Value Driven Healthcare and Geriatric Medicine: Implications for Today's Changing Health System

ISBN-13: 9783319770567 / Angielski / Miękka / 2018 / 156 str.

James Powers; Laura Keohane

Opis

Value driven healthcare is the lasting legacy of the Affordable Care Act, which had three goals: to improve access to healthcare by increasing healthcare insurance coverage, to improve the patient's experience and quality of care, and to slow the rate of increase in healthcare costs.

Recenzje

"This book covers an extremely important topic, focusing on geriatric medicine and healthcare system administration, with some of the most up-to-date discussions. ... The book is straightforward, clear, and the tables and figures help to illustrate the discussions. The chapters provide unique information and precise data that complements the findings and discussions throughout the book. ... This book is quite informative and is an excellent resource for health administrators and healthcare professionals." (Marina Celly M R Souza, Doody's Book Reviews, September, 2018)

Spis treści

1.   Introduction – The Legacy of the Affordable Care Act

·         US healthcare spending, categories, regional variability, comparison to other countries

·         Growth of healthcare spending 1960-2010 and history of policy efforts to contain spending growth

·         Aims of the Affordable Care Act: Improve access, Improved quality, Slow the rate of healthcare cost increase

·         Outcomes of the Affordable Care Act: 20 million more individuals insured, enhanced uniform healthcare coverage requirements, improvement of the Medicare Health Insurance Trust Fund reserves, Healthcare inflation flat 2010-2015

·         Definition of value-based healthcare purchasing

 

2.  Quality Indicators, Outcomes, and Performance Pay

·         History of policy efforts to enhance healthcare quality

·         Nursing homes and long-term care, STAR ratings, Nursing Home Compare

·         Hospitals, DRG’s,  Inpatient Quality  Reporting Program, Hospital Compare, Medicare Annual Payment Updates

·         Home and community-based services, Home Health  Compare

·         Physician PQRS and MACRA

 

3.  Are the Drivers of Healthcare Change Changing Healthcare Outcomes?

·         Standardization and reporting versus quality improvement

·         Measures of success: Better health care (IOM 6 domains), Access (preventive care, population health), Slow the rate of healthcare inflation

·         High value care

·         Quality reporting requirements

·         Transfer of healthcare costs and risk to insurance, corporations, individuals

 

4.  Value-Based Healthcare Purchasing

·         Transparency and accountability in healthcare

·         Variability in cost and utilization

·         High value care recommendations

 

5.  New Models of Healthcare Delivery

·         Trajectory of healthcare models, cost, risk, population impact

·         Bundled payments models

·         Single and to detailed risk for healthcare organizations

·         Capitated models

·         Disease state innovations

·         Transitions of care programs (hospital initiated post discharge interventions, joint accountability for hospitals home health agencies long-term care facilities)

·         Hospital at home

·         Telehealth and coordinated transitions of care

 

6.  Educating New Healthcare Providers for the 21st Century

·         Collaborative practice models

·         Inter-professional teamwork

·         Education regarding new healthcare models

 

7.  The Primary Care dilemma

·         Incentives for primary care

·         The composition of primary care workforce

·         New models of primary care delivery

 

8.  Transitions of Care

·         Value-based purchasing in the continuum of care

·         Cost avoidance as a new cost center

·         Systematic assessment in targeting of modifiable risk factors

 

 

9.  Through the Looking Glass - Visions of the Future of Healthcare

·         Global healthcare system budgeting

·         Value-based purchasing and stimulation of new healthcare models

·         Oversight of healthcare training

·         Risk sharing and the scope of personal responsibility for healthcare

O autorze

James S. Powers, MD

VA Tennessee Valley Healthcare System

Vanderbilt University School of Medicine

Geriatric Research Education and Clinical Center

Nashville, TN 

Dr. Powers is Professor of Medicine at Vanderbilt University School of Medicine and Associate Clinical Director at the Tennessee Valley Healthcare System, Geriatrics Research Education and Clinical Center (TVHS GRECC), Nashville TN.  He is Geriatrics Fellowship Program Director.  The views expressed are his own and based on his experience of over three decades developing evaluating, and sustaining geriatric healthcare models and educational programs throughout the Mid-South.  The main premise of this book is that value-based purchasing for healthcare is likely to remain a constant for the foreseeable future despite any changes in the financing of healthcare.  The second is that value-based purchasing drives quality metrics which are important levers for changes in healthcare delivery.  Dr. Powers focuses on quality improvement and evaluating educational and clinical outcomes, maintains a large practice and teaches geriatrics to healthcare professionals of all disciplines.

Blurb

This book traces the origins of value-based purchasing and current geriatric care models to deliver value in the broader healthcare system.  The text focuses on the three goals that are expected to remain at the center of healthcare: improving access to healthcare via insurance coverage, improving the patient’s experience and quality of care, and effectively managing healthcare costs.  Chapters cover the quality indicators of care, drivers for improved outcomes, and models of care as seen in geriatrics as they can be expanded upon for the larger system.  The text also discusses some of the most critical periods for aging patients and the ways that these lessons can inform the larger system.  These topics include transitioning from the hospital to the home setting, integrating care between geriatric workers, and staff training and the clinical pearls for all changing demographics.

 

As the healthcare system evolves and the population ages, Value Driven Health Care proves to be a vital resource for geriatricians, primary care physicians, specialists who work with aging patients, hospital administrators, healthcare educators, healthcare organizations, and all medical professionals working with aging patients and patients affected by healthcare reform.