Consumer-Driven Health Care: Implications for Providers, Payers, and Policy-Makers / Edition 1

Consumer-Driven Health Care: Implications for Providers, Payers, and Policy-Makers / Edition 1

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by Regina E. Herzlinger
     
 

Increased consumer control of health care is shaking up the medical and insurance systems. In Consumer-Driven Health Care, Harvard Business School’s acclaimed professor Regina E. Herzlinger states that hospitals, doctors, benefits administrators, accountants, government policymakers, and insurers had better adapt or else they will be replaced.

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Overview

Increased consumer control of health care is shaking up the medical and insurance systems. In Consumer-Driven Health Care, Harvard Business School’s acclaimed professor Regina E. Herzlinger states that hospitals, doctors, benefits administrators, accountants, government policymakers, and insurers had better adapt or else they will be replaced.

Professor Herzlinger documents how the consumer-driven health care movement is being implemented and its impact on insurers, providers, new intermediaries, and governments. With additional contributions by health care’s leading strategists, innovators, regulators and scholars, Consumer-Driven Health Care presents a compelling vision of a health care system built to satisfy the people it serves.

"Professor Herzlinger provides a compelling argument for consumer-driven health care. The health care system has been marked for decades with rising costs and consumer dissatisfaction. Professor Herzlinger challenges the reader to look beyond solutions that are based on what consumers should want to solutions that give consumers what they want."
–Barbara Bigelow, Ph.D., Co-Editor, Health Care Management Review, Professor of Management, Clark University Graduate School of Management

"Regina Herzlinger has a formidable reputation as an expert on reforming health care. There are lessons here for all of us who care about reforming our health systems to make them better."
–David Willets, MP, Shadow Work and Pensions Secretary and Member of Parliament , UK

"This book is a must-read for anyone who wants to know why the American model of health insurance benefits that has been around for about 50 years is all washed up, and what is most likely to replace it."
–Roger Feldman, Blue Cross Professor of Health Insurance, University of Minnesota

"Professor Herzlinger can persuade corporate CEOs, Washington policymakers, benefits administrators, and hospital executives to reshape their strategy based on a market run by consumers. This book translates health economics into simple English, reducing the "mystery-inside-a-conundrum" field into everyday transactions like selecting a health plan that any health care consumer can recognize. Consumer-Driven Health Care will be a top candidate for health care’s 'book of the year.' "
–Russell C. Coile, Jr., consultant, editor, Russ Coile’s Health Trends, and author, Competing On Excellence (2003)

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Product Details

ISBN-13:
9780787952587
Publisher:
Wiley
Publication date:
04/28/2004
Edition description:
New Edition
Pages:
928
Product dimensions:
7.24(w) x 9.46(h) x 2.47(d)

Table of Contents

Preface.

Introduction.

PART ONE: WHY WE NEED CONSUMER-DRIVEN HEALTH CARE.

1. Fear and Loathing of Defined Benefit Health Insurance.

2. The Frayed Safety Net.

3. The Solution.

4. Consumer-Driven Health Insurance: What Works.

5. Health Care Productivity.

6. The Silent Revolution.

7. Scare Stories, Opponents, and the Role of Government.

8. How to Make Consumer-Driven Health Care Happen.

PART TWO: VISION AND MODELS.

9. The Future of Twenty-First Century Health (William W.George).

10. How Employers Can Make Consumer-Driven Health Care a Reality(Brian J. Marcotte).

11. Designing Health Insurance for the Information Age (John C.Goodman).

12. Risk Adjustment: An Overview and Three Case Studies (Lisa I.Iezzoni).

13. Consumer-Driven Health Care: Dialogues with Socrates(Stephen S. Hyde).

14. Employee Tax Payments and Consumer-Driven Health Care(Jeanne A. Brown).

15. The Implications of Tax Rulings on “SavingsAccounts” (Charles H. Klippel).

16. You Just Can’t Pay Tom, Juan, and Ashley the Old WayAnymore (Bonnie B. Whyte).

17. The Federal Employees Health Benefits Program (James W.Morrison Jr.).

18. Health-Based Premium Payments and Consumer AssessmentInformation (Vicki M. Wilson, Jenny M. Hamilton, Mary K. Uyeda,Cynthia A. Smith, with Graydon M. Clouse).

19. The Buyers Health Care Action Group: Creating Incentives toSeek the Sick (Ann L. Robinow).

20. An Insurance CEO’s Perspective on Consumer-DrivenHealth Care (Leonard D. Schaeffer).

21. An Alternative to Managed Care: A European Perspective onInformed Choice (Bruno L. Holthof).

22. Medical Savings Accounts and Health Care Financing in SouthAfrica (Shaun Matisonn).

23. European Health Care: The Cost of Solidarity and the Promiseof Risk-Adjusted Consumer-Driven Health Care (Paul Belien).

24. Consumer-Driven Health Care: An International View (AlvaroSalas-Chaves).

25. Challenges of Consumer-Driven Health Care (Eugene D. HillIII).

26. Making the Transition to Consumer-Driven Health Care (JesseS. Hixson).

27. The New Consumer-Driven Health Care System (Daniel H.Johnson).

28. The Patient’s Right to Decide (Warner V. Slack).

29. Comments on Consumer-Driven Health Care (Corbette S.Doyle).

30. The Evolution of Consumer-Driven Health Care (Robert W.Coburn).

31. Will Consumer-Driven Health Care Work for Employers? (JohnC. Erb).

32. The Perspective of an Advocate for the Elderly (JohnRother).

PART THREE: THE NEW INTERMEDIARIES.

33. Where Will Consumer-Driven Health Care Take the Health CareSystem? (Bernard T. Ferrari).

34. The Role of Information: J. D. Power’s ParadigmLessons from the Automotive Industry (J. D. Power III).

35. Providing Information to Consumers (David Lansky).

36. Consumer-Driven Health Care and the Internet (Mark A.Pearl).

37. The Present and Future Roles of Information in aConsumer-Driven Health System (Russell Ricci).

38. Who Has Star Quality? (Jon A. Chilingerian).

39. Grounding Consumer-Driven Health Care in Social ScienceResearch (Arnold Milstein, Nancy E. Adler).

40. Providing the Most-Wanted Information When Most Needed: BestDoctors (Steven W. Naifeh, Gregory White Smith).

41. The Half-Billion Dollar Impact of Information About Quality(Becky J. Cherney).

42. Buyers Health Care Action Group: Consumer Perceptions ofQuality Differences (Katherine M. Harris, Roger Feldman, JenniferS. Schultz, Jon Christianson).

43. Helping Consumers Choose Among Complex Insurance Plans(Colleen M. Murphy).

44. CareCounsel: Consumer-Driven Health Care Advocacy (LawrenceN. Gelb).

45. Access Health Group: A Medical Management Perspective(Joseph P. Tallman).

46. Consumer’s Medical Resource: Helping ConsumersEvaluate Medical Treatment Options (David J. Hines).

47. The Cost Effectiveness of Consumer-Driven Lifestyle Changesin the Treatment of Cardiac Disease (Dean Ornish).

48. Healthtrac: Proven Reduction of the Need and Demand forMedical Services (James F. Fries).

49. The Healthwise® Approach: Reinventing the Patient(Donald W. Kemper, Molly Mettler).

PART FOUR: INNOVATIVE CONSUMER-DRIVEN SOLUTIONS TO CHRONICPROBLEMS.

50. The Role of Providers (Michael L. Millenson).

51. A Disease Management Approach to Chronic Illness (Jessie C.Gruman, Cynthia M. Gibson).

52. Consumer-Driven Health Care: Management Matters (Richard M.J. Bohmer, Amy C. Edmondson, Gary P. Pisano).

53. Consumer-Driven Health Care for the Chronically Ill (AlLewis).

54. A Cost-Effective Model for High-Quality Catastrophic Care(Bernard Salick, Seth M. Yellin).

55 Collaborating with Consumers to Advance Health Knowledge andImprove Practice (S. Robert Levine, Laura L. Adams).

56. Package Pricing at the Texas Heart Institute (Denton A.Cooley, John W. Adams Jr.).

57. Helping Patients Manage Their Asthma: The National JewishApproach (Lynn M. Taussig, David Tinkelman).

58. A Model of Focused Health Care Delivery: Shouldice Hospital(Daryl J. B. Urquhart, Alan O’Dell).

59. Chronic Problems, Innovative Solutions: Paving the Way tothe Focused Factory (Stuart Lovett).

60. Improving Health and Reducing the Costs of Chronic Diseases(Robert E. Stone).

61. The Impact of Horizontal Integration in Hospitals: HCAHealthcare Corporation (Thomas F. Frist Jr.).

62. An Innovative Approach to Population Health: KaiserPermanente Southern California (Les Zendle).

63. The Right Care: Vanderbilt Medical Center (Harry R.Jacobson).

64. Achieving Focus in Hospital Care: The Role of RelationalCoordination (Jody Hoffer Gittell).

65. Consumer-Driven Health Care Is a Message of Hope (James F.Rodgers).

66. An Academic Health Center Perspective (Roger J. Bulger).

67. Consumer Choice in Consumer-Driven Health Care(François Maisonrouge).

68. Individual Genetic Profiles: The Empowerment of the HealthCare Consumer (Tony L. White).

69. Delivering the Right Drug to the Right Patient (MarkLevin).

PART FIVE: THE ROLE OF GOVERNMENT.

70. The Uninsured: Understanding and Resolving an AmericanDilemma (Jon R. Gabel).

71. A Health Insurance Tax Credit: The Key to More Coverage andChoice for Consumers (David B. Kendall).

72. The Politics of Consumer-Driven Health Care (Eric S. Berger,Carrie Gavora, Daniel H. Johnson).

73. Health Care: What Role for Regulation? (Karen Ignagni).

74. Adult Health Insurance (Ken Abramowitz).

75. AmeriChoice Corporation: The Personal Care Model (AnthonyWelters).

76. The Uninsured and Access (Constance G. Jackson).

77. Consumer-Driven Health Care for the Uninsured (KevinVigilante).

78. A Health Care SEC: The Truth, The Whole Truth, and NothingBut the Truth (Regina E. Herzlinger).

79. Keep ’Em Honest: The Health Care SEC (Robert N.Shamansky).

80. The U.S. Needs a Consumer-Driven Medical Care System (RitaRicardo-Campbell).

81. Government’s New Roles in the Era of Consumer-DrivenHealth Care (Richard A. D’Amaro).

The Editor.

The Participants.

The Contributors.

Name Index.

Subject Index.

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