An Essential Guide to the Processes and Operational Complexities of the U.S. Healthcare System The U.S. Healthcare Ecosystem serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem will inspire you to think more critically about the business of healthcare and make informed assessments. Features: Includes often neglected topics impacting healthcare delivery such as employer-based health insurance, pharmacy benefits, healthcare consolidation, and biotechnology Highly readable and single-authored by a Wharton Professor who has taught health care delivery and management for over 20 years Filled to the brim with helpful diagrams, charts and tables - nearly 350 figures complement the text Every chapter ends with a helpful Summary and Questions to Ponder

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

The first wide-ranging analysis of business trends in the manufacturing segment of the health care industry.

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.

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. .

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.

Over the past decade, businesses have faced relentless change on multiple dimensions, and the list of the world’s largest companies has changed enormously. The keys to success are likely to be just as different for the new decade. Winning the ’20s analyzes the new competitive environment that businesses face and outlines what will it take to win in the 2020s. To stay ahead of the trends that are reshaping business, leaders need to rethink existing assumptions and retool their companies. Both traditional incumbents and younger digital giants will face very different but equally critical challenges in the 2020s—and would do well to learn from each other’s strengths. This book discusses the new dimensions of competition that will affect corporate strategy in the next decade and how leaders can reinvent their organizations to be better suited for the new environment. The companies that succeed in the 2020s will look very different than they do today—they will have evolved their businesses to harness new technologies and reshaped their external relationships, organizations, and approaches accordingly. Winning the ’20s will help business professionals as well as academics and students with an interest in strategy and leadership answer this critical question for the start of this decade: How should you prepare your company to avoid being left behind and emerge as a winner in a rapidly evolving business landscape?

This volume provides a comprehensive review of China's healthcare system and policy reforms in the context of the global economy. Following a value-chain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China's system. It also provides a detailed analysis of the historical development of China's healthcare system, the current state of its broad reforms, and the uneasy balance between China's market-driven approach and governmental regulation. Most importantly, it devotes considerable attention to the major problems confronting China, including chronic illness, public health, and long-term care and economic security for the elderly. Burns and Liu have assembled the latest research from leading health economists and political scientists, as well as senior public health officials and corporate executives, making this book an essential read for industry professionals, policymakers, researchers, and students studying comparative health systems across the world.

Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.