Format:
1 Online-Ressource (168 Seiten)
ISBN:
9783030951498
Note:
Description based on publisher supplied metadata and other sources
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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
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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
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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?
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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
