Understanding Healthcare Economics
Managing Your Career in an Evolving Healthcare System, Second Edition
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.
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
Jeanne Wendel, PhD Economics:
Dr. Wendel is a Professor of Economics at the University of Nevada Reno. Her interest in health economics was jump-started in the early 1990s, when a hospital bought half of her time from the UNR College of Business. She attended the first four-week Advanced Training conducted by Dr. Brent James, at LDS Hospital in Utah, and then served on the Design Team that implemented a quality improvement program at the hospital. Recently, she worked with co-authors to evaluate the health information exchange in Nevada, analyze questions posed by a state Medicaid program, and evaluate the impact of incentives on wellness behaviors. She has coauthored published papers on the impacts of wellness, preventive care and disease management programs, and the impact of weight-gain on smoking cessation efforts. She has also coauthored published papers on quality improvement, hospital costs, the impact of organization size on risk, he impact of bundled payments efficiency, and the impact of competition on hospital provision of uncompensated care.
William O’Donahue, PhD:
William O’Donahue, PhD is a Professor of Psychology at the University of Nevada Reno. He received his doctorate in psychology from SUNY at Stony Brook and has published over 75 books and 200 journal articles. He has directed the Victims of Crime Treatment Center for 20 years where children who have been sexually abused and women who have been sexually assaulted can receive free treatment. He has also helped numerous organizations forms and sustain integrated care delivery systems.
Teresa D. Serratt PhD, RN:
Dr. Serratt is an associate professor in the School of Nursing at Boise State University. She earned her doctorate in nursing from the University of California, San Francisco, with a specialty in health policy. She currently teaches courses in healthcare leadership, healthcare analysis, health care delivery models, quality improvement and healthcare policy. Her primary research focus is health policy, nursing workforce and organizational analysis of economic and quality issues.
As a registered nurse for over 25 years, she has spent the majority of her career at the bedside providing care to critically ill adult patients. She has experienced firsthand some of the failures of our healthcare system and feels it is imperative that healthcare professionals understand the healthcare reform issues and join the debate.