Value-Based Healthcare and Payment Models PDF Download

Author: Grace E. Terrell
Publisher:
ISBN: 9780984831012
Category : Medical
Languages : en
Pages : 290

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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.

Author: Vineet Arora
Publisher: McGraw Hill Professional
ISBN: 007181700X
Category : Medical
Languages : en
Pages : 417

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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. .

Author: Rita E. Numerof
Publisher: CRC Press
ISBN: 1498735150
Category : Business & Economics
Languages : en
Pages : 354

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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.

Author: Nathan William Tierney
Publisher: Taylor & Francis
ISBN: 1351591487
Category : Business & Economics
Languages : en
Pages : 379

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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.

Author: Jennifer Ternay
Publisher: Medical Group Management Association/Center for Research in Ambulatory Health Care Administration
ISBN: 9781568296692
Category : Medical
Languages : en
Pages : 266

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Book Description
"What does it mean to shift value-based payment models? Maybe you aren't sure where to start. How can you stay competitive amidst the changes in healthcare when resources are limited? While reading this book, you will dive deeply into the key challenges and opportunities of value-based care. We will explore how you can use your core values and strengths to transform your practice-driving away from maximizing volume with fee-for-service billing to reimbursement under incentive programs that are part of value-based payments. By answering critical questions such as where to start, what the finish line looks like, and what happens along the way you will gain the insight needed to deliver a better patient experience while improving health and lowering the cost of care. Learn to: Support your practice's transformation by understanding the leadership skills needed to succeed in value-based incentive programs; evaluate what already exists in your practice and what needs to change to succeed in demonstrating outcomes; determine key elements to assess when considering options for participating in programs with alternative payment models; examine how the organization of teams can deliver better patient experience and higher staff satisfaction; determine how to create a high-functioning team based on each person's strengths; analyze the behavioral traits of team members to maximize their potential and improve retention. Across the healthcare industry, the push is to deliver value rather than volume with value-based payment programs being the financing mechanism to drive change. This book is the perfect starting point to gather information about how to prepare for and maximize, your participation in value-based payment models. You will learn to create the foundation to evaluate value-based payment models and understand how your practice needs to be structured to succeed in value-based care and avoid penalties or exclusion from networks. Reading this book, you will gain insights from a managed care perspective and walk away with recommendations to implement in your practice"--

Author: Michael E. Porter
Publisher: Harvard Business Press
ISBN: 1422133362
Category : Business & Economics
Languages : en
Pages : 540

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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.

Author: Nola A. Schmidt
Publisher: Jones & Bartlett Learning
ISBN: 1284300617
Category : Medical
Languages : en
Pages : 673

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Book Description
Evidence-Based Practice for Nurses: Appraisal and Application of Research continues to be an essential resource for teaching students how to translate research into practice in an updated sixth edition. Built upon the foundation of the five step IDP process (knowledge, persuasion, decision, implementation, and confirmation), this comprehensive resource guides students through the hierarchy of evidence while interweaving concepts such as the evolution of nursing science, quality improvement projects and how they relate to evidence-based practice, as well as search strategies and how to choose a specific research design. Both students and instructors alike praise the organization and presentation of content from authors, Schmidt and Brown. They divided chapters into ‘bites', breaking down larger core concepts into smaller, easily digestible parts of the whole, ensuring nursing students grasp a key concept before progressing to the next.

Author: Thom Walsh
Publisher: Medical Group Management Association/Center for Research in Ambulatory Health Care Administration
ISBN: 9781568296715
Category : Medical
Languages : en
Pages : 186

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Book Description
"How can an administrative team build a value-based outcome? While it is true that you can't improve what you don't measure, it is also true that you can't act on measurements you don't understand. Every healthcare system, form a single provider office up to a national chain, has to bridge administrative and clinical workflows to create better outcomes for the patient. Learn to rebuild an organization with tools already extant in the practice environment to listen to the patient and create a system to empower patients and staff alike. Create an environment where outcomes are: measured in a meaningful way, evaluated based on both the patient and the practice's needs, and acted upon to strengthen both the practice's community and bottom line. Dr. Walsh utilizes extensive clinical, business, and academic experience to demonstrate a proven methodology to identify and measure what matters most to patients. Learn to: capture the data the matters to the patients, create data governance and oversight structures, employ new cost-allocation techniques, evaluate the effectiveness of varied transformation techniques, implement shared decision making, and improve the patient experience with all levels of the practice. Gain a detailed roadmap to identifying actionable and effective improvement activities and strategies perfect for your organization"--

Author: Dianne V. Jewell
Publisher: Jones & Bartlett Learning
ISBN: 1284284824
Category : Medical
Languages : en
Pages : 434

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Book Description
Guide to Evidence-Based Physical Therapist Practice, Fifth Edition teaches the knowledge and skills to evaluate medical evidence and apply it to the practice of physical therapy. This valuable reference explains the fundamentals of medical research and how to determine which studies are useful in practice. As the leading evidence-based practice text for physical therapy, this is a comprehensive resource no physical therapist or student should be without. This practical guide empowers readers to learn how to evaluate research designs, appraise evidence, and apply research in clinical practice. Its reader-friendly style facilitates learning and presents the knowledge essential for physical therapist students to develop a strong foundation in research methods and methodologies related to evidence-based medicine.

Author: Thom Walsh
Publisher:
ISBN: 9781568296722
Category :
Languages : en
Pages :

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Book Description
"How can an administrative team build a value-based outcome? While it is true that you can't improve what you don't measure, it is also true that you can't act on measurements you don't understand. Every healthcare system, form a single provider office up to a national chain, has to bridge administrative and clinical workflows to create better outcomes for the patient. Learn to rebuild an organization with tools already extant in the practice environment to listen to the patient and create a system to empower patients and staff alike. Create an environment where outcomes are: measured in a meaningful way, evaluated based on both the patient and the practice's needs, and acted upon to strengthen both the practice's community and bottom line. Dr. Walsh utilizes extensive clinical, business, and academic experience to demonstrate a proven methodology to identify and measure what matters most to patients. Learn to: capture the data the matters to the patients, create data governance and oversight structures, employ new cost-allocation techniques, evaluate the effectiveness of varied transformation techniques, implement shared decision making, and improve the patient experience with all levels of the practice. Gain a detailed roadmap to identifying actionable and effective improvement activities and strategies perfect for your organization"--