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Controlling Costs and Changing Patient Care?

Controlling Costs and Changing Patient Care?
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 321
Release: 1989-02-01
Genre: Medical
ISBN: 0309040450

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Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.


Controlling Costs and Changing Patient Care?

Controlling Costs and Changing Patient Care?
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 321
Release: 1989-01-01
Genre: Medical
ISBN: 0309040485

Download Controlling Costs and Changing Patient Care? Book in PDF, ePub and Kindle

Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.


Changing the U.S. Health Care System

Changing the U.S. Health Care System
Author: Ronald M. Andersen
Publisher: Jossey-Bass
Total Pages: 744
Release: 2007-03-15
Genre: Medical
ISBN: 0787994081

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The third edition of Changing the U.S. Health Care System is a thoroughly revised and updated compendium of the most current thought on three key components of health care policy—improving access, ensuring quality, and controlling costs. Written by a panel of health care policy experts, this third edition highlights the most recent research relevant to health policy and management issues. New chapters address topics such as the disparities in health and in health care, information systems, and performance in the area of nursing. Revisions to chapters from the previous edition emphasize the most recent developments in the field.


Best Care at Lower Cost

Best Care at Lower Cost
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 437
Release: 2013-05-10
Genre: Medical
ISBN: 0309282810

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America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.


For-Profit Enterprise in Health Care

For-Profit Enterprise in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 580
Release: 1986-01-01
Genre: Medical
ISBN: 0309036437

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"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.


Cracking Health Costs

Cracking Health Costs
Author: Tom Emerick
Publisher: John Wiley & Sons
Total Pages: 157
Release: 2013-06-07
Genre: Business & Economics
ISBN: 1118710916

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Cracking Health Costs reveals the best ways for companies and small businesses to fight back, right now, against rising health care costs. This book proposes multiple, practical steps that you can take to control costs and increase the effectiveness of the health benefit. The book is all about rolling back health care costs to save companies and employees money. Working hand-in-hand with their employees, businesses need to ensure that, whenever feasible, employees with the most expensive diagnoses get optimal treatment at hospitals not practicing “volume-driven” medicine for higher profits. Less than 10% of employees incur 80% of costs. About 20% of patients have been completely misdiagnosed, while many others are simply the victims of surgeons who are either practicing bad medicine or overtreating for profit. For example, some companies, such as Walmart and Lowe’s, are turning to the “Centers of Excellence” approach author Tom Emerick helped to pioneer while running benefits for Walmart. By determining which hospitals are adopting the highest standards of care, benefits managers can reduce the number of unnecessary high-cost surgeries and improve employees’ overall health. The solution-based approach offered by the book is unique, because it can be implemented by businesses today.


The New Health Care for Profit

The New Health Care for Profit
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 186
Release: 1983-01-01
Genre: Medical
ISBN: 0309033772

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An introduction to the new health care for profit. Legal differences between investor-owned and nonprofit health care institutions. Wall Street and the for-profit hospital management companies. When investor-owned corporations buy hospitals: some issues and concerns. Physician involvement in hospital decision making. Economic incentives and clinical decisions. Ethical dilemmas of for-profit enterprise in health care. Secondary income from recommended treatment: should fiduciary principles constrain physician behavior?


The Healthcare Imperative

The Healthcare Imperative
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 852
Release: 2011-01-17
Genre: Medical
ISBN: 0309144337

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The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.