Practical Strategies To Assess Value In Health Care

These days, the idea of "value" is at the center of many activities and decisions in health care in the United States. While there exist books that detail the technical steps for how to carry out a specific type of value assessment, such as cost-effectiveness or return on investment, there are few that attempt to teach healthcare professionals how to think about value. This book provides a deeper understanding of value as a concept as well as an endeavor (as in, to determine or uncover the value of care) within the healthcare industry by illustrating the different components of value that should guide decision-making processes for policy, infrastructure, and quality improvement. Through an exploration of theories of economics and implementation science, as well as practical suggestions for real-world applications, this text provides a foundation for the long and complicated "value" journey the US has bet its entire healthcare system on. In the US, policy to promote what is referred to as "value-based care" is here to stay. As we move forward within this construct, we need to move beyond the over-simplified definition of value as "quality per dollar spent" to a more functional framework for how to think about value that can adapt to different circumstances and points of view. Only then will it be possible to compare value across settings, conditions, and activities. The book consists of 9 chapters organized in four sections: Part I: Understanding the Challenges of Assessing the Value of Health Care Part II: A Primer on Fundamental Concepts and Current Techniques Used to Measure Value in Health Care Part III: A Discussion of the Real-world Motivations and Requirements that Should be Contemplated when Exploring Value Part IV How to Design and Perform a Value Assessment Practical Strategies to Assess Value in Health Care is an essential resource for healthcare professionals at all levels and points of care who are interested in understanding how best to assess and interpret value for a particular situation including providers, administrators, payers, insurers, health plans, and policy-makers.

These days, the idea of “value” is at the center of many activities and decisions in health care in the United States. While there exist books that detail the technical steps for how to carry out a specific type of value assessment, such as cost-effectiveness or return on investment, there are few that attempt to teach healthcare professionals how to think about value. This book provides a deeper understanding of value as a concept as well as an endeavor (as in, to determine or uncover the value of care) within the healthcare industry by illustrating the different components of value that should guide decision-making processes for policy, infrastructure, and quality improvement. Through an exploration of theories of economics and implementation science, as well as practical suggestions for real-world applications, this text provides a foundation for the long and complicated “value” journey the US has bet its entire healthcare system on. In the US, policy to promote what is referred to as “value-based care” is here to stay. As we move forward within this construct, we need to move beyond the over-simplified definition of value as “quality per dollar spent” to a more functional framework for how to think about value that can adapt to different circumstances and points of view. Only then will it be possible to compare value across settings, conditions, and activities. The book consists of 9 chapters organized in four sections: Part I: Understanding the Challenges of Assessing the Value of Health Care Part II: A Primer on Fundamental Concepts and Current Techniques Used to Measure Value in Health Care Part III: A Discussion of the Real-world Motivations and Requirements that Should be Contemplated when Exploring Value Part IV: How to Design and Perform a Value Assessment Practical Strategies to Assess Value in Health Care is an essential resource for healthcare professionals at all levels and points of care who are interested in understanding how best to assess and interpret value for a particular situation including providers, administrators, payers, insurers, health plans, and policy-makers.

This book offers a comprehensive overview of performing return-on-investment (ROI) analyses for healthcare quality improvement (QI). In the United States, healthcare policy regarding physician and facility payment/reimbursement is steadily trending towards the use of “value-based” systems and away from the traditional “fee-for-service” (FFS) payment mechanisms. Healthcare professionals and organizations who have previously focused on quality metrics are now finding themselves burdened with having to define and assess value metrics, without much guidance or assistance. This volume aims to be a guide and a reference for healthcare professionals tasked with estimating and establishing ROI for QI. Chapters describe the general framework for how to perform QI; establish standard definitions of important terms, concepts, and calculations; and provide specific instructions for how to complete each step of an ROI analysis. These include: selecting a QI initiative and identifying the associated metrics, establishing measurable, monetizable, and attributable costs and benefits, determining the appropriate scope and perspective, calculating ROI and related metrics (payback period, benefit-to-cost ratio, etc.), comparing with established benchmarks or previously published results, and interpreting the results for the intended audience. In addition, chapters offer examples of real studies (or hypothetical studies of real situations), as well as templates for several of the necessary activities that readers can leverage for their own use. Return on Investment for Healthcare Quality Improvement is a must-have resource for healthcare providers, administrators, and other professionals who work in healthcare organizations, hospitals and other healthcare settings, health systems, and residency programs seeking to obtain outside funding, as well as policy makers and administrators of federal programs.

HOW TO REDUCE OVERUSE IN HEALTHCARE Reduce low-value care with this practical guide Low-value care harms patients, overburdens healthcare professionals, threatens healthcare systems and damages the climate. How to Reduce Overuse in Healthcare: a practical guide is designed to provide practical guidance and tools for healthcare providers, their professional societies and policy makers developing programs to de-implement low-value or unnecessary care. This guide provides a five-step evidence and theory-based framework for developing and evaluating programs such as Choosing Wisely to reduce low-value care and improve patient outcomes. How to Reduce Overuse in Healthcare: a practical guide readers will also find: An author team involved in the leading Choosing Wisely international network Detailed analysis of how to identify potential low-value care areas, select interventions and more Practical, real-world examples at the end of each chapter illustrating examples of overuse and de-implementation How to Reduce Overuse in Healthcare: a practical guide describes the state of the art in de-implementation for healthcare professionals, healthcare administrators and policy makers looking to reduce low-value care in a more effective and evidence-based way.

We have a problem in healthcare. That problem is this: in today’s healthcare environment, especially in the United States, people take a back seat to the numbers in almost every aspect of healthcare service delivery. Productivity, utilization, and other business metrics rule the roost. If it’s not calculatable, spreadsheet-able, or measurable, it hardly receives any attention from healthcare managers, administrators, and decision-makers. We can’t simply sit back and allow the dehumanization that currently runs rampant in our clinics and hospitals continue to wreak havoc on one of the most important factors in clinical outcomes: the relationships between healthcare professionals and the people (patients) that they serve. Healthcare is a great and noble profession, but it will only remain so if we, as healthcare professionals, return its focus to its true purpose: people, the people receiving care, and the people working to deliver that care. After all, we’re all more than simply numbers on spreadsheets or items on checklists. Better Outcomes: A Guide for Humanizing Healthcare outlines the 8 changes that organizations and clinicians need to commit to in order to return to the focus of healthcare to where it should be: the patient. The book covers topics related to truly patient-centered care, a biopsychosocial approach to service delivery, patient engagement, interpersonal communication, and developing long-term relationships with patients. Through an exploration of both clinical research and real-life examples and cases, the book outlines and supports a vision of a new healthcare, where skilled, competence, and caring clinicians care for engaged patients to promote better clinical outcomes, deliver unmatched satisfaction, and lasting relationships.

This book brings together the best thinking from both sides of the Atlantic to explore the issues surrounding soaring health care costs. It employs disciplinary perspectives from economics, ethics, philosophy, psychology, clinical practice, and epidemiology to explore various ways that value for patients have and can be determined. A major section of the book discusses problems that can reduce the value to patients of medical care. The volume is must read for practitioners, policy makers, and researchers who want to find in one place the state-of-the-art thinking and future directions of valuing medical care from the patient’s perspective.

A comprehensive guide to effective strategic management of health care organizations. Strategic Management of Health Care Organizations provides essential guidance for leading health care organizations through strategic management. This structured approach to strategic management examines the processes of strategic thinking, consensus building and documentation of that thinking into a strategic plan, and creating and maintaining strategic momentum – all essential for coping with the rapidly evolving health care industry. Strategic Management of Health Care Organizations fully explains how strategic managers must become strategic thinkers with the ability to evaluate a changing industry, analyze data, question assumptions, and develop new ideas. The book guides readers through the strategic planning process demonstrating how to incorporate strategic thinking and create and document a clear and coherent plan of action. In addition, the all-important processes of creating and maintaining the strategic momentum of the organization are fully described. Finally, the text demonstrates how strategic managers in carrying out the strategic plan, must evaluate its success, learn more about what works, and incorporate new strategic thinking into operations and subsequent planning. This strategic management approach has become the de facto standard for health care management as leadership and strategic management are more critical than ever in coping with an industry in flux. This book provides heath care management students as well as health care administrators with foundational guidance on strategic management concepts and practices, tailored to the unique needs of the health care industry. Included are a clear discussion of health services external analysis, organizational internal analysis, the development of directional strategies, strategy alternative identification and evaluation, and the development and management of implementation strategies providing an informative and insightful resource for anyone in the field. This new eighth edition has been fully updated to reflect new insights into strategic thinking, new methods to conceptualize and document critical environmental issues, practical steps for carrying out each of the strategic management processes, industry and management essentials for strategic thinkers , and new case studies for applying the strategic management processes. More specifically, readers of this edition will be able to: Create a process for developing a strategic plan for a health care organization. Map and analyze external issues, trends, and events in the general environment, the health care system, and the service area. Conduct a comprehensive service area competitor analysis. Perform an internal analysis and determine the competitive advantages and competitive disadvantages. Develop directional strategies. Identify strategic alternatives and make rational strategic decisions for a health care organization. Develop a comprehensive strategy for a health care organization. Create effective value-adding service delivery and support strategies. Translate service delivery and support plans into specific action plans. The health care industry’s revolutionary change remains ongoing and organizational success depends on leadership. Strategic management has become the single clearest manifestation of effective leadership of health care organizations and the strategic management framework’s strengths are needed now more than ever. The Strategic Management of Health Care Organizations provides comprehensive guidance and up-to-date practices to help leaders keep their organizations on track.

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.