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Index
Cover Copyright Dedication Preface Introduction
The Failure of Competition Competing on Value Competing on Results The Structure of This Book How Will Redefining Health Care Occur?
1: Scoping the Problem 2: Identifying the Root Causes
Positive-Sum Competition on Value Zero-Sum Competition in Health Care The Root Cause: Competition at the Wrong Level Why Is Health Care Competition at the Wrong Level?
3: How Reform Went Wrong
The Rise of Group Health Insurance Limiting Payments to Physicians and to Hospitals Managed Care The Medical Arms Race The Clinton Plan Patients’ Rights Consumer-Driven Health Care Quality and Pay for Performance A Single-Payer System Medical or Health Savings Accounts Non-Reforms Reforming Competition: The Only Answer
4: Principles of Value-Based Competition
Focus on Value, Not Just Costs Competition Is Based on Results Competition Is Centered on Medical Conditions over the Full Cycle of Care High-Quality Care Should Be Less Costly Value Is Driven by Provider Experience, Scale, and Learning in Medical Conditions Competition Is Regional or National Results Information Is Widely Available Innovations That Increase Value Are Strongly Rewarded The Opportunity of Value-Based Competition
5: Strategic Implications for Health Care Providers
The Strategy Vacuum in Health Care Delivery Defining the Right Goal: Superior Patient Value Moving to Value-Based Competition: Imperatives for Providers How Would Industry Structure in Health Care Delivery Change? Enabling the Transformation Overcoming Barriers to Value-Based Competition The Benefits of Moving Early
6: Strategic Implications for Health Plans
Past and Future Roles of Health Plans Moving to Value-Based Competition: Imperatives for Health Plans Overcoming Barriers to Health Plan Transformation The Benefits of Moving Early
7: Implications for Suppliers, Consumers, and Employers
Implications for Suppliers Implications for Consumers as Subscribers and Patients Implications for Employers
8: Health Care Policy and Value-Based Competition
Broad Issues in Health Care Policy Moving to Value-Based Competition: Improving Health Insurance and Access Moving to Value-Based Competition: Setting Standards for Coverage Moving to Value-Based Competition: Improving the Structure of Health Care Delivery Implications for Health Care Policy in Other Nations
Conclusion Appendix A: Making Results Public The Cleveland Clinic Appendix B: The Care Delivery Value Chain Notes Bibliography About the Authors
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