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

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Overview

Harvard Business School professor Regina E. Herzlinger believes that the future of heath care depends on people becoming empowered as active consumers or purchasers of their health benefits and services. In this, her newest book, the internationally acclaimed health care guru presents a compelling vision of a system built to satisfy the people it serves. She advances her argument with a comprehensive selection of examples of consumer-driven health care in action, contributed from all parts of the health care system, here and abroad.

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What People Are Saying

From the Publisher
"Professor Herzlinger provides a compelling argument forconsumer-driven health care. The health care system has been markedfor decades with rising costs and consumer dissatisfaction.Professor Herzlinger challenges the reader to look beyond solutionsthat are based on what consumers should want to solutions that giveconsumers what they want."
—Barbara Bigelow, Ph.D., co-editor, Health Care ManagementReview, professor of management, Clark University GraduateSchool of Management

"Regina Herzlinger has a formidable reputation as an expert onreforming health care. There are lessons here for all of us whocare about reforming our health systems to make them better."
—David Willets, MP, Shadow Work and Pensions Secretaryand member of Parliament , UK.

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

"No other author in the health field could write a book likeConsumer-Driven Health Care, or make the kind of impact that ReginaHerzlinger can make on America’s $1.5 trillion health careindustry. As one of the health field’s most respectedeconomists and business strategists, Professor Herzlinger canpersuade corporate CEOs, Washington policymakers, benefitsadministrators, and hospital executives to reshape their strategybased on a market run by consumers. Remarkably, for an academic,she can write. This book translates health economics into simpleEnglish, reducing the “mystery-inside-a-conundrum”field into everyday transactions like selecting a health plan thatany health care consumer can recognize. Consumer-Driven HealthCare will be a top candidate for health care’s 'book ofthe year.'"
—Russell C. Coile, Jr., consultant, editor, RussCoile’s Health Trends, and author, Competing OnExcellence

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Product Details

  • ISBN-13: 9780787952587
  • Publisher: Wiley
  • Publication date: 4/28/2004
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 928
  • Sales rank: 1,567,256
  • Product dimensions: 7.24 (w) x 9.46 (h) x 2.47 (d)

Meet the Author

Regina E. Herzlinger is the Nancy R. McPherson Professor of Business Administration at the Harvard Business School.

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Read an Excerpt

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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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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  • Anonymous

    Posted September 18, 2005

    Thoughtful Contribution on Consumer-Directed Health Care Issue

    In Consumer-Driven Health Care, Regina E. Herzlinger, a leading health care thought leader and a professor at the Harvard Business School, provides a thought-provoking look inside a new, powerful force slowly transforming America's dysfunctional health care industry. Consumer-Driven Health Care builds on her popular 1997 book Market-Driven Health Care: Who Wins, Who Loses in the Transformation of America's Largest Service Industry. In the first part of her new 900-page book, Dr. Herzlinger makes a convincing case about how and why health care is broken and why market-based solutions - which empower consumers - are best. She restates the case she made in Market-Driven Health Care for putting consumers directly in charge of their own decisions (picking insurance plans, making medical decisions). Through transparency of information, a realignment of incentives, and new tools to support decision-making by patients, the consumer-driven model gives individuals a clear stake in their own health care. While not unique to other parts of the US economy, the approach is a radical departure for the $1.7 trillion health care market. As Dr. Herzlinger makes clear in her energetic analysis, the absence of these proven market-based tools goes a long to explain why health care became our most inefficient, outdated, and error-prone industry. The second part - about 80 percent of the book - is a collection of 73 think pieces written by 92 other experts. With short introductions by Dr. Herzlinger, these articles serve as a useful initial knowledge base for a growing field with an uncertain future. The book has its limitations. For example, Dr. Herzlinger's case for the consumer-driven model fails to address the Medicare and Medicaid systems. It also leaves a variety of practical transition and execution issues unaddressed, although these are beyond the purpose of this volume. Because articles were written several years ago as part of a conference and most of the writers lack purchaser-side experience, the book also does not deal with the growing list of market-based reforms underway by large employers and innovative health plans. In addition, since the field is still in its infancy, Dr. Herzlinger is a business researcher, and the contributors are largely wide-eyed entrepreneurs, the book will likely frustrate health policy wonks and others stuck in the technical minutia and ideological fights that characterize most health care discussions. But then, that's just as well. Too often analysts forget that health care is a business and operates as a market, albeit a flawed one insulated from tools proven to drive quality and efficiency. And we need all the wide-eyed, out-of-the-box thinking we can get. Dr. Herzlinger also has her detractors. It reminds me of the old joke that there are two kinds of people in the world: people who like Wayne Newton and people who don't. Well, it seems that health care wonkdom is divided by those who like Reggie Herzlinger's ideas and those who don't. However, given the massive problems in American health care, her plain-spoken, business-savvy contributions remain as useful as they are provocative.

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