Author: Nathan William Tierney
Publisher: Taylor & Francis
ISBN: 1351591487
Category : Business & Economics
Languages : en
Pages : 337
Book Description
"Nathan Tierney’s powerful storytelling is rarely seen in today’s health care business environment. We must redesign the health care delivery system---a team sport in service of patients, hold it accountable with measurement to improve outcomes, and quantify the resource costs over the full cycle of care. Value-based health care is a framework through which these goals are achieved, and Tierney provides a detailed playbook to get your organization there. Outlined in incredible detail and clarity, he presents core concepts and dives into the key metrics needed to build, maintain, and scale a successful value-based health care organization. Nathan shares a realistic vision of what any CEO should expect when developing their own Value Management Office. Nothing is more important to me than improving the lives of those I love. My personal mission is to create systemic change with an impact on the global stage. This playbook needs to be on the desk of every executive, clinician, and patient today." -Mahek Shah, MD, Senior Researcher and Senior Project Leader, Harvard Business School Our current healthcare system’s broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book ‘Redefining Health Care: Creating Value-Based Competition on Results.’ In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Professor Porter, accompanied by his esteemed Harvard colleague, Profesor Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. This book defines the practice of value-based health care as Value Management. The book explores Profesor Porter’s Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. The Value Realization Framework is based on Professor Kaplan's ground-breaking Balanced Scorecard approach, but specific to healthcare organizations. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations. This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.
Value Management in Healthcare
Author: Nathan William Tierney
Publisher: Taylor & Francis
ISBN: 1351591487
Category : Business & Economics
Languages : en
Pages : 337
Book Description
"Nathan Tierney’s powerful storytelling is rarely seen in today’s health care business environment. We must redesign the health care delivery system---a team sport in service of patients, hold it accountable with measurement to improve outcomes, and quantify the resource costs over the full cycle of care. Value-based health care is a framework through which these goals are achieved, and Tierney provides a detailed playbook to get your organization there. Outlined in incredible detail and clarity, he presents core concepts and dives into the key metrics needed to build, maintain, and scale a successful value-based health care organization. Nathan shares a realistic vision of what any CEO should expect when developing their own Value Management Office. Nothing is more important to me than improving the lives of those I love. My personal mission is to create systemic change with an impact on the global stage. This playbook needs to be on the desk of every executive, clinician, and patient today." -Mahek Shah, MD, Senior Researcher and Senior Project Leader, Harvard Business School Our current healthcare system’s broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book ‘Redefining Health Care: Creating Value-Based Competition on Results.’ In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Professor Porter, accompanied by his esteemed Harvard colleague, Profesor Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. This book defines the practice of value-based health care as Value Management. The book explores Profesor Porter’s Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. The Value Realization Framework is based on Professor Kaplan's ground-breaking Balanced Scorecard approach, but specific to healthcare organizations. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations. This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.
Publisher: Taylor & Francis
ISBN: 1351591487
Category : Business & Economics
Languages : en
Pages : 337
Book Description
"Nathan Tierney’s powerful storytelling is rarely seen in today’s health care business environment. We must redesign the health care delivery system---a team sport in service of patients, hold it accountable with measurement to improve outcomes, and quantify the resource costs over the full cycle of care. Value-based health care is a framework through which these goals are achieved, and Tierney provides a detailed playbook to get your organization there. Outlined in incredible detail and clarity, he presents core concepts and dives into the key metrics needed to build, maintain, and scale a successful value-based health care organization. Nathan shares a realistic vision of what any CEO should expect when developing their own Value Management Office. Nothing is more important to me than improving the lives of those I love. My personal mission is to create systemic change with an impact on the global stage. This playbook needs to be on the desk of every executive, clinician, and patient today." -Mahek Shah, MD, Senior Researcher and Senior Project Leader, Harvard Business School Our current healthcare system’s broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book ‘Redefining Health Care: Creating Value-Based Competition on Results.’ In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Professor Porter, accompanied by his esteemed Harvard colleague, Profesor Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. This book defines the practice of value-based health care as Value Management. The book explores Profesor Porter’s Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. The Value Realization Framework is based on Professor Kaplan's ground-breaking Balanced Scorecard approach, but specific to healthcare organizations. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations. This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.
Value in Healthcare
Author: Jonathan Hart
Publisher:
ISBN: 9780578805344
Category :
Languages : en
Pages : 224
Book Description
This book explores the differences between volume-based and value-based healthcare, offering a framework for value creation based on the principles of Population Health Management.
Publisher:
ISBN: 9780578805344
Category :
Languages : en
Pages : 224
Book Description
This book explores the differences between volume-based and value-based healthcare, offering a framework for value creation based on the principles of Population Health Management.
Redefining Health Care
Author: Michael E. Porter
Publisher: Harvard Business Press
ISBN: 1422133362
Category : Business & Economics
Languages : en
Pages : 540
Book Description
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.
Publisher: Harvard Business Press
ISBN: 1422133362
Category : Business & Economics
Languages : en
Pages : 540
Book Description
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.
Bringing Value to Healthcare
Author: Rita E. Numerof
Publisher: CRC Press
ISBN: 1498735150
Category : Business & Economics
Languages : en
Pages : 354
Book Description
In Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model, Rita Numerof and Michael Abrams lay out the roadmap to a healthcare system that is accountable for delivering optimal patient outcomes at a sustainable cost. This is the handbook for payer, provider, pharmaceutical, and medical device executives seeking to preserve today‘s profitability while positioning their organizations for success in the very different markets of tomorrow. The book‘s guidance is illuminated by case studies and each chapter concludes with a self-assessment tool and key questions.
Publisher: CRC Press
ISBN: 1498735150
Category : Business & Economics
Languages : en
Pages : 354
Book Description
In Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model, Rita Numerof and Michael Abrams lay out the roadmap to a healthcare system that is accountable for delivering optimal patient outcomes at a sustainable cost. This is the handbook for payer, provider, pharmaceutical, and medical device executives seeking to preserve today‘s profitability while positioning their organizations for success in the very different markets of tomorrow. The book‘s guidance is illuminated by case studies and each chapter concludes with a self-assessment tool and key questions.
Understanding Value Based Healthcare
Author: Vineet Arora
Publisher: McGraw Hill Professional
ISBN: 007181700X
Category : Medical
Languages : en
Pages : 417
Book Description
Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .
Publisher: McGraw Hill Professional
ISBN: 007181700X
Category : Medical
Languages : en
Pages : 417
Book Description
Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .
Value-Based Healthcare and Payment Models
Author: Grace E. Terrell
Publisher:
ISBN: 9780984831012
Category : Medical
Languages : en
Pages : 290
Book Description
NEW GUIDE DECODES VALUE-BASED CARE AND PAYMENT MODELS As value-based care is coming of age, deciding how to start can be an overwhelming task. Risks are high and success with the new models is challenging and time consuming. This book fills an important need by providing concrete and proven strategies to aid in an organization's successful transformation. The book is filled with practical, no-nonsense advice on the shift to value-based care in both the private and public healthcare sectors. This is the time when healthcare stakeholders need to rethink their own added-value strategies in a manner that best serves patients and providers alike. In the complicated world of payment and delivery system reform, this book deconstructs the most challenging concepts for the novice yet provides sophisticated insights for even the most seasoned executive. BONUS! The authors also lay out high-value strategies for 20 different subspecialties with specialty-specific changes in the way medicine is practiced and paid for.
Publisher:
ISBN: 9780984831012
Category : Medical
Languages : en
Pages : 290
Book Description
NEW GUIDE DECODES VALUE-BASED CARE AND PAYMENT MODELS As value-based care is coming of age, deciding how to start can be an overwhelming task. Risks are high and success with the new models is challenging and time consuming. This book fills an important need by providing concrete and proven strategies to aid in an organization's successful transformation. The book is filled with practical, no-nonsense advice on the shift to value-based care in both the private and public healthcare sectors. This is the time when healthcare stakeholders need to rethink their own added-value strategies in a manner that best serves patients and providers alike. In the complicated world of payment and delivery system reform, this book deconstructs the most challenging concepts for the novice yet provides sophisticated insights for even the most seasoned executive. BONUS! The authors also lay out high-value strategies for 20 different subspecialties with specialty-specific changes in the way medicine is practiced and paid for.
The Patient Centered Value System
Author: Anthony M. DiGioia
Publisher: Taylor & Francis
ISBN: 1351677640
Category : Business & Economics
Languages : en
Pages : 266
Book Description
Imagine: You are a hospital Chief Executive Officer, Chief Financial Officer, medical or nursing director, patient safety specialist, quality improvement professional, or a doctor or nurse on the front lines of patient care. Every day you’re aware that patients and families should be more engaged in their care so they would fare better both in the hospital and after discharge; their care could be safer and more seamlessly coordinated; patients should be ready for discharge sooner and readmitted less often; your bottom line stronger; your staff more fulfilled. You enter into new payment models such as bundling with an uneasy awareness that your organization is at risk because you don’t know what the care you deliver actually costs. Like most healthcare leaders, you are also still searching for a way to deliver care that will help you to achieve the Triple Aim: care that leads to improved clinical outcomes, better patient and family care experiences, and reduced costs. Sound familiar? If so, then it’s time to read The Patient Centered Value System: Transforming Healthcare through Co-Design. This book explains how to introduce the Patient Centered Value System in your organization to go from the current state to the ideal. The Patient Centered Value System is a three-part approach to co-designing improvements in healthcare delivery—collaborating with patients, families, and frontline providers to design the ideal state of care after listening to their wants and needs. Central to the Patient Centered Value System is seeing every care experience through the eyes of patients and families. The Patient Centered Value System is a process and performance improvement technique that consists of 1) Shadowing, 2) the Patient and Family Centered Care Methodology, and 3) Time-Driven Activity-Based Costing. Shadowing is the essential tool in the Patient Centered Value System that helps you to see every care experience from the point of view of patients and families and enables you to calculate the true costs of healthcare over the full cycle of care. Fundamental to the Patient Centered Value System is the building of teams to take you from the currents state of care delivery to the ideal. Healthcare transformation depends not on individual providers working to fix broken systems, but on teams of providers working together while breaking down silos. The results of using the Patient Centered Value System are patients and families who are actively engaged in their care, which also improves their outcomes; providers who see the care experience from the patient’s and family’s point of view and co-design care delivery as a result; the tight integration of clinical and financial performance; and the realization of the Triple Aim.
Publisher: Taylor & Francis
ISBN: 1351677640
Category : Business & Economics
Languages : en
Pages : 266
Book Description
Imagine: You are a hospital Chief Executive Officer, Chief Financial Officer, medical or nursing director, patient safety specialist, quality improvement professional, or a doctor or nurse on the front lines of patient care. Every day you’re aware that patients and families should be more engaged in their care so they would fare better both in the hospital and after discharge; their care could be safer and more seamlessly coordinated; patients should be ready for discharge sooner and readmitted less often; your bottom line stronger; your staff more fulfilled. You enter into new payment models such as bundling with an uneasy awareness that your organization is at risk because you don’t know what the care you deliver actually costs. Like most healthcare leaders, you are also still searching for a way to deliver care that will help you to achieve the Triple Aim: care that leads to improved clinical outcomes, better patient and family care experiences, and reduced costs. Sound familiar? If so, then it’s time to read The Patient Centered Value System: Transforming Healthcare through Co-Design. This book explains how to introduce the Patient Centered Value System in your organization to go from the current state to the ideal. The Patient Centered Value System is a three-part approach to co-designing improvements in healthcare delivery—collaborating with patients, families, and frontline providers to design the ideal state of care after listening to their wants and needs. Central to the Patient Centered Value System is seeing every care experience through the eyes of patients and families. The Patient Centered Value System is a process and performance improvement technique that consists of 1) Shadowing, 2) the Patient and Family Centered Care Methodology, and 3) Time-Driven Activity-Based Costing. Shadowing is the essential tool in the Patient Centered Value System that helps you to see every care experience from the point of view of patients and families and enables you to calculate the true costs of healthcare over the full cycle of care. Fundamental to the Patient Centered Value System is the building of teams to take you from the currents state of care delivery to the ideal. Healthcare transformation depends not on individual providers working to fix broken systems, but on teams of providers working together while breaking down silos. The results of using the Patient Centered Value System are patients and families who are actively engaged in their care, which also improves their outcomes; providers who see the care experience from the patient’s and family’s point of view and co-design care delivery as a result; the tight integration of clinical and financial performance; and the realization of the Triple Aim.
Value Stream Mapping for Healthcare Made Easy
Author: Cindy Jimmerson
Publisher: CRC Press
ISBN: 1441623906
Category : Business & Economics
Languages : en
Pages : 136
Book Description
In no industry is the concept of quality more essential than it is in healthcare, which is why the lean quality principles learned through the example of the Toyota Production System are so applicable. Two fundamental principles of Toyota‘s push for excellence are especially relevant to healthcare: ensuring quality at every step and keeping improve
Publisher: CRC Press
ISBN: 1441623906
Category : Business & Economics
Languages : en
Pages : 136
Book Description
In no industry is the concept of quality more essential than it is in healthcare, which is why the lean quality principles learned through the example of the Toyota Production System are so applicable. Two fundamental principles of Toyota‘s push for excellence are especially relevant to healthcare: ensuring quality at every step and keeping improve
Rewarding Provider Performance
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309102162
Category : Medical
Languages : en
Pages : 273
Book Description
The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.
Publisher: National Academies Press
ISBN: 0309102162
Category : Medical
Languages : en
Pages : 273
Book Description
The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.
Leading the Lean Healthcare Journey
Author: Joan Wellman
Publisher: CRC Press
ISBN: 1439828660
Category : Business & Economics
Languages : en
Pages : 296
Book Description
Every healthcare organization can learn from Seattle Children‘s continuous improvement process, but this book is not an operator‘s manual. Instead, it is a challenge to everyone concerned with healthcare to reexamine deeply held assumptions. While it is commonly believed that improved quality, access, and safety, and an improved bottom line are mut
Publisher: CRC Press
ISBN: 1439828660
Category : Business & Economics
Languages : en
Pages : 296
Book Description
Every healthcare organization can learn from Seattle Children‘s continuous improvement process, but this book is not an operator‘s manual. Instead, it is a challenge to everyone concerned with healthcare to reexamine deeply held assumptions. While it is commonly believed that improved quality, access, and safety, and an improved bottom line are mut