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x | |
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xii | |
| Preface |
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xiii | |
| Introduction |
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1 | (2) |
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The Failure of Competition |
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3 | (1) |
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4 | (2) |
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6 | (3) |
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The Structure of This Book |
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9 | (4) |
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How Will Redefining Health Care Occur? |
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13 | (4) |
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17 | (16) |
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Identifying the Root Causes |
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33 | (38) |
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Positive-Sum Competition on Value |
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33 | (1) |
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Zero-Sum Competition in Health Care |
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34 | (10) |
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The Root Cause: Competition at the Wrong Level |
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44 | (2) |
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Why Is Health Care Competition at the Wrong Level? |
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46 | (25) |
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71 | (26) |
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The Rise of Group Health Insurance |
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71 | (3) |
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Limiting Payments to Physicians and to Hospitals |
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74 | (2) |
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76 | (2) |
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78 | (1) |
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79 | (2) |
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81 | (2) |
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Consumer-Driven Health Care |
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83 | (1) |
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Quality and Pay for Performance |
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84 | (4) |
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88 | (2) |
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Medical or Health Savings Accounts |
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90 | (3) |
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93 | (2) |
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Reforming Competition: The Only Answer |
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95 | (2) |
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Principles of Value-Based Competition |
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97 | (52) |
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Focus on Value, Not Just Costs |
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98 | (3) |
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Competition Is Based on Results |
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101 | (4) |
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Competition Is Centered on Medical Conditions over the Full Cycle of Care |
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105 | (2) |
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High-Quality Care Should Be Less Costly |
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107 | (4) |
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Value Is Driven by Provider Experience, Scale, and Learning in Medical Conditions |
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111 | (6) |
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Competition Is Regional or National |
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117 | (5) |
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Results Information Is Widely Available |
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122 | (18) |
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Innovations That Increase Value Are Strongly Rewarded |
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140 | (7) |
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The Opportunity of Value-Based Competition |
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147 | (2) |
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Strategic Implications for Health Care Providers |
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149 | (80) |
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The Strategy Vacuum in Health Care Delivery |
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150 | (5) |
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Defining the Right Goal: Superior Patient Value |
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155 | (2) |
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Moving to Value-Based Competition: Imperatives for Providers |
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157 | (43) |
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How Would Industry Structure in Health Care Delivery Change? |
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200 | (2) |
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Enabling the Transformation |
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202 | (16) |
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Overcoming Barriers to Value-Based Competition |
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218 | (9) |
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The Benefits of Moving Early |
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227 | (2) |
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Strategic Implications for Health Plans |
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229 | (54) |
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Past and Future Roles of Health Plans |
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230 | (9) |
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Moving to Value-Based Competition: Imperatives for Health Plans |
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239 | (36) |
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Overcoming Barriers to Health Plan Transformation |
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275 | (6) |
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The Benefits of Moving Early |
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281 | (2) |
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Implications for Suppliers, Consumers, and Employers |
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283 | (40) |
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Implications for Suppliers |
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284 | (11) |
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Implications for Consumers as Subscribers and Patients |
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295 | (9) |
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Implications for Employers |
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304 | (19) |
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Health Care Policy and Value-Based Competition |
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323 | (58) |
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Implications for Government |
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Broad Issues in Health Care Policy |
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327 | (2) |
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Moving to Value-Based Competition: Improving Health Insurance and Access |
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329 | (9) |
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Moving to Value-Based Competition: Setting Standards for Coverage |
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338 | (3) |
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Moving to Value-Based Competition: Improving the Structure of Health Care Delivery |
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341 | (33) |
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Implications for Health Care Policy in Other Nations |
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374 | (7) |
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381 | (6) |
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Appendix A: Making Results Public |
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387 | (10) |
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Appendix B: The Care Delivery Value Chain |
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397 | (16) |
| Notes |
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413 | (32) |
| Bibliography |
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445 | (44) |
| Index |
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489 | (18) |
| About the Authors |
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507 | |