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

Increased consumer control of health care is shaking up the medical and insurance systems. In Consumer–Driven Health Care, Harvard Business School’s acclaimed professor Regina E. Herzlinger states that hospitals, doctors, benefits administrators, accountants, government policymakers, and insurers had better adapt or else they will be replaced.
Professor Herzlinger documents how the consumer–driven health care movement is being implemented and its impact on insurers, providers, new intermediaries, and governments. With additional contributions by health care’s leading strategists, innovators, regulators and scholars, Consumer–Driven Health Care presents a compelling vision of a health care system built to satisfy the people it serves.
"Professor Herzlinger provides a compelling argument for consumer–driven health care. The health care system has been marked for decades with rising costs and consumer dissatisfaction. Professor Herzlinger challenges the reader to look beyond solutions that are based on what consumers should want to solutions that give consumers what they want."
–Barbara Bigelow, Ph.D., Co–Editor, Health Care Management Review, Professor of Management, Clark University Graduate School of Management
"Regina Herzlinger has a formidable reputation as an expert on reforming health care. There are lessons here for all of us who care about reforming our health systems to make them better."
–David Willets, MP, Shadow Work and Pensions Secretary and Member of Parliament , UK
"This book is a must–read for anyone who wants to know why the American model of health insurance benefits that has been around for about 50 years is all washed up, and what is most likely to replace it."
–Roger Feldman, Blue Cross Professor of Health Insurance, University of Minnesota
"Professor Herzlinger can persuade corporate CEOs, Washington policymakers, benefits administrators, and hospital exe cutives to reshape their strategy based on a market run by consumers. This book translates health economics into simple English, reducing the "mystery–inside–a–conundrum" field into everyday transactions like selecting a health plan that any health care consumer can recognize. Consumer–Driven Health Care will be a top candidate for health care’s ′book of the year.′ "
–Russell C. Coile, Jr., consultant, editor, Russ Coile’s Health Trends, and author, Competing On Excellence (2003)

Spis treści:
Preface.
Introduction.
PART ONE: WHY WE NEED CONSUMER–DRIVEN HEALTH CARE.
1. Fear and Loathing of Defined Benefit Health Insurance.
2. The Frayed Safety Net.
3. The Solution.
4. Consumer–Driven Health Insurance: What Works.
5. Health Care Productivity.
6. The Silent Revolution.
7. Scare Stories, Opponents, and the Role of Government.
8. How to Make Consumer–Driven Health Care Happen.
PART TWO: VISION AND MODELS.
9. The Future of Twenty–First Century Health (William W. George).
10. How Employers Can Make Consumer–Driven Health Care a Reality (Brian J. Marcotte).
11. Designing Health Insurance for the Information Age (John C. Goodman).
12. Risk Adjustment: An Overview and Three Case Studies (Lisa I. Iezzoni).
13. Consumer–Driven Health Care: Dialogues with Socrates (Stephen S. Hyde).
14. Employee Tax Payments and Consumer–Driven Health Care (Jeanne A. Brown).
15. The Implications of Tax Rulings on “Savings Accounts” (Charles H. Klippel).
16. You Just Can’t Pay Tom, Juan, and Ashley the Old Way Anymore (Bonnie B. Whyte).
17. The Federal Employees Health Benefits Program (James W. Morrison Jr.).
18. Health–Based Premium Payments and Consumer Assessment Information (Vicki M. Wilson, Jenny M. Hamilton, Mary K. Uyeda, Cynthia A. Smith, with Graydon M. Clouse ).
19. The Buyers Health Care Action Group: Creating Incentives to Seek the Sick (Ann L. Robinow).
20. An Insurance CEO’s Perspective on Consumer–Driven Health Care (Leonard D. Schaeffer).
21. An Alternative to Managed Care: A European Perspective on Informed Choice (Bruno L. Holthof).
22. Medical Savings Accounts and Health Care Financing in South Africa (Shaun Matisonn).
23. European Health Care: The Cost of Solidarity and the Promise of Risk–Adjusted Consumer–Driven Health Care (Paul Belien).
24. Consumer–Driven Health Care: An International View (Alvaro Salas–Chaves).
25. Challenges of Consumer–Driven Health Care (Eugene D. Hill III).
26. Making the Transition to Consumer–Driven Health Care (Jesse S. Hixson).
27. The New Consumer–Driven Health Care System (Daniel H. Johnson).
28. The Patient’s Right to Decide (Warner V. Slack).
29. Comments on Consumer–Driven Health Care (Corbette S. Doyle).
30. The Evolution of Consumer–Driven Health Care (Robert W. Coburn).
31. Will Consumer–Driven Health Care Work for Employers? (John C. Erb).
32. The Perspective of an Advocate for the Elderly (John Rother).
PART THREE: THE NEW INTERMEDIARIES.
33. Where Will Consumer–Driven Health Care Take the Health Care System? (Bernard T. Ferrari).
34. The Role of Information: J. D. Power’s Paradigm Lessons from the Automotive Industry (J. D. Power III).
35. Providing Information to Consumers (David Lansky).
36. Consumer–Driven Health Care and the Internet (Mark A. Pearl).
37. The Present and Future Roles of Information in a Consumer–Driven Health System (Russell Ricci).
38. Who Has Star Quality? (Jon A. Chilingerian).
39. Grounding Consumer–Driven Health Care in Social Science Research (Arnold Milstein, Nancy E. Adler).
40. Providing the Most–Wanted Information When Most Needed: Best Doctors (Steven W. Naifeh, Gregory White Smith).
41. The Half–Billion Dollar Impact of Information About Quality (Becky J. Cherney).
42. Buyers Health Care Action Group: Consumer Perceptions of Quality Differences (Katherine M. Harris, Roger Feldman, Jennifer S. Schultz, Jon Christianson).
43. Helping Consumers Choose Among Complex Insurance Plans (Colleen M. Murphy).
44. CareCounsel: Consumer–Driven Health Care Advocacy (Lawrence N. Gelb).
45. Access Health Group: A Medical Management Perspective (Joseph P. Tallman).
46. Consumer’s Medical Resource: Helping Consumers Evaluate Medical Treatment Options (David J. Hines).
47. The Cost Effectiveness of Consumer–Driven Lifestyle Changes in the Treatment of Cardiac Disease (Dean Ornish).
48. Healthtrac: Proven Reduction of the Need and Demand for Medical Services (James F. Fries).
49. The Healthwise® Approach: Reinventing the Patient (Donald W. Kemper, Molly Mettler).
PART FOUR: INNOVATIVE CONSUMER–DRIVEN SOLUTIONS TO CHRONIC PROBLEMS.
50. The Role of Providers (Michael L. Millenson).
51. A Disease Management Approach to Chronic Illness (Jessie C. Gruman, Cynthia M. Gibson).
52. Consumer–Driven Health Care: Management Matters (Richard M. J. Bohmer, Amy C. Edmondson, Gary P. Pisano).
53. Consumer–Driven Health Care for the Chronically Ill (Al Lewis).
54. A Cost–Effective Model for High–Quality Catastrophic Care (Bernard Salick, Seth M. Yellin).
55 Collaborating with Consumers to Advance Health Knowledge and Improve Practice (S. Robert Levine, Laura L. Adams).
56. Package Pricing at the Texas Heart Institute (Denton A. Cooley, John W. Adams Jr.).
57. Helping Patients Manage Their Asthma: The National Jewish Approach (Lynn M. Taussig, David Tinkelman).
58. A Model of Focused Health Care Delivery: Shouldice Hospital (Daryl J. B. Urquhart, Alan O’Dell).
59. Chronic Problems, Innovative Solutions: Paving the Way