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