Understanding healthcare economics: managing your career in an evolving healthcare system

Table of Contents:

Introduction; Section 1: Pressures for Change; Chapter 1: Access; Chapter 2: Cost; Chapter 3: Quality; Section 2: Strategies to Increase Efficiency; Chapter 4: Align Incentives Via Payment System Design; Chapter 5: Managed Care Organizations, ACOs, PCMHs; Chapter 6: Wellness, Prevention and Disease Management; Chapter 7: New Types of Providers; Chapter 8: HIT = EMR + HIE; Appendix

Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation’s healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today’s healthcare system.

The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes.

Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed.

The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change – and some of the changes – on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.

(https://www.routledge.com/Understanding-Healthcare-Economics-Managing-Your-Career-in-an-Evolving/Wendel-Serratt-ODonohue/p/book/9781032095974)