The United States has the highest per capita spending on health care of any industrialized nation. Yet despite the unprecedented levels of spending, harmful medical errors abound, uncoordinated care continues to frustrate patients and providers, and U.S. healthcare costs continue to increase. The growing ranks of the uninsured, an aging population with a higher prevalence of chronic diseases, and many patients with multiple conditions together constitute more complicating factors in the trend to higher costs of care. A variety of strategies are beginning to be employed throughout the health system to address the central issue of value, with the goal of improving the net ratio of benefits obtained per dollar spent on health care. However, despite the obvious need, no single agreed-upon measure of value or comprehensive, coordinated systemwide approach to assess and improve the value of health care exists. Without this definition and approach, the path to achieving greater value will be characterized by encumbrance rather than progress. To address the issues central to defining, measuring, and improving value in health care, the Institute of Medicine convened a workshop to assemble prominent authorities on healthcare value and leaders of the patient, payer, provider, employer, manufacturer, government, health policy, economics, technology assessment, informatics, health services research, and health professions communities. The workshop, summarized in this volume, facilitated a discussion of stakeholder perspectives on measuring and improving value in health care, identifying the key barriers and outlining the opportunities for next steps.
Author(s): Pierre L. Young, LeighAnne Olsen, J. Michael McGinnis, Roundtable on Evidence-Based Medicine, Institute of Medicine
Year: 2010
Language: English
Pages: 284
FrontMatter......Page 2
Reviewers......Page 10
Institute of Medicine Roundtable on Value & Science-Driven Health Care Charter and Vision Statement......Page 12
Foreword......Page 14
Preface......Page 16
Contents......Page 20
Summary......Page 24
1 The Need to Improve Value in Health Care......Page 46
2 Stakeholder Perspectives on Value......Page 52
3 Approaches to Assessing Value—Illustrative Examples......Page 62
4 Approaches to Improving Value—Consumer Incentives......Page 134
5 Approaches to Improving Value—Provider and Manufacturer Payments......Page 176
6 Approaches to Improving Value—Organization and Structure of Care......Page 196
7 Aligning the System to Promote Value—Now and in the Future......Page 224
8 Common Themes and Opportunities for Action......Page 238
Appendixes......Page 248
Appendix A: Workshop Agenda......Page 250
Appendix B: Biographical Sketches of Workshop Participants......Page 256
Appendix C: Workshop Attendee List......Page 278
