Atjaunināt sīkdatņu piekrišanu

E-grāmata: Healthcare at a Turning Point: A Roadmap for Change [Taylor & Francis e-book]

(Numerof & Associates, Inc., St. Louis, Missouri, USA),
  • Formāts: 276 pages, 2 Tables, black and white; 6 Illustrations, black and white
  • Izdošanas datums: 16-Aug-2012
  • Izdevniecība: CRC Press Inc
  • ISBN-13: 9780429254062
Citas grāmatas par šo tēmu:
  • Taylor & Francis e-book
  • Cena: 35,57 €*
  • * this price gives unlimited concurrent access for unlimited time
  • Standarta cena: 50,80 €
  • Ietaupiet 30%
  • Formāts: 276 pages, 2 Tables, black and white; 6 Illustrations, black and white
  • Izdošanas datums: 16-Aug-2012
  • Izdevniecība: CRC Press Inc
  • ISBN-13: 9780429254062
Citas grāmatas par šo tēmu:
If the furious debate around the state of healthcare in the US has led to any consensus, its that the system should be delivering better quality for less cost than it does. The truth is that our healthcare system is a sprawling mix of competing interests in which those of the patient are valued least. Too much discussion has devolved to simplistic scapegoating, and too few comprehensive, constructive solutions have been offered. Its time for a fresh vision.

In straightforward language, Healthcare at a Turning Point: A Roadmap for Change outlines a new market-based business model that aligns industry financing mechanisms with the goals of prevention, improved quality, and reduced costs. Drawing on more than 25 years of cross-industry consulting experience, the authors:





Articulate a market-based vision of the industry Examine past efforts to reduce costs, their failures and their unanticipated consequences Spotlight perverse incentives that distort the way the healthcare system operates and make it less than it could be Present concrete recommendations for change within the healthcare delivery, insurance, pharmaceutical, device and diagnostics sectors Explain the changes that employers, consumers and policy makers can make to create a more customer-responsive system that delivers more value

For all the uncertainty in the current environment, there is also a rare opportunity to fundamentally redefine who wins in this market. Healthcare at a Turning Point provides guidance to executives ready for that contest as well as a roadmap for change.
Foreword xvii
Acknowledgments xxi
Introduction xxiii
1 A Vision for Tomorrow
1(12)
Vision of a Fundamentally Different Future
1(5)
Seeds of Disruption
6(1)
Healthcare Isn't the First Industry in Transition
7(2)
Where Are We Currently?
9(4)
2 Whose Agenda Controls Your Healthcare?
13(26)
Why a Market-Based Model for Healthcare Is a Good Thing
13(1)
How Did We Get into This Mess?
14(5)
End of the Model Year
19(2)
Understanding Healthcare Reform as Business Model Change
21(2)
Central Role of Payment Reform
23(1)
Unintended Consequences: The Hospital Example
24(4)
Paying for Volume, Not Results
24(1)
Real Impact of CMS on Quality of Care and Costs
25(3)
Unintended Consequences: The Primary Care Example
28(2)
Discouraging the Type of Care That Results in Better Outcomes
28(1)
Creating a Critical Shortage of the "Right" Kind of Doctors
29(1)
Healthcare Is Big Business
30(2)
Recent Example
31(1)
Creating a Competitive, Functioning Market
32(4)
There Is Little Accountability in the Current System
33(1)
There Is Little Information Available on Which to Base Responsible Care Decisions
33(2)
There Is Already Enough Money in the System
35(1)
There Is a Solution, and It's Closer than Some Think
36(1)
Endnotes
37(2)
3 In the Eye of the Storm: The Role of Consumers and Employers
39(12)
A Personal Example
40(2)
Whose Agenda Controls Your Healthcare? Another Look
42(3)
Perversion of the Concept of Insurance
45(1)
Where Do Employers Fit into the Equation?
46(1)
What Can Consumers and Employers Do?
46(3)
Demand Transparency and Accountability
47(1)
Move Conversation toward a Continuum of Care
47(1)
Create/Become Informed Consumers
48(1)
Create Incentives for Better Health Behaviors
48(1)
Change Is Never Easy, but It Is Possible
49(2)
4 Comparative Effectiveness Research: Creating an Environment for Change
51(12)
Drivers of CER
52(3)
Role of Cost Containment
52(2)
Role of Political Expediency
54(1)
Why Is the Federal Government Specifically Involved?
55(1)
Focus of CER
56(5)
Expected Criteria for Choosing Priorities
60(1)
Endnotes
61(2)
5 Redesigning Healthcare Delivery: Hospitals Were Never Meant to Be Destinations of Choice
63(28)
Adapting to the Changing Landscape of Healthcare
65(6)
Needed: A Transfusion of Fresh Thinking
66(3)
Management Infrastructure
69(1)
Misuse of IT
70(1)
Comparative Effectiveness Research Is Shaping Healthcare Delivery
71(8)
Development of Predictive Care Paths
73(1)
Changing Quality Metrics
73(1)
Impact of CER on Hospital Operations
73(2)
Prudent Responses and Defensive Strategies
75(4)
Accountable Care Is Needed, ACOs Are Not
79(5)
Laudable Goals
80(1)
Any Provider Can Provide More Accountable Care
81(3)
What Are You Waiting For?
84(1)
Bundled Payment: The Next Step in Improving Quality and Reducing Cost
84(5)
Why Will Bundled Payment Models Do Any Better?
85(1)
So How Do We Get There?
86(1)
St. Elsewhere: A Case Study in Bundled Pricing
87(1)
Taking a Proactive Approach to a Market in Transition
88(1)
Competing with a Bundled Price
89(1)
Endnotes
89(2)
6 A Brave New World for Payers
91(20)
Adapting to the Changing Landscape of Healthcare Insurance
92(3)
Needed Here, Too: A Transfusion of Fresh Thinking
95(1)
Rethinking the Customer
95(2)
Rethinking Products
97(1)
Implications for Healthcare Insurers
98(1)
What Payers Can Do
99(9)
Develop Partnerships with Providers
101(1)
Segment Providers
102(1)
Focus Partnerships on the Prevention of Never Events
102(1)
Require and Pay for Predictive Care Paths
103(1)
Change the Basis for Paying Primary Care Physicians
104(2)
Increase Consumer Engagement and Personal Responsibility, Reducing the Abuse of the System by Consumers
106(1)
Reduce Fraud and Abuse by Providers
107(1)
Are You Ready for Disruptive Innovation?
108(1)
Endnotes
109(2)
7 Big Pharma: How to Regain Success
111(24)
Vulnerabilities of the Current Model
113(2)
Market-Driven Business Model
115(5)
Ensuring Stakeholder Value
116(2)
Strategic Marketing Capabilities
118(1)
Innovation Stewardship
119(1)
Pressures on Innovation
120(1)
Role of CER in the Pharmaceutical Industry
121(6)
Treatment Guidelines
122(2)
Focus on Cost Effectiveness
124(1)
End of the Placebo-Only Controlled Trial
125(1)
Impact of CER on Pharmaceutical Operations
125(2)
Prudent Responses and Defensive Strategies
127(6)
Develop Service Wraps
127(1)
Diversify Revenue Streams Away from Payers
128(1)
Adopt a Rolling Blockbuster Approach
129(3)
Real-World Example
132(1)
Looking Ahead
133(1)
Endnotes
134(1)
8 A New Day Is Dawning for Medical Device and Diagnostics Manufacturers
135(28)
Getting Products to Market: Change Is in the Wind
135(5)
Implications for the Industry
138(1)
Commercial Challenges
139(1)
CER: The Threat for Medical Devices
140(7)
End of the "Last Version Plus 5%" Business Model
141(2)
Increased Pressure to Rightsize Functionality
143(1)
Increased Competition with Drugs
144(1)
Restricted Qualification for Devices
144(1)
Impact of CER on Medical Device Operations
145(2)
Prudent Responses and Defensive Strategies for Medical Device Companies
147(2)
Adopt Strategies Suited to the New Environment
147(1)
Focus on Reducing the Cost of the Procedure
148(1)
Develop Service Wraps
148(1)
Embrace the Cost--Functionality Trade-Off
149(1)
CER: The Opportunity for Diagnostics
149(4)
Reduced Tolerance for Redundant Testing
150(1)
New Commercial Model
151(1)
Possibility of Mass Screening
152(1)
Impact of CER on Diagnostics Manufacturer Operations
152(1)
Prudent Responses and Defensive Strategies for Diagnostics
153(2)
Diversify the Revenue Base
154(1)
Begin to Develop Partnerships for Custom Diagnostics
155(1)
Where Do Medical Device and Diagnostics Companies Go from Here?
155(5)
Hospital-as-Customer Requires a New Sales Model
159(1)
Endnotes
160(3)
9 Putting Value at the Center of Healthcare
163(34)
Recent Legislative Solutions and Why They Won't Work
165(1)
Accountability for Care Is a Good Concept
166(11)
ACOs: Their Original Purpose
166(1)
ACOs: Their Role in PPACA
167(2)
Government-Sponsored Payment and Delivery Systems
169(1)
Top-Down Approach to Complex Health Policy Problems
170(2)
ACOs: Key Deficiencies
172(2)
Recommendations for Policymakers: Healthcare Delivery
174(3)
Enabling Markets to Create Access to Care
177(6)
Creating Access to Affordable Health Coverage
178(1)
Recommendations for Policymakers: Access to Care
179(4)
Supporting Innovation: Finding the Right Balance at the Food and Drug Administration
183(9)
Regulation's Impact on Innovation: A Two-Edged Sword
184(5)
Making the Rules Clearer, More Transparent, and Simpler
189(1)
Real-Life Example
190(2)
Patent Life: Shooting Ourselves in the Foot
192(1)
Endnotes
193(4)
10 Creating a Roadmap for Change
197(22)
Revisiting the Challenge of Industry Transition
197(4)
Safety in Size? The Rush to Affiliation
201(4)
Consolidation and the Challenge for Manufacturers
203(2)
Additional Challenges for Manufacturers
205(3)
Creating Collaborations to Develop Lifetime Value
206(2)
Why Now?
208(1)
Reprising the Consumer
208(4)
Power of Choice
209(2)
Increase Perceived Quality
211(1)
Creating and Sustaining a New Business Model
212(1)
Harnessing Consumer Choice and Competition to Ensure Accountability: Final Thoughts for Policymakers
213(3)
End Game
216(3)
Index 219(26)
About the Authors 245(4)
About NAI 249
Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc., is an internationally recognized consultant and author with more than twenty-five years of experience in the field of strategy development and execution, business model design, and market analysis. Her clients have included Fortune 500 companies such as Johnson & Johnson, Eli Lilly, Pfizer, Westinghouse, AstraZeneca, Merck, Abbott Laboratories, major healthcare institutions, payers, and government agencies. The focus of her consulting addresses the challenges of maintaining competitive advantage in highly dynamic and regulated markets.

Dr. Numerof has been a consistent advocate for the importance of strategic differentiation, organizational alignment of structure, competencies and metrics to ensure effective implementation, and anticipating, rather than reacting to industry trends. Shes been a pioneer in the area of economic and clinical value, anticipating the impact of changing global payer attitudes on the fundamental business model of the healthcare industry. Her work across the entire healthcare spectrum gives her a unique perspective on the challenges and needs of manufacturers, physicians, payers, and healthcare delivery institutions.

Under her leadership, NAI has developed proprietary approaches that provide precise insight and practical solutions to some of the industrys most complex business challenges. Taking a systemic approach, Dr. Numerof has addressed such diverse issues as comparative effectiveness research, accountable care, bundled pricing, consumer engagement, operationalizing compliance and transparency, portfolio management and the identification of growth platforms that provide sustainable differentiation through economic and clinical value, and effective commercialization based on value propositions that matter to key constituencies.

Dr. Numerof is widely published in business journals and has authored five books. She serves as an advisor to members of Congress on healthcare reform and comparative effectiveness research. She was a senior advisor with the Center for Health Transformation, a regular contributor to the Manhattan Institute, and wrote the Heritage Foundations policy paper, "Why Accountable Care Organizations Wont Deliver Better Healthcareand Market Innovation Will." She led a tri-partisan, cross-industry work group on payment reform and developed recommendations for new payment models that incent better health outcomes at lower cost. In addition, Dr. Numerof provides guidance to policy organizations and agencies on the relationship between innovation and regulation, working to support innovation and ensure responsive regulatory oversight.

Dr. Numerof graduated magna cum laude from the Honors College, Syracuse University and received her MSS and PhD from Bryn Mawr College.

Michael N. Abrams, M.A., Cofounder and Managing Partner of Numerof & Associates, Inc., has served as an internal and external consultant to Fortune 50 corporations, major pharmaceutical and medical device companies, healthcare delivery institutions, the financial services industry, and government agencies for over twenty-five years. He has worked extensively in the areas of strategic planning and implementation, product strategy and portfolio development, market analysis, consumer engagement, and operational improvement.

Abrams is well known for his expertise in the design and implementation of strategies for building competitive differentiation, defining sustainable value, identifying market influence mechanisms, and translating white space analysis into the creation of innovative solutions to meet unmet needs. His ability to identify market opportunities and to effectively improve organizational performance has been an invaluable resource to client companies on a global basis across industries.

Abrams has structured and managed innovative programs to evaluate care delivery and payment models, thereby defining the internal change processes necessary to translate business opportunities into effective market position, operations, product portfolio management, and new product design consistent with changing regulatory requirements. He has provided solutions to healthcare delivery systems to improve the management of care transitions, thereby reducing unnecessary hospitalizations, and reduced length of stay by identifying and managing factors causing extended stays, changing admissions and patient care management processes, and managing across the continuum of care while maintaining or improving clinical outcomes and reducing costs.

He is experienced in the design and execution of econometric modeling and analysis and decision support systems for a variety of science-driven industries and applications. He has designed technology solutions to meet a wide range of needs, including strategic account planning and management, thought leader interface, and key opinion leader management. His ability to manage the process of technology integration to support business objectives across multiple business environments ensures return on investment (ROI).

Abrams has written extensively on economic and clinical value creation and the need for integrated, systemic solutions to the challenges facing the global healthcare industry. His articles have appeared in more than a dozen leading business journals, and he coauthored the book Solving the Healthcare Crisis. As an adjunct faculty member of Washington University in St. Louis and LaSalle College School of Business Administration in Philadelphia, Abrams has taught MBA courses in strategic management, product planning and evaluation, quantitative decision making, and market analysis.

Michael Abrams completed his doctoral work in Business Policy at St. Louis University. He received his MA from George Washington University in Washington, DC.