US Health System Reform

How the US has improved hospital care, saving thousands of lives – from Croakey – 19 August 2009

Posted on August 19, 2009. Filed under: Health Systems Improvement, US Health System Reform | Tags: , , |

How the US has improved hospital care, saving thousands of lives
August 19, 2009 – 12:23 pm, by Croakey

“Health policy analyst Dr Lesley Russell has written an indepth analysis of the state of health reform in the US for the online publication, Inside Story.

In this piece for Croakey she writes about the lessons from the US in using financial incentives to improve hospital care:

“As Australia looks to improve the quality of health care delivered in hospitals and implement national reporting against a range of  performance indicators to assess these improvements, a US pilot  program provides some instructive insights into how such changes can  work.

The Hospital Quality Incentive Demonstration (HQID) project,  the first national project of its kind, was designed to determine if  economic incentives to hospitals are effective at improving the  quality of inpatient care.”

…continues on the website

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US Health Care in the Year 2015 – CSC Computer Sciences Corporation – August 2009

Posted on August 19, 2009. Filed under: Health Informatics, US Health System Reform | Tags: |

US Health Care in the Year 2015 – CSC Computer Sciences Corporation – August 2009
Author:  Jordan Battani, Walt Zywiak

Summary:

“The U.S. health care industry is at a crossroads in 2009, and the next five years promise to be a time of upheaval and transformation as the entire industry redefines itself to deliver health care that is safe, effective, and high quality to enough people at a sustainable cost. The magnitude of these changes will affect every sector of the U.S. health care economy and providers, hospitals, and payer organizations that anticipate, prepare for, and embrace these changes are the ones that will survive and succeed.

In this paper we examine the changes underway in U.S. health care, and make some predictions about what will happen with health care cost inflation, coverage, capacity constraints, changing expectations, and health information technology by the year 2015. Recognizing that these changes will affect stakeholders in profoundly different ways, we discuss the implications for purchasers, consumers, providers, and payers, and provide strategic and tactical guidance for organizations to navigate successfully through the industry transformation.”

Download “US Healthcare in theYear 2015”

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How Do They Do That? Low-Cost, High-Quality Health Care in America – Institute for Healthcare Improvement

Posted on August 19, 2009. Filed under: US Health System Reform |

How Do They Do That?  Low-Cost, High-Quality Health Care in America

“For anyone joining in the lively debates underway about US health care reform, it’s easy to highlight examples of how broken the system is today. Recently, a group of quality visionaries, including IHI’s Don Berwick, did something different: they brought together health care leaders from regions that are already redesigning care for the better – delivering high-quality care at low cost. What lessons can the rest of us learn by asking, “How Do They Do That?” ”

Read a New York Times op-ed about this initiative and implications for policy-makers

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Variety of articles and sites on US health reform – August 2009

Posted on August 12, 2009. Filed under: US Health System Reform |

How to Rein in Medical Costs, RIGHT NOW
By GEORGE LUNDBERG    August 11, 2009

The White House fights back against the health insurance lobbiests etc trying to stop the health reform processes

about this site

12 Ways Health Reform May Improve Care and Save Costs
Cheryl Clark, for HealthLeaders Media, August 11, 2009

Dartmouth Atlas of health Care

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Leadership Commitments to Improve Value in Healthcare: Toward Common Ground: Workshop Summary – National Academies Press – 2009

Posted on August 1, 2009. Filed under: Evidence Based Practice, Health Mgmt Policy Planning, US Health System Reform | Tags: , |

Leadership Commitments to Improve Value in Healthcare: Toward Common Ground: Workshop Summary
Authors: LeighAnne Olsen, W. Alexander Goolsby, and J. Michael McGinnis; Roundtable on Evidence-Based Medicine, Institute of Medicine Published by National Academies Press, 2009 – title is forthcoming

“This volume reports on discussions among multiple stakeholders about ways they might help transform health care in the United States. The U.S. healthcare system consists of a complex network of decentralized and loosely associated organizations, services, relationships, and participants. Each of the healthcare system’s component sectors–patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved in information technology–conducts activities that support a common goal: to improve patient health and wellbeing. Implicit in this goal is the commitment of each stakeholder group to contribute to the evidence base for health care, that is, to assist with the development and application of information about the efficacy, safety, effectiveness, value, and appropriateness of the health care delivered.”

ISBN-10: 0-309-11053-X
ISBN-13: 978-0-309-11053-2

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US Health System Reform – links

Posted on July 10, 2009. Filed under: US Health System Reform |

Dartmouth Atlas of Health Care

The White House  – Reality Check

NEJM Health Reform Center

12 Ways Health Reform May Improve Care and Save Costs
Cheryl Clark, for HealthLeaders Media, August 11, 2009

Report to the Congress: Improving Incentives in the Medicare Program – June 2009 – by the Medicare Payment Advisory Commission (MedPAC) – an independent congressional agency established by the Balanced Budget Act of 1997 (P.L. 105–33) to advise the U.S. Congress on issues affecting the Medicare program

Healthcare Administrative Simplification Coalition (HASC) – “The goal of the HASC is to reduce administrative complexity and cost in healthcare. Unnecessarily complex or duplicative administrative processes waste billions of dollars each year in our nation’s healthcare system. Organized in 2005 by the American Academy of Family Physicians (AAFP), the American Health Information Management Association (AHIMA) and the Medical Group Management Association (MGMA), the coalition has expanded to include physicians, hospitals, health plans, employers and others dedicated to identifying and reducing unnecessary administrative complexity and cost in healthcare.”

Healthy examples: Plenty of countries get healthcare right by By Jonathan Cohn – July 5, 2009  – Boston Globe

Annals of Medicine: The Cost Conundrum – What a Texas town can teach us about health care by Atul Gawande June 1, 2009 – the New Yorker

The Health Care Blog

Medical Bankruptcy in the United States, 2007: Results of a National Study
David U. Himmelstein, MD,a Deborah Thorne, PhD, Elizabeth Warren, JD, Steffie Woolhandler, MD, MPH
American Journal of Medicine 2009   Article in press
http://dx.doi.org/10.1016/j.amjmed.2009.04.012
ABSTRACT
BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.
METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.
RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.
CONCLUSIONS: Illness and medical bills contribute to a large and increasing share of US bankruptcies

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