This book not only provides a review of how the healthcare system operates, but also arms physician leaders with actionable information to reform the healthcare economy and satisfy their own motivations for entering the field of medicine.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics: Managing Your Career in an Evolving Healthcare System provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation’s healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today’s healthcare system. Explaining what the term healthcare crisis means, the book evaluates key reforms designed to ameliorate the crisis. It examines emerging trends in the healthcare delivery system to provide a clear understanding of the implications of recently implemented policy solutions. It also illustrates how public- and private-sector initiatives are working to reduce cost increases by fundamentally altering the systems for delivery of care through managed care organizations, accountable care organizations, and patient-centered medical homes. The text identifies the pressures for change and examines six emerging strategies that can help boost efficiencies in the healthcare system. It addresses the macro-economic problems, such as the impact of changing demographics, as well as the micro-economic problems, such as lifestyle choices on healthcare costs. Demystifying the terminology, facts, and types of changes that are currently underway, the book provides you with the understanding of healthcare economics you will need to identify viable strategies for adapting to the changes on the horizon.

Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation’s healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today’s healthcare system. The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes. Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed. The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change – and some of the changes – on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.

This book focuses on how to lead transformative and strategic change in the healthcare industry in times of great uncertainty. Written for senior healthcare leaders, it will provide new tools, processes, examples and case studies offering an effective framework in which to transform healthcare systems. Specifically, leaders will be able to answer the following questions: • Why change? What has led us to today, and what is the current situation in healthcare? • What to change? What areas for change are most promising—areas with the greatest potential to yield significant benefits? • How to change? Will incremental changes meet the need, or are true transformations required? • When to change? Should changes start now, or should change wait for the stars to come into some special alignment? Healthcare is personal. Healthcare is local. And at the same time, healthcare is one of the greatest challenges faced by countries around the world. All major economies confront similar issues: “demand-side” growth in the care of aging populations in the face of “supply-side” resource constraints driven by ever-increasing costs of providing such care. While cultural, historical, and political differences among nations will yield different solutions, healthcare leaders across the globe must deal with ever-increasing uncertainty as to the scope and speed of their healthcare systems’ evolution. The magnitude of these challenges calls for fundamental change to address inherent problems in the healthcare system and ensure sustainable access to healthcare for generations to come. The problem is understanding where and how to change. Failures of strategy are often failures to anticipate a reality different than what organizations are prepared or willing to see. Both system-wide and organizational transformation means doing current activities more efficiently while layering on change. This book aims to provide leaders with the tools to help organizations and health care systems adapt and evolve to meet the new challenges of healthcare as it continues to evolve. Praise for Leading Strategic Change in an Era of Healthcare Transformation "The authors make the case for healthcare transformation, and more importantly outline the required steps from changing mindsets to opinions development...a useful guide for all future healthcare leaders."- John A. Quelch, Charles Edward Wilson Professor of Business Administration at Harvard Business School "There are several lifetimes of knowledge in the book about leading strategic transformation in the healthcare sector... Strategic transformation requires 2 ingredients: expertise in the healthcare sector and knowledge about leading change. This volume accomplishes both."- Karen Hein, Former President of the William T. Grant Foundation, Adjunct Professor of Family & Community Medicine, Dartmouth Medical School and Visiting Fellow, Feinstein International Center, Tufts University "An essential guide for healthcare leaders seeking to transform their organization in these demanding times."- Dr. Mario Moussa, President, Moussa Consulting and co-author of The Art of Woo: Using Strategic Persuasion to Sell Your Ideas and Committed Teams: Three Steps to Inspiring Passion and Performance

"Readers should go broad and go deep with this book. Readers who do both will find this book a valuable framework for approaching the complexities of leading health care organizations today...it will provide a framework for approaching the work, and that framework is one likely to lead to business success and personal satisfaction." —From the Foreword by Thomas H. Lee, MD, Chief Medical Officer, Press Ganey and Senior Physician, Brigham and Women’s Hospital The U.S. health care system continues to undergo transformation, with a rate of change that has accelerated in recent years. This rapidly evolving field requires a new level of astute clinical leadership. The bottom line is that physician leadership will be the key ingredient for any dramatic change in our health care system and a fundamental driver of outcomes for patients and communities. Leading Heath Care Transformation prepares physician leaders with the evidence, tools, and ideas to make and lead systemic improvement. This second edition provides fresh insights, new evidence, and modern topics with revised and updated chapters. Each chapter is complete with contemporary evidence, pragmatic case studies, lessons learned, and action steps for physician leaders. This second edition of Leading Health Care Transformation is a succinct and practical primer on 16 key topics in health care transformation. Physician leadership is critical to transform care; this book will help guide the way.

Praise for Partners in Health "The combination of visionary leadership, knowledge, and superb timing makes this book a winner. Health care is evolving toward collaboration and integration, and this book is essential reading for anyone wishing to change the relationships between hospitals and physicians." Donald W. Fisher, PhD, president and CEO, the American Medical Group Association "This book is a must-read for anyone committed to a high-performance health system. It spells out the practical steps that will move us toward an accessible, coordinated, patient-centered system of care. Its recommendations for payment and regulatory reform underscore the urgency of comprehensive health reform if the current misaligned incentives are to be changed to support those on the frontlines in providing the best care with prudent stewardship of resources." Karen Davis, PhD, president, The Commonwealth Fund "Closer physician-hospital integration would lead to higher quality care at lower cost. Partners in Health is a masterful guide to past integration efforts, current models of success, and thoughtful recommendations for future progress." Victor R. Fuchs, PhD, Henry J. Kaiser Jr. Professor Emeritus, Stanford University "The working relationship of hospitals and physicians must be restructured for the United States to achieve more efficient, accountable care. But addressing our urgent challenges can't wait for all hospitals and physicians to join highly structured systems. Thankfully, the authors offer steps that all the major stakeholders can take today to spur new models and start the flywheel of trust spinning at new speeds." Richard Umbdenstock, president and CEO of the American Hospital Association "Transitioning U.S. health care from fragmentation to integration, in the context of a more rational payment system, is sure to be a long and tortuous journey. Partners in Health is a kind of Fodor's Guide to the voyage. No one committed to health reform should travel without it." Susan Dentzer, editor-in-chief, Health Affairs