Theory and Reality of Value-Based Medical Purchasing


Book Description

Presents findings from a project that examined the state of the art in value-based purchasing. A few employers & coalitions -- the pioneers -- are acting in a bold innovative fashion to implement the principles of value-based purchasing. They: collect data on both cost & quality; use the data to select health plans & providers; have financial incentives for employees to enroll in plans with good performance records; & sometimes work directly with providers to identify & implement best practices. The report also spells out a valuable list of research questions for the future.




Health Care Transition


Book Description

This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.




Health Care Quality


Book Description







Patient Safety Handbook


Book Description

Examines the newest scientific advances in the science of safety.




Social Justice


Book Description

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice.




The Ethics of Managed Care


Book Description

The Ethics of Managed CareA Pragmatic Approach Mary R. Anderlik A breakthrough reappraisal of the managed healthcare debate. Discussions of managed care frequently begin and end with an opposition between the Hippocratic ethic of dedication to patient welfare and a business ethic of self-interest in the service of efficiency. Mary R. Anderlik approaches managed care as a problem of organizations. Rejecting a simple "medicine vs. business" analysis, she directs attention to management as manipulation, the neglect of such personal goods as satisfaction in professional accomplishment, and organizational moral myopia. In this account, "pragmatic" suggests practical idealism, not the jettisoning of principle in the interests of expediency. In The Ethics of Managed Care, Anderlik favors a broad empiricism and a moral vision centered on values of democracy and community. She describes how organizations can nourish or destroy openness, creativity, cooperation, and faithfulness -- and display "virtues" such as justice, integrity, responsiveness, and efficiency, rightly understood. She uses community care clinics, asthma outreach programs, and new contexts for participatory decision-making to show the promise of managed care. She also explains the complexities of financial arrangements, arguing for an end to schemes that reward clinicians for providing less care and profiting from avoiding people who need a lot of it. The book concludes with a look at the future of managed care, proposing a program for reform. Mary R. Anderlik is Research Professor at the Health Law and Policy Institute, University of Houston Law Center. Medical Ethics SeriesDavid H. Smith and Robert M. Veatch, editors April 2001352 pages, 6 1/8 x 9 1/4cloth 0-253-33848-4 $39.95 s / £30.50




Pay for Performance in Health Care


Book Description

This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.