9781466511217

Healthcare Beyond Reform: Doing It Right for Half the Cost

by ;
  • ISBN13:

    9781466511217

  • ISBN10:

    1466511214

  • Edition: 1st
  • Format: Hardcover
  • Copyright: 2012-04-24
  • Publisher: Productivity Pr

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Summary

Along with being the biggest sector of the U.S. economy, healthcare is also the most dysfunctional. This book presents a compelling vision of how healthcare can work better and how we can get there with the current resources. Providing a comprehensive, positive, and intriguing vision of the future, this book tells healthcare providers how they can reposition their organizations to thrive regardless of what the government does in regards to policy. It also outlines how employers can save money by changing the way they provide healthcare to their employees. Check out Joe Flower discussing his new book, Healthcare Beyond Reform.

Table of Contents

Acknowledgmentsp. xiii
About the Authorp. xvii
The Factsp. xix
First, a Story: Tom Johnson's Belly Encounters Healthcare as It Has Beenp. xxi
Introductionp. xxxiii
How We Got Here
Half Off?p. 3
Looking at Normal Countriesp. 3
Economists Behaving Badly with Smoke and Mirrorsp. 6
The Fairness Factorp. 7
The American Ways of Healthcarep. 9
Possible Savings: Getting to Halfp. 10
Wastep. 13
Doing the Right Things the Wrong Wayp. 13
Doing the Right Things in the Wrong Placep. 14
Doing the Wrong Things-and Not Doing the Right Thingsp. 14
How Much?p. 14
Where Are the Biggest Savings?p. 16
Inappropriate Therapiesp. 16
How Big Is This Waste?p. 22
Heroic End-of-Life Treatmentp. 23
Insurance Wastep. 25
Pharmaceutical Wastep. 26
Chronic Diseasep. 26
Trends: Opportunitiesp. 31
The Economyp. 31
Rampaging Geezersp. 32
Aging Clinical Workforcep. 34
Chronic Diseasep. 35
Computerization and Automationp. 37
Reform and Insurancep. 38
Brute Force Cost Reductionsp. 39
Healthcare Economics 101p. 41
Ahmed Buys a Rugp. 42
The Convoluted Economics of Healthcarep. 43
Competing Influencesp. 46
No Cost Accountingp. 48
Split Buyers, Split Sellersp. 49
Why the Ever-Popular "Cost Controls" Do Not Control Costsp. 52
Health Systems: More Complexp. 54
No More Cost Decantingp. 55
It's About to Get Really Complicatedp. 56
Inflexible Systemsp. 57
Unit Costs vs. System Costsp. 58
The Two Core Rules of Economicsp. 59
What Must Be Done
The Five Strategiesp. 63
1. Explode the Business Modelp. 67
The End of Fee-for-Service Healthcare?p. 68
What Are We Buying?p. 69
What's Wrong with Competition?p. 69
Emerging Business Modelsp. 72
The Safeway Experiencep. 72
CIGNA's Choice Fundp. 74
Formula Onep. 75
The Boeing Experiencep. 76
On-Site Clinicsp. 77
On-Site Clinics without Employers?p. 79
Medicaid-Based Business Modelsp. 79
Disease Management Programs That Failp. 80
Disease Management Programs That Workp. 81
Direct Primary Carep. 82
Direct Primary Care-Onlinep. 83
Structure Mattersp. 84
Share the Riskp. 85
A Brief History of Risk in Healthcarep. 86
Putting the Customer at Financial Riskp. 87
"But Capitation Doesn't Work"p. 89
Putting the Provider At Riskp. 90
Providers At Risk Behave Differentlyp. 91
Putting Providers Systemkally At Riskp. 92
Shoppingp. 94
Virtuous Deflationary Spiralp. 95
Redesigning Marketsp. 96
Explode the Business Modelp. 98
2. Build on Smart Primary Carep. 99
The Medical Homep. 100
How a Medical Home Actually Worksp. 102
Making More Money by Being a Better Doctorp. 103
Taking on Riskp. 103
Integration: It's Not Just "Kumbaya"p. 104
From Evidence-Based Medicine to Evidence-Based Healthp. 105
Explode the Business Model and Build on Smart Primary Carep. 106
3. Put a Crew on Itp. 107
A Team Care Example: Diabetesp. 108
Teamwork at All Levelsp. 109
Getting on the Same Team with the Docsp. 110
Alaska Native Healthcarep. 111
What Makes a Team? A Scoreboardp. 113
Explode the Business Model, Build on Smart Primary Care, and Put a Crew on Itp. 114
4. Swarm the Customerp. 115
The Magic of Mr. Moonp. 116
The Pareto Principle in Healthcarep. 118
Hotspottingp. 121
The 5% That Does the 50%p. 124
More Help, Smarter, Earlierp. 125
5. Rebuild Every Processp. 127
The Tough Business of Caringp. 127
Time to Get Fiercep. 128
Perfecting Clinical Processesp. 129
Evidence or Intuition?p. 130
Measure It-and Get It Rightp. 132
Check It Out, Dude!p. 133
Other Industries: "Quality Is Job One"p. 135
The Institute for Healthcare Improvementp. 136
Comparative Effectiveness Researchp. 138
Evidence-Based Designp. 140
The Lean Medical Practicep. 143
Doing It Cheaperp. 144
Raise a Glass to Carlosp. 146
Big Datap. 147
Analytics for the Countryp. 148
Analytics for Systemsp. 150
Analytics for Youp. 151
With the Doctorp. 153
Taking It Homep. 153
Appsp. 154
Extending the Clinic into the Homep. 156
India and China: Globalization Cuts Both Waysp. 157
Indiap. 158
Chinap. 159
Cheap Biologicals and Biosimilarsp. 159
Reverse Innovationp. 160
Making It All Work
Beyond Healthcarep. 165
Len Duhl, the Father of Healthy Communitiesp. 167
Involve Everyonep. 169
The Evil Profit Motive and the Virtues of Competitionp. 173
Arguments for a Single-Payer Systemp. 174
Insurance Companies Are Evilp. 174
Extra Transaction Costsp. 174
Extra Fundamental Costsp. 175
For Profit? Or Not?p. 176
Is Healthcare a Right?p. 180
It's Not That Simplep. 182
There Ought to Be a Lawp. 187
Introductionp. 187
Scope of Practicep. 187
Corporate Practice of Medicinep. 188
Certificate of Needp. 189
Anti-Kickback Legislationp. 190
Transparencyp. 190
Fraudp. 192
Insurance Regulationp. 193
ERISA Immunityp. 193
End Fraudulent Rescissions and Claim Denialsp. 194
Swiss Rulep. 197
Direct Primary Carep. 198
Transparencyp. 199
Competitionp. 200
Operating across State Lines?p. 200
Malpracticep. 201
It's Not Greedy Patientsp. 204
Fixing Malpracticep. 205
Systemic Effectsp. 208
Fixing the Pharmaceutical Industryp. 209
Pharma Runs into a Wallp. 210
Burying Germany in Jeepsp. 212
Why We Don't Get Legislation That Worksp. 214
The X Questionsp. 215
A New Mind-Setp. 215
The X Questionsp. 216
Confronting Your Riskp. 220
It's the Systemp. 221
Wait. Half?p. 222
Our Shaky Equilibriump. 222
Beyond the Tipping Point: Rapid System Changep. 223
True Shoppersp. 226
Automatic Cost Reductionsp. 227
Beyond Reform-The Next Healthcarep. 229
Employersp. 230
The Poorp. 230
Medicarep. 231
Statesp. 231
How Fast?p. 232
Stupid Computer Tricks: How Not to Digitize Healthcarep. 239
Indexp. 245
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