| |
| |
| List of Figures | |
| |
| |
| List of Boxes | |
| |
| |
| Preface | |
| |
| |
| Introduction | |
| |
| |
| The Failure of Competition | |
| |
| |
| Competing on Value | |
| |
| |
| Competing on Results | |
| |
| |
| The Structure of This Book | |
| |
| |
| How Will Redefining Health Care Occur? | |
| |
| |
| |
| Scoping the Problem | |
| |
| |
| |
| Identifying the Root Causes | |
| |
| |
| Positive-Sum Competition on Value | |
| |
| |
| Zero-Sum Competition in Health Care | |
| |
| |
| The Root Cause: Competition at the Wrong Level | |
| |
| |
| Why Is Health Care Competition at the Wrong Level? | |
| |
| |
| |
| How Reform Went Wrong | |
| |
| |
| The Rise of Group Health Insurance | |
| |
| |
| Limiting Payments to Physicians and to Hospitals | |
| |
| |
| Managed Care | |
| |
| |
| The Medical Arms Race | |
| |
| |
| The Clinton Plan | |
| |
| |
| Patients' Rights | |
| |
| |
| Consumer-Driven Health Care | |
| |
| |
| Quality and Pay for Performance | |
| |
| |
| A Single-Payer System | |
| |
| |
| Medical or Health Savings Accounts | |
| |
| |
| Non-Reforms | |
| |
| |
| Reforming Competition: The Only Answer | |
| |
| |
| |
| Principles of Value-Based Competition | |
| |
| |
| Focus on Value, Not Just Costs | |
| |
| |
| Competition Is Based on Results | |
| |
| |
| Competition Is Centered on Medical Conditions over the Full Cycle of Care | |
| |
| |
| High-Quality Care Should Be Less Costly | |
| |
| |
| Value Is Driven by Provider Experience, Scale, and Learning in Medical Conditions | |
| |
| |
| Competition Is Regional or National | |
| |
| |
| Results Information Is Widely Available | |
| |
| |
| Innovations That Increase Value Are Strongly Rewarded | |
| |
| |
| The Opportunity of Value-Based Competition | |
| |
| |
| |
| Strategic Implications for Health Care Providers | |
| |
| |
| The Strategy Vacuum in Health Care Delivery | |
| |
| |
| Defining the Right Goal: Superior Patient Value | |
| |
| |
| Moving to Value-Based Competition: Imperatives for Providers | |
| |
| |
| How Would Industry Structure in Health Care Delivery Change? | |
| |
| |
| Enabling the Transformation | |
| |
| |
| Overcoming Barriers to Value-Based Competition | |
| |
| |
| The Benefits of Moving Early | |
| |
| |
| |
| Strategic Implications for Health Plans | |
| |
| |
| Past and Future Roles of Health Plans | |
| |
| |
| Moving to Value-Based Competition: Imperatives for Health Plans | |
| |
| |
| Overcoming Barriers to Health Plan Transformation | |
| |
| |
| The Benefits of Moving Early | |
| |
| |
| |
| Implications for Suppliers, Consumers, and Employers | |
| |
| |
| Implications for Suppliers | |
| |
| |
| Implications for Consumers as Subscribers and Patients | |
| |
| |
| Implications for Employers | |
| |
| |
| |
| Health Care Policy and Value-Based Competition: Implications for Government | |
| |
| |
| Broad Issues in Health Care Policy | |
| |
| |
| Moving to Value-Based Competition: Improving Health Insurance and Access | |
| |
| |
| Moving to Value-Based Competition: Setting Standards for Coverage | |
| |
| |
| Moving to Value-Based Competition: Improving the Structure of Health Care Delivery | |
| |
| |
| Implications for Health Care Policy in Other Nations | |
| |
| |
| Conclusion | |
| |
| |
| |
| Making Results Public: The Cleveland Clinic | |
| |
| |
| |
| The Care Delivery Value Chain | |
| |
| |
| Notes | |
| |
| |
| Bibliography | |
| |
| |
| Index | |
| |
| |
| About the Authors | |