health outcomes."---Mryl Weinberg, CAE President, National Health Council

"In drawing on the collective leadership and knowledge of the nation's foremost policy experts, this volume is testimony to ability of the Institute of Medicine to provide a framework and venue for stakeholders from different sectors to better understand the complex issues that are central to controlling unsustainable health costs."---Risa J. Lavizzo-Mourey, M.D., M.B.A. President and CEO, Robert Wood Johnson Foundation
Synopsis and Overview 1(68)
Section I Excessive Healthcare Costs
1 The Healthcare Imperative
69(16)
Promoting Efficiency and Reducing Disparities in Health Care
72(4)
Peter R. Orszag
Why Americans Spend More for Health Care
76(9)
Eric Jensen
Lenny Mendonca
2 Unnecessary Services
85(24)
Saving Money (and Lives)
86(9)
Amitabh Chandra
Jonathan S. Skinner
Douglas O. Staiger
Regional Insights and U.S. Health Care Savings
95(6)
Elliott S. Fisher
Kristen K. Bronner
Opportunities to Reduce Unwarranted Care Differences
101(8)
David Wennberg
3 Inefficiently Delivered Services
109(32)
Costs of Errors and Inefficiency in Hospitals
111(5)
Ashish Jha
Costs from Inefficient Use of Caregivers
116(9)
Robert S. Mecklenburg
Gary S. Kaplan
Costs from Physician Office Inefficiencies
125(4)
William F. Jessee
Low-Cost Hospitals with High-Quality Scores
129(12)
Arnold Milstein
4 Excess Administrative Costs
141(34)
Excess Billing and Insurance-Related Administrative Costs
142(9)
James G. Kahn
What Does It Cost Physician Practices to Interact with Payers?
151(8)
Lawrence P. Casalino
Sean Nicholson
David N. Gans
Terry Hammons
Dante Morra
Wendy Levinson
Cost Savings from Simplifying the Billing Process
159(7)
James L. Heffernan
Bonnie B. Blanchfield
Brad Osgood
Rosemary Sheehan
Gregg S. Meyer
Excess Health Insurance Administrative Expenses
166(9)
Andrew L. Naugle
5 Prices That are Too High
175(44)
Price Implications of Hospital Consolidation
177(10)
Cory S. Capps
Prescription Drug Prices
187(10)
Jack Hoadley
Durable Medical Equipment Prices
197(5)
Thomas J. Hoerger
Market Pricing and the Medicare Program
202(7)
Mark E. Wynn
Medical Device Prices
209(10)
Jeffrey C. Lerner
6 Missed Prevention Opportunities
219(22)
The Price Paid for Not Preventing Diseases
220(5)
Steven H. Woolf
Cost Savings from Primary and Secondary Prevention
225(7)
Thomas J. Flottemesch
Michael V. Maciosek
Nichol M. Edwards
Leif I. Solberg
Ashley B. Coffield
Tertiary Prevention and Treatment Costs
232(9)
Michael P. Pignone
Section II Strategies that Work
7 Strategies that Work
241(16)
Strategies That Work and How to Get There
245(6)
Glenn Steele, Jr
International Success at Cost Containment
251(6)
Gerard F. Anderson
8 Knowledge Enhancement
257(24)
Successes with Cost and Quality
259(6)
Lucy A. Savitz
The Value of Electronic Health Records with Decision Support
265(5)
Rainu Kaushal
Lisa M. Kern
Comparative Effectiveness Research
270(3)
Carolyn M. Clancy
Enhancing Clinical Data as a Knowledge Utility
273(8)
Peter K. Smith
9 Care Culture and System Redesign
281(54)
Community-Engaged Models of Team Care
283(4)
Michelle J. Lyn
Mina Silberberg
J. Lloyd Michener
Using Production System Methods in Medical Practice: Improving Medical Costs and Outcomes
287(7)
Kim R. Pittenger
Managing Variability in Healthcare Delivery
294(7)
Eugene Litvak
Sandeep Green Vaswani
Michael C. Long
Brad Prenney
Cost Savings from Managing High-Risk Patients
301(9)
Timothy G. Ferris
Eric Weil
Gregg S. Meyer
Mary Neagle
James L. Heffernan
David F. Torchiana
Health Information Exchange and Care Efficiency
310(4)
Ashish Jha
Antitrust Policy in Health Care
314(5)
Roger Feldman
Reducing Service Capacity: Evidence and Policy Options
319(5)
Frank A. Sloan
Malpractice Reform and Healthcare Costs
324(11)
Randall R. Bovbjerg
10 Transparency of Cost and Performance
335(24)
Transparency in the Cost of Care
337(3)
John Santa
Transparency in Comparative Value of Treatment Options
340(4)
G. Scott Gazelle
Provider Price and Quality Transparency
344(3)
Paul B. Ginsburg
Transparency to Improve the Value of Hospital Care
347(5)
Peter K. Lindenauer
Health Plan Transparency
352(7)
Margaret E. O'Kane
11 Payment and Payer-Based Strategies
359(48)
Value-Based Payments, Outcomes, and Costs
361(9)
Harold D. Miller
Bundled and Fee-for-Episode Payments: An Example
370(6)
Francois de Brantes
Amita Rastogi
Alice Gosfield
Doug Emery
Edison Machado
Effective Health Insurance Exchanges: An Example
376(4)
David R. Riemer
Value-Based Insurance Designs and Healthcare Spending
380(6)
Niteesh K. Choudhry
Tiered-Provider Networks and Value
386(4)
Lisa Carrara
Simplifying Administrative Complexity
390(7)
Robin J. Thomashauer
Technology and Simplifying Healthcare Administration
397(10)
David S. Wichmann
12 Community-Based and Transitional Care
407(26)
Community Health Teams: Outcomes and Costs
408(7)
Kenneth E. Thorpe
Lydia L. Ogden
Palliative Care, Quality and Costs
415(5)
Diane E. Meier
Jessica Dietrich
R. Sean Morrison
Lynn Spragens
Community Prevention and Healthcare Costs
420(13)
Jeffrey Levi
13 Entrepreneurial Strategies
433(22)
Decentralizing Healthcare Delivery
435(3)
Jason Hwang
Retail Clinics and Healthcare Costs
438(5)
N. Marcus Thygeson
Care Coordination and Home Telehealth (CCHT)
443(12)
Adam Darkins
Section III The Policy Agenda
14 The Policy Agenda
455(18)
Getting to High-Performance
456(9)
Karen Davis
CBO Scoring: Methods and Implications
465(8)
Joseph R. Antos
15 Payments for Value Over Volume
473(20)
Bundled Payments: A Private Payer Perspective
474(4)
John M. Bertko
Medicare and Bundled Payments
478(4)
Armen H. Thoumaian
Linda M. Magno
Cynthia K. Mason
Bundled Payment: Physician Engagement Issues
482(7)
George J. Isham
Patient Perspective and Payment Reform
489(4)
Nancy Davenport-Ennis
16 Medically Complex Patients
493(24)
Payment Policies and Medically Complex Patients
495(3)
Arnold Milstein
Palliative Care, Access, Quality, and Costs
498(6)
R. Sean Morrison
Diane E. Meier
Melissa Carlson
Payment and Better Care of Complex Patients
504(5)
Ronald A. Paulus
Jonathan Darer
Walter F. Stewart
Care of Patients with Multiple Chronic Conditions
509(8)
Anand K. Parekh
17 Delivery System Integration
517(18)
Profile of System Fragmentation
519(1)
John Toussaint
Payments to Promote Delivery System Integration
520(5)
Mark E. Miller
Payment Reform to Promote Integration and Value
525(4)
Harold S. Luft
Health Information Technology to Promote Integration
529(6)
Andrew M. Wiesenthal
18 Delivery System Efficiency
535(12)
Better Use of Healthcare Professionals
536(6)
Mary D. Naylor
Transparency and Informed Choice
542(5)
Steven J. Spear
19 Administrative Simplification
547(22)
Administrative Simplification and Payer Harmonization
548(4)
Lewis G. Sandy
Payer Harmonization on the Provider Perspective
552(4)
Linda L. Kloss
Policies Targeting Payer Harmonization
556(13)
Harry Reynolds
20 Consumer-Directed Policies
569(16)
Consumer Views of Higher-Value Care
570(4)
Jennifer Sweeney
Insurers, Consumers, and Higher-Value Care
574(3)
Dick Salmon
Jeffrey Kang
Policies Shaping Consumer Preferences on Value
577(8)
Dolores L. Mitchell
Section IV Getting to 10 Percent
21 Taking Stock: Numbers and Policies
585(14)
A Look at the Numbers
585(14)
J. Michael McGinnis
22 Getting to 10 Percent: Opportunities and Requirements
599(20)
23 Common Themes and Next Steps
619(16)
Appendixes
A Workshop Discussion Background Paper
635(120)
B Workshop Agendas
755(18)
C Planning Committee Biographies
773(6)
D Speaker Biographies
779