Download Ebook Redefining Health Care: Creating Value-Based Competition on Results, by Michael E. Porter
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Redefining Health Care: Creating Value-Based Competition on Results, by Michael E. Porter
Download Ebook Redefining Health Care: Creating Value-Based Competition on Results, by Michael E. Porter
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Review
"...a profound and powerful critique of AmericaÂ’s health-care system. It deserves to be read widely. And probably will be." -- Economist.com
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About the Author
Michael Porter acts as one of the World Economic Forum's Global Competitiveness Report's primary editors.
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Product details
Hardcover: 528 pages
Publisher: Harvard Business Review Press; 1 edition (May 25, 2006)
Language: English
ISBN-10: 9781591397786
ISBN-13: 978-1591397786
ASIN: 1591397782
Product Dimensions:
6.5 x 1.5 x 9.5 inches
Shipping Weight: 2 pounds (View shipping rates and policies)
Average Customer Review:
4.1 out of 5 stars
65 customer reviews
Amazon Best Sellers Rank:
#47,595 in Books (See Top 100 in Books)
Great baseline for anyone who wants to understand the gamut of the healthcare market and all the key players - employers, plans, providers, consumers, suppliers. Yes it’s all covered and value based care and how to achieve VBC is well treated.
This book has received probably disproportionate attention due to Prof. Porter's notoriety as a strategic thinking theorist. There are better overall books on healthcare policy available. In particular I recommend the Bodenheimer/Grumbach books, one on healthcare policy and one on primary care, Dr. Arnold Relman's book, A Second Opinion, Strained Mercy, an outstanding and thorough analysis of healthcare economics with particular regard to Canada's healthcare system and Pricing the Priceless a more technically-oriented economic analysis by Prof. Joseph Newhouse, among other books.I find the analysis of the USA healthcare system by Profs. Porter and Teisberg to generally be excellent, although I find it wanting in regard to their disparagement of a single-payer/single-insurer system and to their description and analysis of healthcare systems outside the USA. From my perspective private health plans play only a net negative role in the system. The authors' analysis of how the health insurance market works is quite good. However their recommendation that a system of private insurers should persist is refuted by their own analysis! A single payer/insurer system will not cure many problems of the USA system, as they clearly point out, but it does remove the inherently dysfunctional characteristics of private insurance, not least of which is its failure to meet the needs of the uninsured - a very large number - and its inherent propensity to exclude the very people who need coverage and care. The authors rightly point out that mandatory health insurance along with risk-pooling among insurers to spread the costs of those insured individuals who generate the highest costs is a "solution" to the current non-functioning system, but the same result, at lower cost and with much greater simplicity, can be achieved through a single payer/insurer.The other key aspect of healthcare - how it is delivered - is ultimately more important than the financing/insurance side. The authors provide excellent analysis and recommendations in this regard. They correctly address the aspects of the healthcare market that prevent its functioning as a "competitive" market, specifically the abysmal lack of patient information on prices for services, on outcomes of actions by providers, comparative statistics on provider performance and similar. They also provide an interesting report by the Cleveland Clinic on outcomes, i.e. results, of the Clinic's heart surgery activity. They appropriately use this as an example of the kind of reporting that is needed.The authors' analysis of healthcare systems outside the USA is skimpy and inaccurate in my opinion. The authors underplay the demonstrated efficacy of government-funded systems that outperform the USA system almost across the board in gross measures of outcomes (infant mortality and longevity) and vastly outperform the US system in regard to cost. They gloss over the fact that per capita costs in the USA are 2.5 times! the average per capita costs in other OECD countries. It is not as though the costs are say 10% above the average with comparable outcomes. They are 150% higher with worse outcomes. Instead of noting this and analyzing it thoroughly, the authors assert that waiting times and rationing of care are significant problems in those countries, assertions which are simply not borne out by the facts. Also the fact that (mostly) single-payer/insurer systems function well universally does not fit the authors' main thesis, so rather than revise the thesis based on this evidence they choose to ignore the evidence.As a consequence of these limitations I rate the book with 4 stars rather than 5. Too bad, because most of the book is excellent.
"Redefining Health Care" begins with data detailing the failures of America's "health system" - the highest and most rapidly rising costs among modern nations, combined with millions of uninsured, high error rates, and an average 17 years for the results of clinical trials to become standard clinical practice. Thus, the puzzle: "Why is competition failing in health care?"Porter and Teisberg's answer is that it focuses far too much on cost-reduction, increasing negotiating power, providing broad-lines of service, and cost-shifting, and instead should focus on long-term value (results vs. costs) for patients. Key to accomplishing this is the collection of standardized patient outcome data (preferably risk-adjusted) that are used to identify providers needing improvement and sources from which that improvement can be gleaned, as well as in guiding patient decision-making."Redefining Health Care" also asserts that its recommendations are not just theories, but also supported by a number of cited examples.This book provides a clear vision of how the U.S. can reduce health care costs while improving patient outcomes - without increased complexity. It should be read by legislators at both the state and national level, as well as by health care providers.
Why doesn't it follow the progression to higher quality and lower prices as most other industries do? These are some of the questions that authors Michael Porter of Harvard Business School and Elizabeth Teisberg of University of Virginia School of Business attempt to answer. The book paints an accurate portrait of the shortcomings of the US health care system, which fails to identify and scale up providers who provide the highest quality health care at the lowest cost.Health care providers, health plans, payers, and consumers are responsible for our low performing, high cost health care system. Real reform of the system has implications for all stakeholders and, optimistically, this reform is already underway. Improvements in health care quality reporting and access to these data by consumers and payers is increasing, providers are consolidating from solo private practices to medical groups wherein health plans are supporting transformations to patient center medical homes that actively manage patient health status through preventive care and case management. Employers are expecting that health plans augment their provider contracting discounts and claims processing with health and wellness programs, including disease management. Health care technology, including electronic medical records and telemedicine, are improving the portability of health information and enabling remote hospitals to instantly access medical specialists at nationally and internationally recognized hospital centers.The authors do an excellent job of highlighting the levers in the domains of each stakeholder that must be switched on for transformation to a value based market place to happen. I argue that it will happen out of economic and technological developments, as well as the influence of globalization, rather than via any significant policy changes, with the exception of a government mandate for individual health insurance coverage that has now been passed at the federal level.Even though I share the opinion of several other reviewers that the book is unnecessarily lengthly and redundant, I do recommend it for its broad viewpoints and substantial supporting case studies.
Great book!
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