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Format: 1 Online-Ressource (168 Seiten)

ISBN: 9783030951498

Note: Description based on publisher supplied metadata and other sources , Intro -- Preface -- Contents -- About the Author -- Abbreviations -- Chapter 1: Introduction -- 1.1 Value in Health Care -- 1.1.1 Value as a Concept -- 1.1.1.1 Value: What It Is and What It Isn't -- 1.1.2 Value Perspectives -- 1.2 Value Assessments -- 1.3 Illustrative Examples -- 1.3.1 Value-Based Reimbursement Structures -- 1.3.1.1 The CMS Hospital Value-Based Purchasing Program -- 1.3.1.2 Blue Cross Blue Shield of Minnesota -- 1.3.2 Funding and Acquisitions of Innovative Companies -- 1.3.2.1 Virtual Health Platforms -- 1.4 The Structure of This Book -- References -- Part I: Understanding the Challenges of Assessing the Value of Health Care -- Chapter 2: Challenge 1: Complexity -- 2.1 Complexity -- 2.2 The Healthcare System Is Complex -- 2.2.1 Settings Where Care Is Delivered Are Complex Adaptive Systems -- 2.2.2 Paying for Health Care Is Messy -- 2.3 Patient Health Is Complex -- 2.4 How Complexity-Related Challenges Often Manifest When Assessing Value -- 2.4.1 Complexity Makes It Harder to Obtain Accurate Measurements -- 2.4.2 Complexity Makes It Harder to Determine Attribution -- 2.4.3 Improvements in Quality May Not Result in Higher Value for One or More Stakeholders -- 2.4.4 Complexity Contributes to an Unknowable Future -- 2.5 Summary -- References -- Chapter 3: Challenge 2: Continuity -- 3.1 Continuity -- 3.2 Episodic Care Versus a Care Continuum -- 3.3 Care Continuity Blurs the Lines Between Population Health and Care Delivery -- 3.3.1 Incentives to Improve Population Health Versus Care Delivery -- 3.3.1.1 Payers' Incentives -- 3.3.1.2 Patients' Incentives -- 3.3.1.3 Providers' Incentives -- 3.3.2 The Expected Role of Patients in Population Health and Care Delivery -- 3.4 Individual Health Status as More Than Just Absence of Disease -- 3.5 The Lack of Continuity in Health Policy and Payment , 3.6 How Continuity-Related Challenges Often Manifest When Assessing Value -- 3.6.1 Continuity Makes It Harder to Isolate Components of Health -- 3.6.2 A Lack of Continuity in Policy and Evaluations Makes It Harder to Compare Value -- 3.7 Summary -- References -- Chapter 4: Challenge 3: Inconsistency -- 4.1 Inconsistency -- 4.2 Inconsistencies in the Language of Value -- 4.2.1 Definitions of Value -- 4.3 Inconsistencies in the Motivations to Assess Value -- 4.3.1 Value-Based Payments -- 4.3.2 Investments and Acquisitions -- 4.4 How Inconsistency-Related Challenges Often Manifest When Assessing Value -- 4.4.1 Inconsistent Motivations for Value Make It Difficult to Consistently Define Value -- 4.4.2 Inconsistent Definitions of Value Make It Difficult to Compare Value -- 4.5 Summary -- References -- Part II: A Primer on Fundamental Concepts and Current Techniques Used to Measure Value in Health Care -- Chapter 5: Key Economic Concepts and Their Implications -- 5.1 How an Economist Defines Value -- 5.2 Basic Ideas of Health Economics -- 5.2.1 Demand, Supply, and Prices -- 5.2.2 Utility, Risk, and Uncertainty -- 5.2.3 Economic Evaluation of Health Outcomes -- 5.2.3.1 The Value of Equity -- 5.2.4 Moral Hazard and Price Sensitivity -- 5.2.5 Theories of the Demand for Health Insurance -- 5.2.6 Efficiency -- 5.2.7 Incomplete and Asymmetric Information -- 5.3 Potential Implications of Basic Economic Concepts for Assessing Value in Health Care -- 5.3.1 Asymmetric Information Can Lead to Inefficiency -- 5.3.2 Moral Hazard Can Lead to Either Less Efficient or More Efficient Use of Resources -- 5.3.3 Financially Incentivized Reimbursement Can Encourage Fraud and Inflates the Cost of Care Through Administrative Burden -- 5.4 Summary -- References -- Chapter 6: Current Methods of Value Assessments -- 6.1 A Brief History of Value Assessments , 6.2 Types of Assessments -- 6.2.1 CEA/CUA and QALYs -- 6.2.1.1 Usage, Advantages, and Disadvantages of CEA/CUA -- 6.2.2 ROI -- 6.2.2.1 Usage, Advantages, and Disadvantages of ROI -- 6.2.3 Additional Methods -- 6.2.4 Discounting and Risk Adjustment -- 6.2.4.1 Discounting -- 6.2.4.2 Risk Adjustment -- 6.3 Factors That Influence Health and Outcomes -- 6.4 Summary -- References -- Part III: Practical and Human Considerations: A Discussion of the Real-World Motivations and Requirements That Should Be Contemplated When Exploring Value -- Chapter 7: Practical and Human Considerations -- 7.1 Perspectives -- 7.2 Motivations and Goals -- 7.3 Roles, Responsibilities, and Expectations -- 7.4 Social, Political, and Cultural Factors -- 7.5 Behavioral Economics -- 7.5.1 Complex Adaptive System (Redux) -- 7.5.2 System Thinking and Cognitive Biases -- 7.6 Biases Impacting the Design and Interpretation of Value Assessments -- 7.6.1 Biases That Can Influence Value Measurement -- 7.6.2 Biases That Can Influence Value Interpretation -- 7.7 Summary -- References -- Part IV: How to Design and Perform a Value Assessment -- Chapter 8: The Value Assessment Framework -- 8.1 Overview -- 8.2 Motivating Examples -- 8.2.1 Example 1: Reducing Central Line-Associated Bloodstream Infections (CLABSIs) -- 8.2.2 Example 2: Increasing Coverage and Offerings for Mental and Behavioral Health -- 8.3 Step 1 of the Value Assessment Framework: Define Value -- 8.3.1 Question 1: From Whose Perspective Are We Considering Value-Value to Whom? -- 8.3.2 Question 2: What Is the Scope of the Value Assessment in Terms of Time and Reach? -- 8.3.2.1 Framing the Scope as an Opportunity -- 8.3.3 Question 3: What Is the Value Assessment's Goal or Objective? What Decision Will It Inform? -- 8.3.4 Question 4: What Assumptions Will Be Made in the Value Assessment? , 8.3.5 Who Is the Intended Audience for the Value Assessment? -- 8.4 Step 2 of the Value Assessment Framework: Determine Costs, Benefits, and Metrics -- 8.4.1 Define Costs and Benefits -- 8.4.1.1 Costs -- 8.4.1.2 Benefits -- Utilization -- Efficiency and Reduced Waste -- Patient Experience and/or Health -- Administrative -- Societal -- 8.4.2 Explore Various Metrics -- 8.4.2.1 ROI and BCR -- Net Value -- Payback Period -- Savings per Unit -- 8.4.2.2 Cost per Unit Benefit -- The Incremental Cost-Effectiveness Ratio -- 8.4.3 Identify Relevant Benchmarks or Comparisons -- 8.5 Step 3 of the Value Assessment Framework: Interpret and Communicate -- 8.5.1 Guiding Principles for Interpreting and Communicating Results -- 8.5.1.1 Explore All Types of Value -- 8.5.1.2 Inform, Guide, and Teach -- 8.5.1.3 Merge Technical and Practical Considerations -- 8.5.1.4 Identify Learnings and New Insights -- 8.5.1.5 Describe What's Needed Going Forward -- 8.6 Summary -- Reference -- Chapter 9: Examples and Practical Suggestions -- 9.1 Real-World Examples -- 9.1.1 Example 1: Determining Value Within the CMS Hospital Readmissions Reduction Program -- 9.1.2 Example 2: Determining the Value of a Medical Device or Digital Health Application -- 9.1.2.1 The Value Assessment for a Payer Audience -- 9.1.2.2 The Value Assessment for a Potentially Acquiring Organization -- 9.1.3 Example 3: Determining the Value of Primary Care -- 9.2 General Thoughts and Practical Suggestions for Developing and Carrying Out Value Assessments -- 9.2.1 Collect and Organize Relevant Information -- 9.2.2 Develop and Use Templates -- 9.2.3 How to Standardize Value Assessment Results -- References -- Glossary of Terms -- Index

Additional Edition: Erscheint auch als Druck-Ausgabe Solid, Craig A. Practical Strategies to Assess Value in Health Care Cham : Springer International Publishing AG,c2022 ISBN 9783030951481

Language: English

UID:

Format: XV, 163 p. 19 illus. , online resource.

Edition: 1st ed. 2022.

ISBN: 9783030951498

Content: 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.

Note: 1. Introduction -- Part I: Understanding the Challenges of Assessing the Value of Health Care -- 2. Challenge One: Complexity -- 3. Challenge Two: Continuity -- 4. Challenge Three: Lack of Consistency -- Part II: A Primer on Fundamental Concepts and Current Techniques Used to Measure Value in Health Care -- 5. Key Economic Concepts and Their Implications -- 6. Current Methods of Value Assessments -- Part III: A Discussion of the Real-world Motivations and Requirements that Should be Contemplated when Exploring Value -- 7. Practical and Human Considerations -- Part IV: How to Design and Perform a Value Assessment -- 8. The Value Assessment Framework -- 9. Examples and Practical Suggestions.

In: Springer Nature eBook

Additional Edition: Printed edition: ISBN 9783030951481

Additional Edition: Printed edition: ISBN 9783030951504

Additional Edition: Printed edition: ISBN 9783030951511

Language: English

DOI: 10.1007/978-3-030-95149-8

URL: https://doi.org/10.1007/978-3-030-95149-8

UID:

Format: 1 Online-Ressource (XV, 163 p. 19 illus).

Edition: 1st ed. 2022

ISBN: 978-3-030-95149-8

Additional Edition: Erscheint auch als Druck-Ausgabe ISBN 978-3-030-95148-1

Additional Edition: Erscheint auch als Druck-Ausgabe ISBN 978-3-030-95150-4

Additional Edition: Erscheint auch als Druck-Ausgabe ISBN 978-3-030-95151-1

Language: English

DOI: 10.1007/978-3-030-95149-8

URL: Volltext  (URL des Erstveröffentlichers)

UID:

Format: 1 Online-Ressource (XV, 163 p. 19 illus).

Edition: 1st ed. 2022

ISBN: 978-3-030-95149-8

Additional Edition: Erscheint auch als Druck-Ausgabe ISBN 978-3-030-95148-1

Additional Edition: Erscheint auch als Druck-Ausgabe ISBN 978-3-030-95150-4

Additional Edition: Erscheint auch als Druck-Ausgabe ISBN 978-3-030-95151-1

Language: English

DOI: 10.1007/978-3-030-95149-8

URL: Volltext  (URL des Erstveröffentlichers)