Halvorson | Health Care Will Not Reform Itself | Buch | sack.de

Halvorson Health Care Will Not Reform Itself



A User's Guide to Refocusing and Reforming American Health Care

1. Auflage 2009, 184 Seiten, Gebunden, Format (B × H): 159 mm x 238 mm, Gewicht: 417 g
ISBN: 978-1-4398-1614-1
Verlag: Productivity Press


Halvorson Health Care Will Not Reform Itself

Health care reform is within our reach. According to George Halvorson, CEO of the nation's largest private health care plan,only by improving the intent, quality, and reach of services will we achieve a health system that is economically feasible into the future.
This year, Americans will spend 2.5 trillion for health services that are poorly coordinated, inconsistent, and most typically focused on the belated care of chronic conditions. What we have to show for that expenditure is a nation that continues to become more obese, less healthy, and more depressed.
In Health Care Will Not Reform Itself, Kaiser Permanente CEO George Halvorson proves beyond a doubt that the tragically inconsistent care that currently defines the state of U.S. health services is irresponsible, irrational, but more importantly, fixable. With detail that might shock you, he shows why the nonsystem we now use is failing. Then, applying the same sensible leadership that makes Kaiser the most progressive health care organization in the world, he answers President Obama’s mandate for reform with a profound incentive-based, system-supported, goal-focused, care-improvement plan.
Halvorson draws from respected studies, including his own, and the examples of successful systems across the world to show that while good health care is expensive, it is nowhere near as costly as bad health care. To immediately curb care costs and bring us in line with President Obama's projected parameters, he recommends that we:

Take a preventive approach to the chronic conditions that account for the lion’s share of medical costs
Coordinate patient care through a full commitment to information technology
Increase the pool of contributors by mandating universal insurance
Rearrange priorities by making health maintenance profitable
Convene a national committee to "figure out the right thing" and "make it easy to do"

While this book offers sage advice to policy makers, it is also written to educate the 260 million stakeholders and invite their participation in the debate that is now shaping. What makes this plan so easy to understand and so compelling is that it never strays from a profound truth: that the best health system is one that actually focuses on good health for everyone.

All royalties from the sale of this book go to Oakland Community Voices: Healthcare for the Underserved

Zielgruppe


Policy makers involved with health care reform, legislative staff, and thought leaders in business and industry.


Autoren/Hrsg.


Weitere Infos & Material


Health Care Won’t Reform Itself
Many Treat — Few Prevent
Studies Prove the Inconsistency of Care
Care Linkage Deficiencies Abound
No Money, No Tools, No Accountability for Linkages
Paper Records Are Entirely and Almost Criminally Inadequate
Providers Don’t Create the Economic Reality
Is Care Too Complex to Coordinate Anyway?
In Other Industries, Lower Prices Increase Sales
Screw-Ups Can Be Profitable
Screw-Ups Aren’t Deliberate
We Need the Courage to Reform Care
We Need Universal Coverage
Tools Need a Use or They Are Useless
Strategic Modifications Are Needed
Why Are Health Care Costs Going Up?
Normal Inflation Is the Bottom Line, First Level, and Basic Cost Driver for Health Care Cost Inflation
Worker Shortages Add to Cost Increases for Care
New Technology, New Treatments, and New Drugs Increase Costs
Few Standards of Value Exist
Other Countries Use Screening Programs for "New" Care
Untested, Purely Experimental, Unproven Care
The Dilemma — For Some Patients, There Is No Other Hope
Caregivers Sometimes Own the Businesses
Only in America Does "It Might Work" Work
Let’s Require Disclosure of Effectiveness Research
Massive Care Coordination Deficiencies Add Expenses
Multiple Caregivers Don’t Link Well
Perverse Financial Incentives Also Increase Costs
Problematic Insurance Benefit Design
Changes in Fee Payment Approaches Face Resistance
We Are Getting Older and More Expensive
Inflation, Technology, Inefficiency, Perverse Incentives, and Getting Old Are an Expensive Package
As a Pure, Self-Serving System — Health Care Is Winning
Consumers Pay the Price for More Expensive Care
Care Costs Create Premium Costs
"Pass through" to the Customer
The Answer Is "Right Care"
Set Goals and Improve Care
Data Isn’t Shared
Random Tools Create Random Results
Begin with Goals
We Don’t Need a Thousand Goals
Work Backward from the Goal to the Strategy
Asthma Care Needs Computerized Data
We Need Computerized Asthma Care Data
Universal Coverage for Children Can Improve Asthma Care
Being Insured Creates a Database
Care Won’t Get Better without Goals
Goals for Key Diseases
The Tool Kits Look a Lot Alike
EMRs Need Support Tools
Patient-Focused EMRs Are Key
Benefit Packages Channel Cash
We Don’t Need to Change the Entire Payment System
Data Is the Secret Sauce
Health Care Can Do This Kind of Work
Three Provider Payment Changes Are Needed
We Need Goals
Connectors Are Magic
Older Patients Often Have Major Connection Problems
Medical Home and Packages of Care
A New Generation of Connectors
Connectors Come in Various Versions
Virtual Integration Can Mimic Vertical Integration
EMR Plus Care Support Tools
Denver Improved Outcomes
The Death Rate Dropped
Triple Co-Morbidities in Hawaii
Preventing ER Visits Is a Very Good Thing to Do
Care Registry Worked for "Safety Net" Patients
Hospital Admissions Were Reduced by 70 Percent
We Need to Connect Everyone Who Needs to Be Connected
Buyers Need to Change the Cash Flow
Buyers Should Specify the Context for Care
The Point of Connectors Is to Connect
Claims Data Can Be Used
The Perfect System
All, All, and Then All
Information Security Is Essential
CQI Is Needed — And CQI Needs Data
American Health Care Needs a Culture of
Continuous Learning
Most of Health Care Is Splintered
One-Third Reduction in Broken Bones
Make the Right Thing Easy to Do
The Patient Should Be the Focus of Care Data
Ten Criteria for Ultimate System Design
Six Million E-Visits
All New Systems Should Be Connectable
The Perfect System Is Possible
Personal Health Records Can Fill Part of the Gap
Hub and Spoke Connectivity Can Be Computer Supported
Virtual Care in Remote Sites
Next Step — Connectivity
We Need Universal Coverage, Care System Reform, and Care System Competition
Intermittent Coverage Disrupts Care
Care Improvement Needs Coverage Continuity
Data Should Be Longitudinal
What Kinds of Health Plans Should Compete?
No One Is Accountable if No One Is Accountable
"Insurance Exchanges" Should Offer Care Team Options
Risk Sharing Works Quite Well, Thank You
Risk Pooling Is the Key
Co-Ops Set Quotas
Ugandans Understand the Cost/Premium Connection
Blame Your Fever on Your Thermometer
The Basic Business Model of Insurance
The Key Is Spreading/Sharing Risk
Swiss Rejected Canadian Model
The Double Mandate
Why Do American Insurers Screen Risk?
Large Numbers Are Not Magic
Risk Pools Don’t Cure Cancer
Pooling Small Groups Isn’t Magic, Either
95 Percent Defines the Business Model
Five Percent of Privately Insured People Had Health Screens
Hassles and Disagreements Are Minimized with Inclusion
Individual Enrollees Have Individual Motivations
Using Someone Else’s Money Is Often Attractive
Expensive New Members Increase Average Costs
Death Spirals Can Be Unfortunate
A Single Mandate Can Destroy Risk Pools
The Best Approach Is to Cover Everyone
People Who Need Heart Transplants Should Get Heart Transplants
Focus, Tools, and Better Health
Begin with Chronic Care
Chronic Care Is the First Priority
The Low-Hanging Fruit Is to Bite the Bullet
Focus, Tools, Health
Money Talks
Choices Should Affect Premiums
Registries Should Not Dictate Care
Science Changes
Health May Be the Highest Priority
The Girth of America Is Expanding
Americans Are Also Inert
We Need a Culture of Health
Eliminate, Label, Reduce, and Persuade
We Need Half as Many People to Become Diabetic
We Need an Agenda of Health Improvement
We Also Need to Set Goals to Directly Reduce Costs
We Need a National Forum for Cost Reduction
We Need a Commission
We Need Complete Data about Cost Drivers for Care
The Goal Should Be to "Bend the Trend"
Health Care Could Be Moving to a Golden Age
Endnotes
Index
About the Author


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