Consumer-Driven Health Care: Implications for Providers, Payers, and Policy-Makers

Consumer-Driven Health Care......Page 5
CONTENTS......Page 11
Preface......Page 19
Introduction......Page 21
PART ONE: WHY WE NEED CONSUMER-DRIVEN HEALTH CARE......Page 39
1 Fear and Loathing of Defined Benefit Health Insurance......Page 41
2 The Frayed Safety Net......Page 66
3 The Solution......Page 95
4 Consumer-Driven Health Insurance: What Works......Page 112
5 Health Care Productivity......Page 140
6 The Silent Revolution......Page 165
7 Scare Stories, Opponents, and the Role of Government......Page 191
8 How to Make Consumer-Driven Health Care Happen......Page 233
PART TWO: VISION AND MODELS......Page 237
9 The Future of Twenty-First Century Health......Page 241
10 How Employers Can Make Consumer-Driven Health Care a Reality......Page 251
11 Designing Health Insurance for the Information Age......Page 262
12 Risk Adjustment: An Overview and Three Case Studies......Page 280
13 Consumer-Driven Health Care: Dialogues with Socrates......Page 300
14 Employee Tax Payments and Consumer-Driven Health Care......Page 308
15 The Implications of Tax Rulings on “Savings Accounts”......Page 317
16 You Just Can’t Pay Tom, Juan, and Ashley the Old Way Anymore......Page 322
17 The Federal Employees Health Benefits Program......Page 329
18 Health-Based Premium Payments and Consumer Assessment Information......Page 336
19 The Buyers Health Care Action Group: Creating Incentives to Seek the Sick......Page 347
20 An Insurance CEO’s Perspective on Consumer-Driven Health Care......Page 355
21 An Alternative to Managed Care: A European Perspective on Informed Choice......Page 360
22 Medical Savings Accounts and Health Care Financing in South Africa......Page 368
23 European Health Care: The Cost of Solidarity and the Promise of Risk-Adjusted Consumer-Driven Health Care......Page 376
24 Consumer-Driven Health Care: An International View......Page 400
25 Challenges of Consumer-Driven Health Care......Page 406
26 Making the Transition to Consumer-Driven Health Care......Page 409
27 The New Consumer-Driven Health Care System......Page 411
28 The Patient’s Right to Decide......Page 414
29 Comments on Consumer-Driven Health Care......Page 418
30 The Evolution of Consumer-Driven Health Care......Page 422
31 Will Consumer-Driven Health Care Work for Employers?......Page 429
32 The Perspective of an Advocate for the Elderly......Page 432
PART THREE: THE NEW INTERMEDIARIES......Page 437
33 Where Will Consumer-Driven Health Care Take the Health Care System?......Page 441
34 The Role of Information: J. D. Power’s Paradigm Lessons from the Automotive Industry......Page 448
35 Providing Information to Consumers......Page 457
36 Consumer-Driven Health Care and the Internet......Page 466
37 The Present and Future Roles of Information in a Consumer-Driven Health System......Page 478
38 Who Has Star Quality?......Page 481
39 Grounding Consumer-Driven Health Care in Social Science Research......Page 492
40 Providing the Most-Wanted Information When Most Needed: Best Doctors......Page 496
41 The Half-Billion Dollar Impact of Information About Quality......Page 505
42 Buyers Health Care Action Group: Consumer Perceptions of Quality Differences......Page 513
43 Helping Consumers Choose Among Complex Insurance Plans......Page 525
44 CareCounsel: Consumer-Driven Health Care Advocacy......Page 528
45 Access Health Group: A Medical Management Perspective......Page 539
46 Consumer’s Medical Resource: Helping Consumers Evaluate Medical Treatment Options......Page 548
47 The Cost Effectiveness of Consumer-Driven Lifestyle Changes in the Treatment of Cardiac Disease......Page 554
48 Healthtrac: Proven Reduction of the Need and Demand for Medical Services......Page 561
49 The Healthwise® Approach: Reinventing the Patient......Page 570
PART FOUR: INNOVATIVE CONSUMER-DRIVEN SOLUTIONS TO CHRONIC PROBLEMS......Page 581
50 The Role of Providers......Page 587
51 A Disease Management Approach to Chronic Illness......Page 599
52 Consumer-Driven Health Care: Management Matters......Page 608
53 Consumer-Driven Health Care for the Chronically Ill......Page 627
54 A Cost-Effective Model for High-Quality Catastrophic Care......Page 633
55 Collaborating with Consumers to Advance Health Knowledge and Improve Practice......Page 640
56 Package Pricing at the Texas Heart Institute......Page 650
57 Helping Patients Manage Their Asthma: The National Jewish Approach......Page 657
58 A Model of Focused Health Care Delivery: Shouldice Hospital......Page 665
59 Chronic Problems, Innovative Solutions: Paving the Way to the Focused Factory......Page 673
60 Improving Health and Reducing the Costs of Chronic Diseases......Page 681
61 The Impact of Horizontal Integration in Hospitals: HCA Healthcare Corporation......Page 689
62 An Innovative Approach to Population Health: Kaiser Permanente Southern California......Page 699
63 The Right Care: Vanderbilt Medical Center......Page 707
64 Achieving Focus in Hospital Care: The Role of Relational Coordination......Page 721
65 Consumer-Driven Health Care Is a Message of Hope......Page 734
66 An Academic Health Center Perspective......Page 737
67 Consumer Choice in Consumer-Driven Health Care......Page 741
68 Individual Genetic Profiles: The Empowerment of the Health Care Consumer......Page 745
69 Delivering the Right Drug to the Right Patient......Page 754
PART FIVE: THE ROLE OF GOVERNMENT......Page 765
70 The Uninsured: Understanding and Resolving an American Dilemma......Page 769
71 A Health Insurance Tax Credit: The Key to More Coverage and Choice for Consumers......Page 787
72 The Politics of Consumer-Driven Health Care......Page 802
73 Health Care: What Role for Regulation?......Page 812
74 Adult Health Insurance......Page 817
75 AmeriChoice Corporation: The Personal Care Model......Page 819
76 The Uninsured and Access......Page 827
77 Consumer-Driven Health Care for the Uninsured......Page 832
78 A Health Care SEC: The Truth, The Whole Truth, and Nothing But the Truth......Page 835
79 Keep ’Em Honest: The Health Care SEC......Page 849
80 The U.S. Needs a Consumer-Driven Medical Care System......Page 854
81 Government’s New Roles in the Era of Consumer-Driven Health Care......Page 858
The Editor......Page 867
The Participants......Page 869
The Contributors......Page 871
Name Index......Page 879
Subject Index......Page 895