As health costs in the U.S. soar past $1.5 trillion, much evidence indicates that the nation does not get good value for its money. It is widely agreed that we could do better by using cost-effective ...analysis (CEA) to help determine which health care services are most worthwhile. American policy makers, however, have largely avoided using CEA, and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of EA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plans as examples. In exploring the disconnection between the promise of CEA and the persistent failure of rational intentions, the book seeks to find common ground and practical solutions. It analyzes the prospects for change and presents a roadmap for getting there. It offers pragmatic advice for cost-effectiveness analysts, discussing ways in which they can better translate their research findings into the basis for action. The book also offers advice for policy makers and politicians, including lessons from Europe, Canada, and Australia, and underlines the need for leadership to establish the conditions for change. Available in OSO: http://www.oxschol.com/oso/public/content/publichealthepidemiology/9780195171860/toc.html
Financial Management for Health-System Pharmacists, 2nd edition, serves as a guidebook to support the management of enterprise pharmacy finance across business and care continuums. The 2nd edition ...engages the reader with a mix of chapters, some new to this edition, along with a trove of new health-system pharmacy financial business cases. As leaders look to transform their organizations, the principles and practices provided give the reader the knowledge and guidance to craft a new path forward as they look to improve the provision of pharmacy and patient-care services.
Along with being the biggest sector of the U.S. economy, healthcare is also the most dysfunctional. This book presents a compelling vision of how healthcare can work better and how we can get there ...with the current resources. Providing a comprehensive, positive, and intriguing vision of the future, this book tells healthcare providers how they can reposition their organizations to thrive regardless of what the government does in regards to policy. It also outlines how employers can save money by changing the way they provide healthcare to their employees.
This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition ...with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system.
Mayes and Berenson draw from interviews with more than sixty-five major policy makers—including former Treasury secretary Robert Rubin, U.S. Representatives Pete Stark and Henry Waxman, former White House chief of staff Leon Panetta, and former administrators of the Health Care Financing Administration Gail Wilensky, Bruce Vladeck, Nancy-Ann DeParle, and Tom Scully—to explore how this payment system worked and its significant effects on the U.S. medical landscape in the past twenty years. They argue that, although managed care was an important agent of change in the 1990s, the private sector has not been the major health care innovator in the United States; rather, Medicare’s transition to PPS both initiated and repeatedly intensified the economic restructuring of the U.S. health care system.
Measuring and Modeling Health Care Costs Ana Aizcorbe, Colin Baker, Ernst R. Berndt, David M. Cutler / Ana Aizcorbe, Colin Baker, Ernst R. Berndt, David M. Cutler
2018, 2018-03-05, Volume:
76
eBook
Health care costs represent a nearly 18% of U.S. gross domestic product and 20% of government spending. While there is detailed information on where these health care dollars are spent, there is much ...less evidence on how this spending affects health.The research in Measuring and Modeling Health Care Costs seeks to connect our knowledge of expenditures with what we are able to measure of results, probing questions of methodology, changes in the pharmaceutical industry, and the shifting landscape of physician practice. The research in this volume investigates, for example, obesity's effect on health care spending, the effect of generic pharmaceutical releases on the market, and the disparity between disease-based and population-based spending measures. This vast and varied volume applies a range of economic tools to the analysis of health care and health outcomes.Practical and descriptive, this new volume in the Studies inIncome and Wealth series is full of insights relevant to health policy students and specialists alike.
Guidelines for conducting health economic evaluations have become increasingly standardized, however they don't address the unique concerns of the paediatric population. The challenges of measuring ...costs and consequences in children, from neonate to late adolescence, are numerous and complex. With the growing acceptance of economic evidence to guide decisions in health systems facing economic constraints, it is imperative that these challenges be considered so that this population is not left out of evidence-based decisions. The time has come for a textbook to address economic evaluation in child health. This book is divided into three sections: Methods, Applications, and Using evidence for decision-making, with chapters contributed by international experts. The Methods section presents detailed discussions of measuring lifetime costs and consequences, capturing productivity losses, obtaining unbiased self- and proxy reports, incorporating externalities, choosing valid outcome measures, assessing utility, and designing studies using value of information. The Applications section reviews economic evidence in common childhood conditions and areas of investigation, including newborn screening, harm prevention, mental health services, brain injury, asthma, and immunization. The final section explores the use of economic evidence in decision-making, and includes a description of the WHO-CHOICE approach, the role of clinical research, how to value health gains by children, and the emerging field of health technology assessment. In addition to an emphasis on methods, a deliberate effort was made to include issues relevant to developing countries, where the burden of childhood disease is greatest, and for whom high quality economic evidence is critical. Available in OSO: http://www.oxschol.com/oso/public/content/publichealthepidemiology/9780199547494/toc.html Contributors to this volume - Moses Aikins, Senior Lecturer, School of Public Health, Department of Health Policy, Planning and Management, College of Health Sciences, University of Ghana, Legon, Accra, Ghana Philippe Beutels, Senior Lecturer, Health Economics, Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID), Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium Katherine B. Bevans, Assistant Research Professor, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, USA Robert E. Black, Edgar Berman Professor and Chair, Johns Hopkins Bloomberg School of Public Health, Department of International Health, Johns Hopkins University, Baltimore, USA Werner B.F. Brouwer, Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Medical Centre / Erasmus University, Rotterdam, The Netherlands Sarah Byford, Senior Lecturer, King's College London, Institute of Psychiatry, De Crespigny Park, London, UK Jonathan D. Campbell, Senior Post-Doctoral Fellow, Pharmaceutical Outcomes, Research and Policy Program, School of Pharmacy, University of Washington, Seattle, USA Vania Costa, Research Associate, Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada Gillian Currie, Assistant Professor, Faculty of Medicine, Departments of Paediatrics and Community Health Sciences, University of Calgary, Calgary, Canada Sarah Curtis, Assistant Professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada Kim Dalziel, Senior Research Fellow, Health Economics and Policy Group, Division of Health Sciences, University of South Australia, Adelaide, Australia David B. Evans, Director, Department of Health Systems Financing, World Health Organization, Geneva, Switzerland Christopher B. Forrest, Mary D. Ames Professor of Pediatrics and Advocacy, The Children's Hospital of Philadelphia, Philadelphia, USA Tessa Tan-Torres Edejer, Coordinator, Costs, Effectiveness, Expediture and Priority Setting (CEP), Health System Financing, Health Systems and Services, World Health Organization, Geneva, Switzerland E. Michael Foster, Professor, Maternal and Child Health and Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill, USA Andreas Gerber, Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany Y. Ingrid Goh, Department of Pharmaceutical Science, University of Toronto, Division of Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, Canada Scott D. Grosse, Senior Health Economist, Office of the Director, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, National Center on Birth Defects and Developmental Disabilities, Atlanta, USA Raymond Hutubessy, Economist, Initiative for Vaccine Research (IVR), World Health Organization (WHO), Geneva, Switzerland Terry Klassen, Professor and Chair, Regional Program Clinical Director Child Health, Capital Health, Department of Pediatrics, University of Alberta, Edmonton, Canada Gideon Koren, Senior Scientist and Director, The Motherisk Program, Professor of Medicine, Pediatrics and Physiology/Pharmacology, The University of Toronto, Ivey Chair in Molecular Toxicology, The University of Western Ontario, The Hospital for Sick Children, Toronto, Canada Stavros Petrou, Health Economist, National Perinatal Epidemiology Unit, University of Oxford (Old Road Campus), Oxford, England Ali I. Raja, Assistant Professor, Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, USA Leonie Segal, Professor, Health Economics, Health Economics and Policy Group, Division of Health Sciences, University of South Australia, Adelaide, Australia Donald S. Shepard, Professor, Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, USA Jose A. Suaya, Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, USA Sean D. Sullivan, Professor of Pharmacy, Public Health and Medicine; Director, Pharmacetical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, USA Lillian Sung, Scientist and Assistant Professor, Department of Paediatrics, University of Toronto, Department of Paediatric Haematology/Oncology, Division of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada J. Mick Tilford, Associate Professor, Department of Pediatrics and Health Policy Management, College of Medicine, University of Arkansas for Medical Sciences, Center for Applied Research and Evaluation, Little Rock, USA Wendy J. Ungar, Senior Scientist, Associate Professor, The Hospital for Sick Children Research Institute, University of Toronto, Division of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada N. Job A. van Exel, MSc, Health Economist, Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Medical Centre / Erasmus University, Rotterdam, The Netherlands Damian G. Walker, Professor, Health Economics, Health Systems Program, Bloomberg School of Public Health, Department of International Health, Johns Hopkins University, Baltimore, USA Andrew R. Willan, Senior Scientist and Professor, Public Health Sciences, University of Toronto, The Hospital for Sick Children Research Institute, Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada Lara J. Wolfson, Scientist, Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland
Priced Out Reinhardt, Uwe E
2019, 20190514, 2019-05-14
eBook
From a giant of health care policy, an engaging and enlightening account of why American health care is so expensive-and why it doesn't have to be
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. InPriced 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.
The problem, Reinhardt says, is not one of economics but of social ethics. There is no American political consensus on a fundamental question other countries settled long ago: to what extent should we be our brothers' and sisters' keepers when it comes to health care? Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America finances health care, and he offers a penetrating ethical analysis of recent reform proposals. At this point, he argues, the United States appears to have three stark choices: the government can make the rich help pay for the health care of the poor, ration care by income, or control costs. Reinhardt proposes an alternative path: that by age 26 all Americans must choose either to join an insurance arrangement with community-rated premiums, or take a chance on being uninsured or relying on a health insurance market that charges premiums based on health status.
An incisive look at the American health care system,Priced Outdispels the confusion, ignorance, myths, and misinformation that hinder effective reform.
The burden of skin disease in the United States Lim, Henry W., MD; Collins, Scott A.B., MD; Resneck, Jack S., MD ...
Journal of the American Academy of Dermatology,
05/2017, Volume:
76, Issue:
5
Journal Article
Peer reviewed
Open access
Since the publication of the last US national burden of skin disease report in 2006, there have been substantial changes in the practice of dermatology and the US health care system. These include ...the development of new treatment modalities, marked increases in the cost of medications, increasingly complex payer rules and regulations, and an aging of the US population. Recognizing the need for up-to-date data to inform researchers, policy makers, public stakeholders, and health care providers about the impact of skin disease on patients and US society, the American Academy of Dermatology produced a new national burden of skin disease report. Using 2013 claims data from private and governmental insurance providers, this report analyzed the prevalence, cost, and mortality attributable to 24 skin disease categories in the US population. In this first of 3 articles, the presented data demonstrate that nearly 85 million Americans were seen by a physician for at least 1 skin disease in 2013. This led to an estimated direct health care cost of $75 billion and an indirect lost opportunity cost of $11 billion. Further, mortality was noted in half of the 24 skin disease categories.
