Redefining Health Care Creating Value-Based Competition on Results

ISBN-10: 1591397782
ISBN-13: 9781591397786
Edition: 2005
List price: $45.00 Buy it from $3.00
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Description: 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 costs--not to mention the stability of state and federal  More...

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Book details

List price: $45.00
Copyright year: 2005
Publisher: Harvard Business Review Press
Publication date: 6/1/2006
Binding: Hardcover
Pages: 528
Size: 6.50" wide x 9.50" long x 1.50" tall
Weight: 2.376
Language: English

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 costs--not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael E. Porter and innovation expert Elizabeth Olmsted Teisberg reveal the underlying and largely overlooked causes of the problem and provide a powerful prescription for change. The authors argue that participants in the health care system have competed to shift costs, accumulate bargaining power, and restrict services rather than create value for patients. This zero-sum competition 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. In spite of competition among these systems, the patient care cycle is poorly coordinated. The fractured system undermines both efficiency and quality of outcomes. Redefining Health Care lays out a breakthrough framework for redefining health care competition based on patient value over the full cycle of care-from prevention and diagnosis through recovery or long-term disease management. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move to value-based competition on results that will unleash stunning improvements in quality and efficiency.

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

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