Toward a 21st Century Health System The Contributions and Promise of Prepaid Group Practice

by Enthoven, Alain C.; Tollen, Laura A.; Roper, William L.

• ISBN13: 9781119022473
• ISBN10: 1119022479
• Edition: 1st
• Format: Paperback
• Copyright: 2004-03-12
• Publisher: Jossey-Bass

Summary

Toward a 21^st Century Health System is a collection of thoughtful analyses that explore a key element of the health care delivery system-physician group practices. Edited by policy experts Alain Enthoven and Laura Tollen, and written by a blue ribbon panel of health policy scholars and leaders including Stephen Shortell, Hal Luft, Donald Berwick, James Robinson, and Helen Darling, this resource addresses a variety of topics, including

• Organized delivery systems
• Quality of care in prepaid group practice versus other types of managed care
• The role of physician leadership and culture in group practice
• Prepaid group practice and the formation of national health policy

This comprehensive resource also covers such topics as pharmacy benefit management, technology assessment, health services research, and employer purchasing of benefits– all as they relate to prepaid group practice.

Author Biography

ALAIN C. ENTHOVEN, PH.D (editor) is Marriner S. Eccles Professor of Public and Private Management (Emeritus), Graduate School of Business, and Senior Fellow, Institute for International Relations, Center for Health Policy, Stanford University. He was one of the architect's of the managed competition model of health reform, which was subsequently adopted by President Clinton in the Health Security Act of 1996.

LAURA TOLLEN, MPH, (editor) is Senior Policy Consultant for Kaiser Permanente Institute for Health Policy. Prior to joining the Institute, Laura was Senior Analyst and Project Director at the Institute for Health Policy Solutions, a Washington, DC-based think tank.

Table of Contents

Tables and Exhibits ix

Acknowledgments xi

The Contributors xiii

Foreword xxiii
William L. Roper

Preface xxvii
Alain C. Enthoven, Laura A. Tollen

1 Prepaid Groups and Organized Delivery Systems: Promise, Performance, and Potential 1
Stephen M. Shortell and Julie Schmittdiel

2 Systems and Results: The Basis for Quality Care in Prepaid Group Practice 22
Donald M. Berwick and Sachin H. Jain

3 The Clinical and Economic Performance of Prepaid Group Practice 45
Kenneth H. Chuang, Harold S. Luft, and R. Adams Dudley

4 Prepaid Group Practice and Health Care Policy 61
Jon B. Christianson and George Avery

5 Technology Assessment, Deployment, and Implementation in Prepaid Group Practice 85
David M. Eddy

6 Managing the Pharmacy Benefit in Prepaid Group Practice 108
William H. Campbell, Richard E. Johnson, and Sharon L. Levine

7 Prepaid Group Practice and Medical Workforce Policy 128
Jonathan P. Weiner

8 Prepaid Group Practice and Health Care Research 156
Raymond Fink and Merwyn R. Greenlick

9 Physician Leadership: “Group Responsibility” as Key to Accountability in Medicine 179
Francis J. Crosson, Allan J. Weiland, and Robert A. Berenson

10 The Limits of Prepaid Group Practice 199
James C. Robinson

11 The Relationship Between Prepaid Group Practice and the Employer Community 213
Helen Darling

12 Open the Markets and Level the Playing Field 227
Alain C. Enthoven

Editors’ Introduction to the Epilogue 247

Epilogue: Prepaid Group Practice and Computerized Caregiver

Support Tools 249
George C. Halvorson

Appendix: The Origins of Prepaid Group Practice in the United States 265
Jon A. Stewart

Index 275