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An Essential Guide to the Processes and Operational Complexities of the U.S. Healthcare System The U.S. Healthcare Ecosystem serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem will inspire you to think more critically about the business of healthcare and make informed assessments. Features: Includes often neglected topics impacting healthcare delivery such as employer-based health insurance, pharmacy benefits, healthcare consolidation, and biotechnology Highly readable and single-authored by a Wharton Professor who has taught health care delivery and management for over 20 years Filled to the brim with helpful diagrams, charts and tables - nearly 350 figures complement the text Every chapter ends with a helpful Summary and Questions to Ponder
Managed health care is one of the most confusing areas any consumer can deal with. Rules and regulations are constantly changing, providers are always merging and changing their offerings, and paperwork abounds. In easy-to-understand language, this book explains how to understand options, how to get treatment for chronic and long-term illnesses, how to get the most care for the least cost, and more.
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
The Business of Healthcare Innovation is the first wide-ranging analysis of business trends in the manufacturing segment of the health care industry. In this leading edge volume, Professor Burns focuses on the key role of the 'producers' as the main source of innovation in health systems. Written by professors of the Wharton School and industry executives, this book provides a detailed overview of the pharmaceutical, biotechnology, genomics/proteomics, medical device and information technology sectors. It analyses the market structures of these sectors as well as the business models and corporate strategies of firms operating within them. Most importantly, the book describes the growing convergence between these sectors and the need for executives in one sector to increasingly draw upon trends in the others. It will be essential reading for students and researchers in the field of health management, and of great interest to strategy scholars, industry practitioners and management consultants.
“During a time of tremendous change and uncertainty, Healthcare Disrupted gives executives a framework and language to determine how they will evolve their products, services, and strategies to flourish in a increasingly value-based healthcare system. Using a powerful mix of real world examples and unanswered questions, Elton and O’Riordan lead you to see that ‘no action’ is not an option—and push you to answer the most important question: ‘What is your role in this digitally driven change and how can your firm can gain competitive advantage and lead?’”—David Epstein, Division Head, Novartis Pharmaceuticals “Healthcare Disrupted is an inspirational call-to-action for everyone associated with healthcare, especially the innovators who will develop the next generation of therapeutics, diagnostics, and devices.”—Bob Horvitz, Ph.D., David H. Koch Professor of Biology, MIT; Nobel Prize in Physiology or Medicine “In a time of dizzying change across all fronts: from biology, to delivery, to the use of big data, Health Disrupted captures the impact of these forces and thoughtfully develops new approaches to value creation in the healthcare industry. A must-read for those who strive to capitalize on change and reinvent the industry.”—Deborah Dunsire, M.D., president and CEO, FORUM Pharmaceuticals Healthcare at a Crossroad: Seismic Shifts, New Business Models for Success Healthcare Disrupted is an in-depth look at the disruptive forces driving change in the the healthcare industry and provides guide for defining new operating and business models in response to these profound changes. Based on original research conducted by Accenture and years of experience working with the most successful companies in the industry, healthcare experts Jeff Elton and Anne O’Riordan provide an informed, insightful view of the state of the industry, what's to come, and new emerging business models for life sciences companies play a different role from the past in to driving superior outcomes for patients and playing a bigger role in creating greater value for healthcare overall. Their book explains how critical global healthcare trends are challenging legacy strategies and business models, and examines why historical leaders in the industy must evolve, to stay relevant and compete with new entrants. Healthcare Disrupted captures this pivotal point in time to give executives and senior managers across pharmaceutical, biopharmaceutical, medical device, medical diagnostics, digital technology, and health services companies an opportunity to step back and consider the changing landscape. This book gives companies options for how to adapt and stay relevant and outlines four new business models that can drive sustainable growth and performance. It demonstrates how real-world data (from Electronic Medical Records, health wearables, Internet of Things, digital media, social media, and other sources) is combining with scalable technologies and advanced analytics to fundamentally change how and where healthcare is delivered, bridging to the health of populations, and broadening the resposibility for both. It reveals how this shift in healthcare delivery will significantly improve patient outcomes and the value health systems realize.
Provides a diverse, multi-faceted approach to health care evaluation and management The U.S. Health Care System: Origins, Organization and Opportunities provides a comprehensive introduction and resource for understanding healthcare management in the United States. It brings together the many "moving parts" of this large and varied system to provide both a bird's-eye view as well as relevant details of the complex mechanisms at work. By focusing on stakeholders and their interests, this book analyzes the value propositions of the buyers and sellers of healthcare products and services along with the interests of patients. The book begins with a presentation of frameworks for understanding the structure of the healthcare system and its dynamic stakeholder inter-relationships. The chapters that follow each begin with their social and historical origins, so the reader can fully appreciate how that area evolved. The next sections on each topic describe the current environment and opportunities for improvement. Throughout, the learning objectives focus on three areas: frameworks for understanding issues, essential factual knowledge, and resources to keep the reader keep up to date. Healthcare is a rapidly evolving field, due to the regulatory and business environments as well as the advance of science. To keep the content current, online updates are provided at: healthcareinsights.md. This website also offers a weekday blog of important/interesting news and teaching notes/class discussion suggestions for instructors who use the book as a text. The U.S. Health Care System: Origins, Organization and Opportunities is an ideal textbook for healthcare courses in MBA, MPH, MHA, and public policy/administration programs. In piloting the content, over the past several years the author has successfully used drafts of chapters in his Healthcare Systems course for MBA and MPH students at Northwestern University. The book is also useful for novice or seasoned suppliers, payers and providers who work across the healthcare field and want a wider or deeper understanding of the entire system.
"The U.S. Healthcare Ecosystem, 2nd Edition serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem, 2nd Edition will inspire you to think more critically about the business of healthcare and make informed assessments"--
Essentials of the U.S. Health Care System, Fifth Edition is a clear and concise distillation of the major topics covered in the best-selling Delivering Health Care in America by the same authors. Designed for undergraduate and graduate students in programs across the health disciplines, Essentials of the U.S. Health Care System is a reader-friendly, well organized resource that covers the major characteristics, foundations, and future of the U.S. health care system. The text clarifies the complexities of health care organization and finance and presents a solid overview of how the various components fit together.
Over the past decade, businesses have faced relentless change on multiple dimensions, and the list of the world’s largest companies has changed enormously. The keys to success are likely to be just as different for the new decade. Winning the ’20s analyzes the new competitive environment that businesses face and outlines what will it take to win in the 2020s. To stay ahead of the trends that are reshaping business, leaders need to rethink existing assumptions and retool their companies. Both traditional incumbents and younger digital giants will face very different but equally critical challenges in the 2020s—and would do well to learn from each other’s strengths. This book discusses the new dimensions of competition that will affect corporate strategy in the next decade and how leaders can reinvent their organizations to be better suited for the new environment. The companies that succeed in the 2020s will look very different than they do today—they will have evolved their businesses to harness new technologies and reshaped their external relationships, organizations, and approaches accordingly. Winning the ’20s will help business professionals as well as academics and students with an interest in strategy and leadership answer this critical question for the start of this decade: How should you prepare your company to avoid being left behind and emerge as a winner in a rapidly evolving business landscape?
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.