The evolution of the healthcare system in the U.S. has seen numerous changes in the last 30 years where fee-for-service was the mainstay of reimbursement models and hospitals were managed by physicians and patient care was key. The early 1990’s saw the emergence of HMOs and other managed care models with physicians handing over leadership roles to corporate entities whose main concern was the bottom line and profitability while patient care and satisfaction suffered.
The Healthcare Collapse: Where We’ve been and Where We Need to Go explores the low morale of physicians in this corporate healthcare culture as well as the expansion of hospitals owned by corporations. The author focuses on recovering healthcare morals and return value to the individuals who provide active care and not just business. This book also examines the possible repercussions of Medicare and Medicaid while address the question of single payer healthcare.
This book looks at where healthcare has been, what has worked and what hasn’t, and recommends solutions to create a system that focuses on the patient and providing quality care in this age of reimbursement cuts, demands for better technology and providing a safer environment for both the patient and clinicians who work in hospitals. The author also advocates for a shift in management and recommends hospitals leaders engage physicians and other clinicians in process improvement and other initiatives which can result in a more efficient system – one where quality patient care dominant. The book also outlines programs which can be championed by hospitals such as patient engagement activities, community health and other outreach and education programs.
Table of Contents
Section 1: The Evolution of Healthcare. 1. From the 70’s to HMOs and the eight stages of healthcare. 2. Accountability Care Organization (ACO. and clinical Integration. 3. Negotiating manage Care Contract. 4. Hospital Supply chain and cost containment. 5. Quality crises. 6. Ethics and Deontology. Section 2: Physician Struggles. 7. The economics of becoming a doctor in USA. 8. The fear: the financial report. 9. Stark Laws – impact on physicians. 10. Health Care Grade Web Pages interferences. 11. Health care Impact on physicians: not healthy! Section 3: Broken system.1 2. Health insurance: how to play system for maximum reimbursement – at what cost? 13. Health Care: Who is in charge? Impossible victory. 14. Health Care exclusivity services charges and Reimbursement ratio. 15. Who is controlling the health care? 16. Healthcare Reform: the never-ending story. Section 4: Corporate Healthcare. 17. Corporation interference and compliance – when we lost health care? 18. Corporation and physician dissociation. 19. Moving out from health care. 20. Peer review for Physicians. What about the administrators? 21. Big pharma. Section 5: Medicare and Medicaid. 22. The future of the entitlement programs. 23. Medicaid Disproportionate funding. 24. Medicare and Medicaid spending: unify or crushing? A Financial Nightmare. 25. Macra and The Merit – base- Incentive Payment System (MIPS. 26. Will any healthcare plan ever works? Single payer? Section 6: Towards the Perfect System – what needs to be done and where we need to go. 27. Patient Engagement: education and prevention started on the territory. 28. Population health initiatives: The Teens obesity crises. 29. Clinicians involvement in improvement initiatives. 30. Physician involvement in management. 31. The perfect system.
Eldo E. Frezza, MD, MBA, FACS has been a board-certified physician for more than 20 years with 8 years of experience in health administration. He has a strong ability to improve financial, supply chain, quality and patient safety operations. He is a visible, hands-on leader with advisory expertise. He has a progressive understanding of flow and throughput with a reputation for establishing improvements and has a knowledge of utilization management.
He has served as Chief of Service and Chief of Surgery where he provided leadership and direction to successful transition from operating loss, to financial profit while drastically improving emergency and OR throughput. He also served as Director of Surgical Services for a private hospital where he assessed operations and established new metrics for OR; developed and implemented revised supply chain procedures for the OR to improve efficiency and achieve significant cost savings.
He has published books in Business and Ethics in healthcare including, The Business of Surgery, published by Cine-Med, copyright 2007; Professionalism & Ethics in a Surgical Practice published by Cine-Med, copyright 2008; and numerous articles. He received his medical degree Cum Laude from the University of Padua School of Medicine, Italy and his MBA in Health Organization management from Texas Tech Rawls School of Business, Lubbock, TX.