The Fragmentation of U.S. Health Care

Causes and Solutions

Author: Einer Elhauge

Publisher: Oxford University Press on Demand

ISBN: 019539013X

Category: Law

Page: 388

View: 1838

Why is the American health care system so fragmented in the care it gives patients? This title approaches this question and more with a highly interdisciplinary approach. The articles included in the work address legal and regulatory issues, including laws that mandate separate payments for each provider.

The Future of Healthcare Reform in the United States

Author: Anup Malani,Michael H. Schill

Publisher: University of Chicago Press

ISBN: 022625495X

Category: Law

Page: 358

View: 8188

When the Supreme Court's majority ruling in NFIB v. Sebelius upheld the Patient Protection and Affordable Care Act (the PPACA, or Obamacare), it was clear that this major shift in American health care provision was here to stay. For better or worse, the PPACA is now both a target for, and a constraint on, the next wave of reformist ideas. Driven by curiosity about how the American health care regime will continue to evolve in the near and medium term, Dean Michael Schill and Professor Anup Malani of the University of Chicago Law School commissioned fourteen essays from leading scholars of law, economics, medicine, and public health that offer predictions for the most important issues and debates in health-care reform over the next five to seven years. Essays are arranged in five sections. Part I, ACA and the Law, sets the stage with three essays on legal challenges and justifications for the Act. Part II, ACA and the Federal Budget, explores the variety of potential fiscal consequences resulting from Obamacare. Part III, ACA and Health Care Delivery, offers competing viewpoints on what the Act will ultimately mean for consumers of health care. Part IV, Health Care Costs, Innovation, and the ACA speculates about what the altered financial structure of health care will mean for the pace of development of new medical technologies. Part V, ACA and Health Insurance Markets, concludes the volume with a pair of contrasting assessments of the prospects for the new insurance exchange” markets.

Organizational fragmentation and care quality in the U.S. health care system

Author: Randall D. Cebul,National Bureau of Economic Research

Publisher: N.A

ISBN: N.A

Category: Medical

Page: 34

View: 5155

Many goods and services can be readily provided through a series of unconnected transactions, but in health care close coordination over time and within care episodes improves both health outcomes and efficiency. Close coordination is problematic in the US health care system because the financing and delivery of care is distributed across a variety of distinct and often competing entities, each with its own objectives, obligations and capabilities. These fragmented organizational structures lead to disrupted relationships, poor information flows, and misaligned incentives that combine to degrade care quality and increase costs. We illustrate our argument with examples taken from the insurance and the hospital industries, and discuss possible responses to the problems resulting from organizational fragmentation.

The Privatization of Health Care Reform

Legal and Regulatory Perspectives

Author: M. Gregg Bloche

Publisher: Oxford University Press

ISBN: 0199770026

Category: Medical

Page: 248

View: 1452

Markets, not politics, are driving health care reform in America today. Inventive entrepreneurs have transformed medicine over the past ten years, and no end to this period of rapid change is in sight. Consumer anxieties over managed care are mounting, and medical costs are again soaring. Meanwhile, the federal government remains mostly on the health policy sidelines, as it has since the collapse of the Clinton administration's campaign for health care reform. This book addresses the changes that the market has wrought- and the challenges this transformation poses for courts and regulators. The law that governs the medical marketplace is an incomplete, overlapping patchwork, conceived mainly without medical care specifically in mind. The ensuing confusion and incoherence are a central theme of this book. Fragmentation of health care lawmaking has foreclosed coordinated, system-wide policy responses, and lack of national consensus on many of the central questions in health care policy has translated into legal contradiction and bitter controversy. Written by leading commentators on American health law and policy, this book examines the widely-perceived failings of managed care and the law's relationship to them. Some of the contributors treat law as a cause of trouble; others emphasize the law's potential and limits as a corrective tool when the market disappoints. The first two chapters present contrasting overviews of how the doctrines and decision-makers that constitute health law work together, for better or worse, to constrain the medical marketplace. The next six chapters address particular market developments and regulatory dilemmas. These include the power of state versus federal government in the health sphere, conflict between insureres and patients and providers over medical need, financial rewards to physicians for frugal practice, the role of antitrust law in the organization of health care provision and financing, the future of public hospitals, and the place of investor-owned versus non-profit institutions. Acknowledging the health sphere's complexities, the authors seek remedies that fit this country's legal, political, and cultural constraints and can contribute to reasoned regulatory goverance. Within limits they believe a measure of rationality is possible.

Social Movements and the Transformation of American Health Care

Author: Jane C. Banaszak-Holl,Sandra R. Levitsky,Mayer N. Zald

Publisher: Oxford University Press

ISBN: 9780199742141

Category: Social Science

Page: 400

View: 7357

Few contemporary social problems in the U.S. affect more people daily than those within the American health care system. Social Movements and the Transformation of American Health Care is the first collection of essays to examine dynamics of change in health care institutions through the lens of contemporary theory and research on collective action. Gathering scholars from medicine, health policy, history, sociology, and political science, the book considers health-related social movements from four distinct levels, concentrating on movements seeking changes in the regulation, financing, and distribution of health resources; changes in institutions in public health, bio-ethics, and other fields; interactions between social movements and professions; and the cultural dominance of the medical model, and the difficulties for framing and legitimizing new issues in health care it poses. At a time when American health care is long overdue for major changes, this book takes an essential look at movements, policies, and institutions to identify the common constraints and opportunities for reform within the health care system.

The Oxford Handbook of U.S. Health Law

Author: I. Glenn Cohen,Allison Hoffman,William M. Sage

Publisher: Oxford University Press

ISBN: 0199366535

Category: Law

Page: 992

View: 3984

The Oxford Handbook of U.S. Health Law covers the breadth and depth of health law, with contributions from the most eminent scholars in the field. The Handbook paints with broad thematic strokes the major features of American healthcare law and policy, its recent reforms including the Affordable Care Act, its relationship to medical ethics and constitutional principles, and how it compares to the experience of other countries. It explores the legal framework for the patient experience, from access through treatment, to recourse (if treatment fails), and examines emerging issues involving healthcare information, the changing nature of healthcare regulation, immigration, globalization, aging, and the social determinants of health. This Handbook provides valuable content, accessible to readers new to the subject, as well as to those who write, teach, practice, or make policy in health law.

Health Care in America

A History

Author: John C. Burnham

Publisher: JHU Press

ISBN: 1421416093

Category: Medical

Page: 616

View: 5704

In Health Care in America, historian John C. Burnham describes changes over four centuries of medicine and public health in America. Beginning with seventeenth-century concerns over personal and neighborhood illnesses, Burnham concludes with the arrival of a new epoch in American medicine and health care at the turn of the twenty-first century. From the 1600s through the 1990s, Americans turned to a variety of healers, practices, and institutions in their efforts to prevent and survive epidemics of smallpox, yellow fever, cholera, influenza, polio, and AIDS. Health care workers in all periods attended births and deaths and cared for people who had injuries, disabilities, and chronic diseases. Drawing on primary sources, classic scholarship, and a vast body of recent literature in the history of medicine and public health, Burnham finds that traditional healing, care, and medicine dominated the United States until the late nineteenth century, when antiseptic/aseptic surgery and germ theory initiated an intellectual, social, and technical transformation. He divides the age of modern medicine into several eras: physiological medicine (1910s–1930s), antibiotics (1930s–1950s), technology (1950s–1960s), environmental medicine (1970s–1980s), and, beginning around 1990, genetic medicine. The cumulating developments in each era led to today’s radically altered doctor-patient relationship and the insistent questions that swirl around the financial cost of health care. Burnham’s sweeping narrative makes sense of medical practice, medical research, and human frailties and foibles, opening the door to a new understanding of our current concerns. -- Gerald N. Grob, Rutgers, The State University of New Jersey, author of Aging Bones: A Short History of Osteoporosis

The Oxford Handbook of U.S. Social Policy

Author: Daniel Beland,Christopher Howard,Kimberly J. Morgan

Publisher: Oxford University Press

ISBN: 0199838518

Category: Political Science

Page: 688

View: 1435

The American welfare state has long been a source of political contention and academic debate. This Oxford Handbook pulls together much of our current knowledge about the origins, development, functions, and challenges of American social policy. After the Introduction, the first substantive part of the handbook offers an historical overview of U.S. social policy from the colonial era to the present. This is followed by a set of chapters on different theoretical perspectives available for understanding and explaining the development of U.S. social policy. The three following parts of the volume focus on concrete social programs for the elderly, the poor and near-poor, the disabled, and workers and families. Policy areas covered include health care, pensions, food assistance, housing, unemployment benefits, disability benefits, workers' compensation, family support, and programs for soldiers and veterans. The final part of the book focuses on some of the consequences of the U.S. welfare state for poverty, inequality, and citizenship. Many of the chapters comprising this handbook emphasize the disjointed patterns of policy making inherent to U.S. policymaking and the public-private mix of social provision in which the government helps certain groups of citizens directly (e.g., social insurance) or indirectly (e.g., tax expenditures, regulations). The contributing authors are experts from political science, sociology, history, economics, and other social sciences.

An Introduction to the US Health Care System

Sixth Edition

Author: Steven Jonas, MD,MPH, FACPM,Raymond L. Goldsteen, DrPH,Karen Goldsteen, PhD, MPH

Publisher: Springer Publishing Company

ISBN: 9780826103154

Category: Medical

Page: 328

View: 9718

Completely expanded and updated to account for the latest changes in the U.S. health care system, this best-selling text remains the most concise and balanced introduction to the domestic health care system. Like its predecessors, it provides an accessible overview of the basic components of the system: healthcare personnel, hospitals and other institutions, the federal government, financing and payment mechanisms, and managed care. Finally, it provides an insightful look at the prospects for health care reform. Steven Jonas, a revered expert in public health, has enlisted his colleagues, Drs. Raymond and Karen Goldsteen, to add their expertise in public health and health policy and management to this outstanding volume. All students of health care administration and policy, as well as practicing healthcare professionals who simply want a relatively brief overview of the system, will find it useful.

The Demography of Health and Health Care

Author: Louis G. Pol,Richard K. Thomas

Publisher: Springer Science & Business Media

ISBN: 1461580129

Category: Political Science

Page: 376

View: 7091

The 1980s witnessed the emergence of an applied subdiscipline within de mography that is coming to be termed health demography. As yet there is no distinct body of research formally categorized under this heading, nor are there professionals who bear the title of health demographer. In fact, most of those involved with health demography are not demographers but sociologists, economists, epidemiologists, and others who are applying concepts and tech niques from demography to concrete problems in the delivery of health care. Nevertheless, the vague boundaries of this subdiscipline are becoming in creasingly visible, and the 1990s promise to be the era of health demography. Many factors have contributed to the emergence of this new field. The transition the health care industry underwent during the 1980s served to modify dramatically the mindset of those in health care from one based on a philanthropic orientation to a highly competitive business orientation. Al most overnight the industry became market driven and consumer oriented, resulting in an explosion in the demand for both demographic data and health statistics. The need to integrate and interpret data from these two fields has provided a major impetus for the development of health demography. At the same time, the redefining of health and illness along lines more in keeping with a social than a clinical perspective, and the reconceptualization of etiology within a lifestyles framework, have further emphasized the need for health demography.

Die Geburt der Klinik

eine Archäologie des ärztlichen Blicks

Author: Michel Foucault

Publisher: N.A

ISBN: 9783596274000

Category: Hospitals

Page: 218

View: 6113

Philosophische Abhandlung Michel Foucaults über die Macht und Hierarchie in staatlichen Institutionen sowie deren Auswirkung auf die Personen, die sich in diesen Institutionen aufhalten.

Partners in Health

How Physicians and Hospitals can be Accountable Together

Author: Kaiser Permanente Institute for Health Policy

Publisher: John Wiley & Sons

ISBN: 0470626593

Category: Medical

Page: 272

View: 794

Praise for Partners in Health "The combination of visionary leadership, knowledge, and superb timing makes this book a winner. Health care is evolving toward collaboration and integration, and this book is essential reading for anyone wishing to change the relationships between hospitals and physicians." —Donald W. Fisher, PhD, president and CEO, the American Medical Group Association "This book is a must-read for anyone committed to a high-performance health system. It spells out the practical steps that will move us toward an accessible, coordinated, patient-centered system of care. Its recommendations for payment and regulatory reform underscore the urgency of comprehensive health reform if the current misaligned incentives are to be changed to support those on the frontlines in providing the best care with prudent stewardship of resources." —Karen Davis, PhD, president, The Commonwealth Fund "Closer physician-hospital integration would lead to higher quality care at lower cost. Partners in Health is a masterful guide to past integration efforts, current models of success, and thoughtful recommendations for future progress." —Victor R. Fuchs, PhD, Henry J. Kaiser Jr. Professor Emeritus, Stanford University "The working relationship of hospitals and physicians must be restructured for the United States to achieve more efficient, accountable care. But addressing our urgent challenges can't wait for all hospitals and physicians to join highly structured systems. Thankfully, the authors offer steps that all the major stakeholders can take today to spur new models and start the flywheel of trust spinning at new speeds." —Richard Umbdenstock, president and CEO of the American Hospital Association "Transitioning U.S. health care from fragmentation to integration, in the context of a more rational payment system, is sure to be a long and tortuous journey. Partners in Health is a kind of Fodor's Guide to the voyage. No one committed to health reform should travel without it." —Susan Dentzer, editor-in-chief, Health Affairs

Quality Caring in Nursing and Health Systems

Implications for Clinicians, Educators, and Leaders, 2nd Edition

Author: Joanne R. Duffy, PhD, RN, FAAN

Publisher: Springer Publishing Company

ISBN: 0826110150

Category: Medical

Page: 328

View: 1331

First Edition named an AJN Book of the Year! ìJoanne Duffy makes a compelling argument in this book that relationships have been marginalized and no longer serve as the central organizing principle of health servicesÖThis book resonates with a virtual groundswell of findings regarding the importance of relationships for organizational performance and for human wellbeing.î -Jody Hoffer Gittell Professor of Management, Brandeis University This edition stresses the proven need for a return to the patient-centered care neglected through our health systemís emphasis on procedures, protocols, diagnostic testing, technology, and costs. It addresses the significant challenges to quality care posed by the upcoming changes in our health care system, and focuses on health systems, the role of nursing within them, and the interprofessional health team as the key to change ensuring high quality care. The book responds to the Patient Protection and Affordable Care Actís focus on accountable care organizations, the recent IOMís Future of Nursing Report, the call for radical transformation of nursing education, and current evidence on patient safety and quality of care. This text explores the Quality-Caring Model©, which honors nursingís most deeply felt value, and can be applied to clinical, educational, and leadership practice to advance our nationís health system. Among the bookís strengths are its translation of theoretical knowledge to practical applications that can be used for clinical interventions and resolution of professional issues. Chapters include key terms, case studies along with practical exercises and references, and ìCalls to Actionî offering inspiration and guidance for implementing change. New to the Second Edition: Focuses on current challenges to quality care posed by upcoming changes to our health system Addresses health systems, the interprofessional health team, and the role of nursing within them Combines theoretical foundations for practice with clinical, leadership, and educational applications Examines the powerful role of relationships in promoting nursing excellence, improving patient satisfaction, and patient outcomes Serves as a key guide for graduate nurse educators and students, nurse leaders, and hospital leadership seeking Magnet certification Incorporates recommendations of the Affordable Care Actís focus on accountable care organizations, the IOMís Future of Nursing Report, educational transformation, and current research on safety and quality of care

Healthcare Delivery in the U.S.A.

An Introduction, Second Edition

Author: Margaret F. Schulte

Publisher: CRC Press

ISBN: 1439877939

Category: Business & Economics

Page: 239

View: 5013

With the same clarity that made the previous edition a bestseller, Healthcare Delivery in the U.S.A.: An Introduction, Second Edition provides readers with the understanding required to navigate the healthcare provider field. Brilliantly simple, yet comprehensive, this updated edition explains how recent health care reform will impact hospitals and health systems. It includes updated case studies and describes the new organizational structures being driven by current market conditions. Focusing on healthcare management, the book addresses the range of topics critical to understanding the U.S. healthcare system, including the quality of care movement, recent finance reform, and the recent increase in merger and acquisition activity. Dr. Schulte walks readers through the history of the development of U.S. healthcare delivery. She describes the various venues of care delivery as well as the different elements of the financing system. Offering a glimpse into the global market and medical tourism, the text includes coverage of legal and regulatory issues, workforce, and the drivers and barriers that are shaping healthcare delivery around the world. Painting a clear and up-to-date picture, this quick-and-easy read provides you with the understanding of the terminology, structures, roles, relationships, and nuances needed to interact effectively and efficiently with anyone in the healthcare provider field.

Health Care Reform and Gastroenterology, An Issue of Gastrointestinal Endoscopy Clinics - E-Book

Author: John I. Allen,Mark DeLegge

Publisher: Elsevier Health Sciences

ISBN: 1455742813

Category: Medical

Page: 167

View: 2675

As the National Quality Advisor and Chair of the AGAI Clinical Practice and Quality Management Committee, Dr. Allen, along with Dr. Delegge, have created a very insightful list of topics to educate gastroenterologists about how to adapt to health care reform. The issue addresses the impact in both private practices and academic medical centers. Specific issues discussed include Gastroenterologists and Accountable Care Organizations; Health Information Technology and the Gastroenterologist; Transitioning from Fellowship to Practice 2012; Going Big in Private Practice; Clinical Service Line Management; The Impact of Health Reform on GI Reimbursement; The Impact of Health Care Reform on Innovation and New Technology; Industry and Gastroenterology: A New World; and Demonstrating Value: Registries and Beyond.

Progress in Standardization in Health Care Informatics

Author: Georges J. E. De Moor

Publisher: IOS Press

ISBN: 9789051991147

Category: Medical

Page: 215

View: 9225

In Europe, standardization activities in healthcare informatics officially started in the 90s. The papers featured in this publication were presented at a conference which presented the current standing of important activities connected with healthcare informatics/telematics standards and to explore the ways of ensuring international coordination and cooperation worldwide. The publications shows interest from communities from Europe, United States, Australia and Japan. This guarantees the elaboration of high quality implementable healthcare informatics standards, which play an important role in the achievement of better healthcare to the benefit of the patient.

Practical Predictive Analytics and Decisioning Systems for Medicine

Informatics Accuracy and Cost-Effectiveness for Healthcare Administration and Delivery Including Medical Research

Author: Linda Miner,Pat Bolding,Joseph Hilbe,Mitchell Goldstein,Thomas Hill,Robert Nisbet,Nephi Walton,Gary Miner

Publisher: Academic Press

ISBN: 012411640X

Category: Computers

Page: 1110

View: 4878

With the advent of electronic medical records years ago and the increasing capabilities of computers, our healthcare systems are sitting on growing mountains of data. Not only does the data grow from patient volume but the type of data we store is also growing exponentially. Practical Predictive Analytics and Decisioning Systems for Medicine provides research tools to analyze these large amounts of data and addresses some of the most pressing issues and challenges where data integrity is compromised: patient safety, patient communication, and patient information. Through the use of predictive analytic models and applications, this book is an invaluable resource to predict more accurate outcomes to help improve quality care in the healthcare and medical industries in the most cost–efficient manner. Practical Predictive Analytics and Decisioning Systems for Medicine provides the basics of predictive analytics for those new to the area and focuses on general philosophy and activities in the healthcare and medical system. It explains why predictive models are important, and how they can be applied to the predictive analysis process in order to solve real industry problems. Researchers need this valuable resource to improve data analysis skills and make more accurate and cost-effective decisions. Includes models and applications of predictive analytics why they are important and how they can be used in healthcare and medical research Provides real world step-by-step tutorials to help beginners understand how the predictive analytic processes works and to successfully do the computations Demonstrates methods to help sort through data to make better observations and allow you to make better predictions

Managing Managed Care

Quality Improvement in Behavioral Health

Author: Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care

Publisher: National Academies Press

ISBN: 9780309175050

Category: Medical

Page: 396

View: 1085

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral health--federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

Controversial Issues in Health Care Policy

Author: Jennie Jacobs Kronenfeld

Publisher: SAGE Publications

ISBN: 1452246319

Category: Political Science

Page: 200

View: 6122

In the last 35 years, health care in the US has grown into a multi-billion dollar industry. Americans view access to health care as important and take pride in their excellent medical care technology. However, there is growing consensus that the US health care system is in crisis - but there is far less agreement on what to do about it. This book examines the major controversies confronting American society, health care professionals and policy makers: access to health care, costs and financing health care and the quality of health care. Kronenfeld discusses whether the system can solve these problems or whether there is a health care system at all.