The Us Healthcare Ecosystem Payers Providers Producers

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The U.S. Healthcare Ecosystem: Payers, Providers, Producers

Author : Lawton Robert Burns
Publisher : McGraw Hill Professional
ISBN 13 : 1264264488
Total Pages : 640 pages
Book Rating : 4.2/5 (642 download)

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Book Synopsis The U.S. Healthcare Ecosystem: Payers, Providers, Producers by : Lawton Robert Burns

Download or read book The U.S. Healthcare Ecosystem: Payers, Providers, Producers written by Lawton Robert Burns and published by McGraw Hill Professional. This book was released on 2021-03-16 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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

The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e

Author : Lawton R Burns
Publisher :
ISBN 13 : 9781265941468
Total Pages : 0 pages
Book Rating : 4.9/5 (414 download)

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Book Synopsis The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e by : Lawton R Burns

Download or read book The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e written by Lawton R Burns and published by . This book was released on 2024-10-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Big Med

Author : David Dranove
Publisher : University of Chicago Press
ISBN 13 : 022682392X
Total Pages : 344 pages
Book Rating : 4.2/5 (268 download)

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Book Synopsis Big Med by : David Dranove

Download or read book Big Med written by David Dranove and published by University of Chicago Press. This book was released on 2022-11-18 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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 Business of Healthcare Innovation

Author : Lawton R. Burns
Publisher : Cambridge University Press
ISBN 13 : 9780521838986
Total Pages : 400 pages
Book Rating : 4.8/5 (389 download)

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Book Synopsis The Business of Healthcare Innovation by : Lawton R. Burns

Download or read book The Business of Healthcare Innovation written by Lawton R. Burns and published by Cambridge University Press. This book was released on 2005-08-25 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first wide-ranging analysis of business trends in the manufacturing segment of the health care industry.

The U.S. Healthcare System

Author : Joel I. Shalowitz
Publisher : John Wiley & Sons
ISBN 13 : 047063152X
Total Pages : 720 pages
Book Rating : 4.4/5 (76 download)

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Book Synopsis The U.S. Healthcare System by : Joel I. Shalowitz

Download or read book The U.S. Healthcare System written by Joel I. Shalowitz and published by John Wiley & Sons. This book was released on 2019-09-04 with total page 720 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides a diverse, multi-faceted approach to health care evaluation and management The U.S. Health Care System: Origins, Organization and Opportunities provides a comprehensive introduction and resource for understanding healthcare management in the United States. It brings together the many “moving parts” of this large and varied system to provide both a bird’s-eye view as well as relevant details of the complex mechanisms at work. By focusing on stakeholders and their interests, this book analyzes the value propositions of the buyers and sellers of healthcare products and services along with the interests of patients. The book begins with a presentation of frameworks for understanding the structure of the healthcare system and its dynamic stakeholder inter-relationships. The chapters that follow each begin with their social and historical origins, so the reader can fully appreciate how that area evolved. The next sections on each topic describe the current environment and opportunities for improvement. Throughout, the learning objectives focus on three areas: frameworks for understanding issues, essential factual knowledge, and resources to keep the reader keep up to date. Healthcare is a rapidly evolving field, due to the regulatory and business environments as well as the advance of science. To keep the content current, online updates are provided at: www.HealthcareInsights.MD. This website also offers a weekday blog of important/interesting news and teaching notes/class discussion suggestions for instructors who use the book as a text. The U.S. Health Care System: Origins, Organization and Opportunities is an ideal textbook for healthcare courses in MBA, MPH, MHA, and public policy/administration programs. In piloting the content, over the past several years the author has successfully used drafts of chapters in his Healthcare Systems course for MBA and MPH students at Northwestern University. The book is also useful for novice or seasoned suppliers, payers and providers who work across the healthcare field and want a wider or deeper understanding of the entire system.

Just Enough Healthcare

Author : Sivakumaran Raman
Publisher :
ISBN 13 :
Total Pages : 118 pages
Book Rating : 4.6/5 (651 download)

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Book Synopsis Just Enough Healthcare by : Sivakumaran Raman

Download or read book Just Enough Healthcare written by Sivakumaran Raman and published by . This book was released on 2020-07-10 with total page 118 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare is complex, and occupies a critically important space in American political, social, and financial conversations. There is no other sector poised to be of more consequence and significance than healthcare, especially in light of the recent viral pandemic and the political center-stage accorded to healthcare delivery and access.As a physician and informatician, having worked in healthcare for more than two decades and served as Vice President and Chief Analytics Officer in health insurance and health information technology firms, I have been astounded by the lack of understanding of this sector. I put it down to the fact that healthcare is broad and its segments are isolated from each other in terms of the knowledge of their functioning.To address this, I created a first-of-its-kind resource for anyone wanting to get an overview of the US healthcare system in less than a day while reading fewer than 100 pages. This book's unique ability to connect diverse points in the system will allow the reader to understand all perspectives in this domain.After reading this book, you will be able to answer questions like:- Why can't I get an estimate at the physician's office and the hospital about what my visit and treatments will cost?- What are healthcare data and analytics?- How do I make sense of my medical bills and the Explanation of Benefits documents?- How does a physician treat patients?- How do physicians, hospitals, health insurance companies, pharmaceutical companies, and pharmacies make money?- What are generics and biosimilars?- What is a PBM?Topics covered include:- Healthcare Systems and Providers- Health Insurance and Payers- The Life Science Industry including Pharmaceutical Companies- Medical Billing and Payment, Healthcare Data and Analytics- The Government Role in US Healthcare

Understanding Value Based Healthcare

Author : Vineet Arora
Publisher : McGraw Hill Professional
ISBN 13 : 007181700X
Total Pages : 417 pages
Book Rating : 4.0/5 (718 download)

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Book Synopsis Understanding Value Based Healthcare by : Vineet Arora

Download or read book Understanding Value Based Healthcare written by Vineet Arora and published by McGraw Hill Professional. This book was released on 2015-04-03 with total page 417 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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. .

The Innovator's Prescription: A Disruptive Solution for Health Care

Author : Clayton M. Christensen
Publisher : McGraw Hill Professional
ISBN 13 : 0071592091
Total Pages : 496 pages
Book Rating : 4.0/5 (715 download)

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Book Synopsis The Innovator's Prescription: A Disruptive Solution for Health Care by : Clayton M. Christensen

Download or read book The Innovator's Prescription: A Disruptive Solution for Health Care written by Clayton M. Christensen and published by McGraw Hill Professional. This book was released on 2008-10-31 with total page 496 pages. Available in PDF, EPUB and Kindle. Book excerpt: A groundbreaking prescription for health care reform--from a legendaryleader in innovation . . . Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations. We need a cure, and we need it now. Harvard Business School’s Clayton M. Christensen—whose bestselling The Innovator’s Dilemma revolutionized the business world—presents The Innovator’s Prescription, a comprehensive analysis of the strategies that will improvehealth care and make it affordable. Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field—Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine arange of symptoms and offer proven solutions. YOU’LL DISCOVER HOW “Precision medicine” reduces costs and makes good on the promise of personalized care Disruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors work Patient networks enable better treatment of chronic diseases Employers can change the roles they play in health care to compete effectively in the era of globalization Insurance and regulatory reforms stimulate disruption in health care

Teaming

Author : Amy C. Edmondson
Publisher : John Wiley & Sons
ISBN 13 : 1118216768
Total Pages : 359 pages
Book Rating : 4.1/5 (182 download)

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Book Synopsis Teaming by : Amy C. Edmondson

Download or read book Teaming written by Amy C. Edmondson and published by John Wiley & Sons. This book was released on 2012-03-20 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: New breakthrough thinking in organizational learning, leadership, and change Continuous improvement, understanding complex systems, and promoting innovation are all part of the landscape of learning challenges today's companies face. Amy Edmondson shows that organizations thrive, or fail to thrive, based on how well the small groups within those organizations work. In most organizations, the work that produces value for customers is carried out by teams, and increasingly, by flexible team-like entities. The pace of change and the fluidity of most work structures means that it's not really about creating effective teams anymore, but instead about leading effective teaming. Teaming shows that organizations learn when the flexible, fluid collaborations they encompass are able to learn. The problem is teams, and other dynamic groups, don't learn naturally. Edmondson outlines the factors that prevent them from doing so, such as interpersonal fear, irrational beliefs about failure, groupthink, problematic power dynamics, and information hoarding. With Teaming, leaders can shape these factors by encouraging reflection, creating psychological safety, and overcoming defensive interpersonal dynamics that inhibit the sharing of ideas. Further, they can use practical management strategies to help organizations realize the benefits inherent in both success and failure. Presents a clear explanation of practical management concepts for increasing learning capability for business results Introduces a framework that clarifies how learning processes must be altered for different kinds of work Explains how Collaborative Learning works, and gives tips for how to do it well Includes case-study research on Intermountain healthcare, Prudential, GM, Toyota, IDEO, the IRS, and both Cincinnati and Minneapolis Children's Hospitals, among others Based on years of research, this book shows how leaders can make organizational learning happen by building teams that learn.

Managing Discovery in the Life Sciences

Author : Philip A. Rea
Publisher : Cambridge University Press
ISBN 13 : 1107130905
Total Pages : 557 pages
Book Rating : 4.1/5 (71 download)

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Book Synopsis Managing Discovery in the Life Sciences by : Philip A. Rea

Download or read book Managing Discovery in the Life Sciences written by Philip A. Rea and published by Cambridge University Press. This book was released on 2018-02 with total page 557 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addresses in roughly equal measure the science and management behind several recent marketable biomedical innovations.

China's Healthcare System and Reform

Author : Lawton Robert Burns
Publisher : Cambridge University Press
ISBN 13 : 1316738396
Total Pages : 744 pages
Book Rating : 4.3/5 (167 download)

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Book Synopsis China's Healthcare System and Reform by : Lawton Robert Burns

Download or read book China's Healthcare System and Reform written by Lawton Robert Burns and published by Cambridge University Press. This book was released on 2017-01-26 with total page 744 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Value-Based Healthcare and Payment Models

Author : Grace E. Terrell
Publisher :
ISBN 13 : 9780984831012
Total Pages : 290 pages
Book Rating : 4.8/5 (31 download)

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Book Synopsis Value-Based Healthcare and Payment Models by : Grace E. Terrell

Download or read book Value-Based Healthcare and Payment Models written by Grace E. Terrell and published by . This book was released on 2019-11-15 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Health Insurance and Managed Care

Author : Peter R. Kongstvedt
Publisher : Jones & Bartlett Learning
ISBN 13 : 128415209X
Total Pages : 355 pages
Book Rating : 4.2/5 (841 download)

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Book Synopsis Health Insurance and Managed Care by : Peter R. Kongstvedt

Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2019-02-14 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.

Winning the ’20s

Author : Martin Reeves
Publisher : Walter de Gruyter GmbH & Co KG
ISBN 13 : 3110730111
Total Pages : 98 pages
Book Rating : 4.1/5 (17 download)

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Book Synopsis Winning the ’20s by : Martin Reeves

Download or read book Winning the ’20s written by Martin Reeves and published by Walter de Gruyter GmbH & Co KG. This book was released on 2021-05-10 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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?

The Price of Global Health

Author : Ed Schoonveld
Publisher : Routledge
ISBN 13 : 131701930X
Total Pages : 494 pages
Book Rating : 4.3/5 (17 download)

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Book Synopsis The Price of Global Health by : Ed Schoonveld

Download or read book The Price of Global Health written by Ed Schoonveld and published by Routledge. This book was released on 2016-02-24 with total page 494 pages. Available in PDF, EPUB and Kindle. Book excerpt: Public debate on the rising cost of new biotechnology drug treatments has intensified over the last few years as healthcare budget pressures have mounted under a strained economy. Meanwhile, the demand for new, effective medical and drug treatments continues to rise as unhealthy lifestyles cause further increases in diabetes and cardiovascular disease. Global drug pricing is one of the most hotly debated yet least understood aspects of the pharmaceutical industry. How should drug prices be set and what does it mean for patients? Why do governments increasingly get involved, and what is its impact on the global competitive environment? How can a life-saving industry have a poorer image than gun and tobacco industries, whose products are associated with death? Ed Schoonveld explains how pharmaceutical prices are determined in a complex global payer environment and what factors influence the process. His insights will help a wide range of audiences, from healthcare industry professionals to policy makers and the broader public, to gain a better understanding of this highly complex and emotionally charged field. The Price of Global Health is recognized as a valued and unique reference book that covers a complete array of topics related to global pharmaceutical pricing. It contains an in-depth but straightforward exploration of the pharmaceutical pricing strategy process, its underlying market access, general business and ethical considerations, and its implications for payers, physicians and patients. It is a much-needed and invaluable resource for anybody interested or involved in, or affected by, the development, funding and use of prescription drugs. In particular, it is of critical importance to pharmaceutical company executives and other leaders and professionals in commercialization and drug development, including marketing, business development, market access and pricing, clinical development, drug discovery, regulatory affairs, health outcomes, market research and public affairs. The second edition includes new chapters on payer value story development, oncology, orphan drugs and payer negotiations. Furthermore, many country chapters have been substantially updated to reflect changes in the healthcare systems, including the Affordable Care Act in the US, AMNOG in Germany, medico-economic requirements in France and many other country-specific changes. Lastly, almost every chapter has been updated with new examples and illustrations.

AI-First Healthcare

Author : Kerrie L. Holley
Publisher : "O'Reilly Media, Inc."
ISBN 13 : 149206310X
Total Pages : 222 pages
Book Rating : 4.4/5 (92 download)

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Book Synopsis AI-First Healthcare by : Kerrie L. Holley

Download or read book AI-First Healthcare written by Kerrie L. Holley and published by "O'Reilly Media, Inc.". This book was released on 2021-04-19 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: AI is poised to transform every aspect of healthcare, including the way we manage personal health, from customer experience and clinical care to healthcare cost reductions. This practical book is one of the first to describe present and future use cases where AI can help solve pernicious healthcare problems. Kerrie Holley and Siupo Becker provide guidance to help informatics and healthcare leadership create AI strategy and implementation plans for healthcare. With this book, business stakeholders and practitioners will be able to build knowledge, a roadmap, and the confidence to support AIin their organizations—without getting into the weeds of algorithms or open source frameworks. Cowritten by an AI technologist and a medical doctor who leverages AI to solve healthcare’s most difficult challenges, this book covers: The myths and realities of AI, now and in the future Human-centered AI: what it is and how to make it possible Using various AI technologies to go beyond precision medicine How to deliver patient care using the IoT and ambient computing with AI How AI can help reduce waste in healthcare AI strategy and how to identify high-priority AI application

Health Care for Some

Author : Beatrix Hoffman
Publisher : University of Chicago Press
ISBN 13 : 0226348032
Total Pages : 357 pages
Book Rating : 4.2/5 (263 download)

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Book Synopsis Health Care for Some by : Beatrix Hoffman

Download or read book Health Care for Some written by Beatrix Hoffman and published by University of Chicago Press. This book was released on 2012-09-15 with total page 357 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.