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Flower, Joe
Healthcare beyond reform : doing it right for half the cost / Joe Flower
Boca Raton, FL. : Taylor & Francis, c2012
book jacket
Location Call Number Status
 4th Floor  RA395.A3 .F56 2012    DUE 09-02-14 OFF CAMPUS
Subject(s) Health care reform -- United States
Health care reform -- Cost effectiveness
Medical care -- Cost shifting
Medical care, Cost of
Medical policy -- United States
Physical Description xxxviii, 256 p. : ill. ; 24 cm
Note Includes bibliographical references and index
Summary "Healthcare is the biggest sector of the U.S. economy and the most dysfunctional. In 2010 we spent $2.6 trillion on healthcare in the U.S. We will waste at least 30 percent of that, about $780 billion -- eight times what it would take to cover every American. In Healthcare Beyond Reform: Doing It Right for Half the Cost, Joe Flower, a well respected healthcare futurist and industry thought leader, lays out his compelling practical vision of how healthcare can work better, and how we can get there by utilizing the resources we already have. The author provides a comprehensive, positive, and intriguing vision of the future of healthcare for professionals, employers and investors. This book is much more than a book about healthcare reform; it's a book which specifically tells healthcare providers how they can reposition their organizations to thrive as healthcare changes, regardless of what the government does. It also outlines how employers can save money and help their employees at the same time by changing the way they provide healthcare to their employees"--Provided by publisher
Contents Acknowledgments -- About the Author -- The Facts -- First, a Story: Tom Johnson's Belly Encounters Healthcare as It Has Been -- Introduction -- Section 1. How We Got Here -- 1. Half Off? -- Looking at Normal Countries -- Economists Behaving Badly with Smoke and Mirrors -- The Fairness Factor -- The American Ways of Healthcare -- Possible Savings: Getting to Half -- 2. Waste -- Level 1. Doing the Right Things the Wrong Way -- Level 2. Doing the Right Things in the Wrong Place -- Level 3. Doing the Wrong Things-and Not Doing the Right Things -- How Much? -- Where Are the Biggest Savings? -- Inappropriate Therapies -- How Big Is This Waste? -- Heroic End-of-Life Treatment -- Insurance Waste -- Pharmaceutical Waste -- Chronic Disease -- 3. Trends: Opportunities -- The Economy -- Rampaging Geezers -- Aging Clinical Workforce -- Chronic Disease -- Computerization and Automation -- Reform and Insurance -- Brute Force Cost Reductions -- 4. Healthcare Economics 101 -- Ahmed Buys a Rug -- The Convoluted Economics of Healthcare -- Competing Influences -- No Cost Accounting -- Split Buyers, Split Sellers -- Why the Ever-Popular "Cost Controls" Do Not Control Costs -- Health Systems: More Complex -- No More Cost Decanting -- It's About to Get Really Complicated -- Inflexible Systems -- Unit Costs vs. System Costs -- The Two Core Rules of Economics -- Section 2. What Must Be Done -- 5. The Five Strategies -- 6. 1. Explode the Business Model -- The End of Fee-for-Service Healthcare? -- What Are We Buying? -- What's Wrong with Competition? -- Emerging Business Models -- The Safeway Experience -- CIGNA's Choice Fund -- Formula One -- The Boeing Experience -- On-Site Clinics -- On-Site Clinics without Employers? -- Medicaid-Based Business Models -- Disease Management Programs That Fail -- Disease Management Programs That Work -- Direct Primary Care -- Direct Primary Care-Online -- Structure Matters -- Share the Risk -- A Brief History of Risk in Healthcare -- Putting the Customer at Financial Risk -- "But Capitation Doesn't Work" -- Putting the Provider At Risk -- Providers At Risk Behave Differently -- Putting Providers Systemically At Risk -- Shopping -- Virtuous Deflationary Spiral -- Redesigning Markets -- Explode the Business Model -- 7. 2. Build on Smart Primary Care -- The Medical Home -- How a Medical Home Actually Works -- Making More Money by Being a Better Doctor -- Taking on Risk -- Integration: It's Not Just "Kumbaya" -- From Evidence-Based Medicine to Evidence-Based Health -- Explode the Business Model and Build on Smart Primary Care -- 8. 3. Put a Crew on It -- A Team Care Example: Diabetes -- Teamwork at All Levels -- Getting on the Same Team with the Docs -- Alaska Native Healthcare -- What Makes a Team? A Scoreboard -- Explode the Business Model, Build on Smart Primary Care, and Put a Crew on It -- 9. 4. Swarm the Customer -- The Magic of Mr. Moon -- The Pareto Principle in Healthcare -- Hotspotting -- The 5% That Does the 50% -- More Help, Smarter, Earlier -- 10. 5. Rebuild Every Process -- The Tough Business of Caring -- Time to Get Fierce -- Perfecting Clinical Processes -- Evidence or Intuition? -- Measure It-and Get It Right -- Check It Out, Dude! -- Other Industries: "Quality Is Job One" -- The Institute for Healthcare Improvement -- Comparative Effectiveness Research -- Evidence-Based Design -- The Lean Medical Practice -- Doing It Cheaper -- Raise a Glass to Carlos -- Big Data -- Analytics for the Country -- Analytics for Systems -- Analytics for You -- With the Doctor -- Taking It Home -- Apps -- Extending the Clinic into the Home -- India and China: Globalization Cuts Both Ways -- India -- China -- Cheap Biologicals and Biosimilars -- Reverse Innovation -- Section 3. Making It All Work -- 11. Beyond Healthcare -- Len Duhl, the Father of Healthy Communities -- Involve Everyone -- 12. The Evil Profit Motive and the Virtues of Competition -- Arguments for a Single-Payer System -- Insurance Companies Are Evil -- Extra Transaction Costs -- Extra Fundamental Costs -- For Profit? Or Not? -- Is Healthcare a Right? -- It's Not That Simple -- 13. There Ought to Be a Law -- Introduction -- Scope of Practice -- Corporate Practice of Medicine -- Certificate of Need -- Anti-Kickback Legislation -- Transparency -- Fraud -- Insurance Regulation -- ERISA Immunity -- End Fraudulent Rescissions and Claim Denials -- Swiss Rule -- Direct Primary Care -- Transparency -- Competition -- Operating across State Lines? -- Malpractice -- It's Not Greedy Patients -- Fixing Malpractice -- Systemic Effects -- Fixing the Pharmaceutical Industry -- Pharma Runs into a Wall -- Burying Germany in Jeeps -- Why We Don't Get Legislation That Works -- 14. The X Questions -- A New Mind-Set -- The X Questions -- Confronting Your Risk -- 15. It's the System -- Wait. Half? -- Our Shaky Equilibrium -- Beyond the Tipping Point: Rapid System Change -- True Shoppers -- Automatic Cost Reductions -- 16. Beyond Reform-The Next Healthcare -- Employers -- The Poor -- Medicare -- States -- How Fast? -- Appendix A. Stupid Computer Tricks: How Not to Digitize Healthcare -- Index

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