The U.S. Healthcare Ecosystem: Payers, Providers, Producers

The U.S. Healthcare Ecosystem: Payers, Providers, Producers

Author: Lawton Robert Burns

Publisher: McGraw Hill Professional

Published: 2021-03-16

Total Pages: 640

ISBN-13: 1264264488

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An Essential Guide to the Processes and Operational Complexities of the U.S. Healthcare System The U.S. Healthcare Ecosystem serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem will inspire you to think more critically about the business of healthcare and make informed assessments. Features: Includes often neglected topics impacting healthcare delivery such as employer-based health insurance, pharmacy benefits, healthcare consolidation, and biotechnology Highly readable and single-authored by a Wharton Professor who has taught health care delivery and management for over 20 years Filled to the brim with helpful diagrams, charts and tables - nearly 350 figures complement the text Every chapter ends with a helpful Summary and Questions to Ponder


Book Synopsis The U.S. Healthcare Ecosystem: Payers, Providers, Producers by : Lawton Robert Burns

Download or read book The U.S. Healthcare Ecosystem: Payers, Providers, Producers written by Lawton Robert Burns and published by McGraw Hill Professional. This book was released on 2021-03-16 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: An Essential Guide to the Processes and Operational Complexities of the U.S. Healthcare System The U.S. Healthcare Ecosystem serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem will inspire you to think more critically about the business of healthcare and make informed assessments. Features: Includes often neglected topics impacting healthcare delivery such as employer-based health insurance, pharmacy benefits, healthcare consolidation, and biotechnology Highly readable and single-authored by a Wharton Professor who has taught health care delivery and management for over 20 years Filled to the brim with helpful diagrams, charts and tables - nearly 350 figures complement the text Every chapter ends with a helpful Summary and Questions to Ponder

The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e

The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e

Author: Lawton R Burns

Publisher:

Published: 2024-10-25

Total Pages: 0

ISBN-13: 9781265941468

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Book Synopsis The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e by : Lawton R Burns

Download or read book The U.S. Healthcare Ecosystem: Payers, Providers, Producers, 2e written by Lawton R Burns and published by . This book was released on 2024-10-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The U.S. Healthcare System

The U.S. Healthcare System

Author: Joel I. Shalowitz

Publisher: John Wiley & Sons

Published: 2019-09-04

Total Pages: 720

ISBN-13: 047063152X

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Provides a diverse, multi-faceted approach to health care evaluation and management The U.S. Health Care System: Origins, Organization and Opportunities provides a comprehensive introduction and resource for understanding healthcare management in the United States. It brings together the many “moving parts” of this large and varied system to provide both a bird’s-eye view as well as relevant details of the complex mechanisms at work. By focusing on stakeholders and their interests, this book analyzes the value propositions of the buyers and sellers of healthcare products and services along with the interests of patients. The book begins with a presentation of frameworks for understanding the structure of the healthcare system and its dynamic stakeholder inter-relationships. The chapters that follow each begin with their social and historical origins, so the reader can fully appreciate how that area evolved. The next sections on each topic describe the current environment and opportunities for improvement. Throughout, the learning objectives focus on three areas: frameworks for understanding issues, essential factual knowledge, and resources to keep the reader keep up to date. Healthcare is a rapidly evolving field, due to the regulatory and business environments as well as the advance of science. To keep the content current, online updates are provided at: www.HealthcareInsights.MD. This website also offers a weekday blog of important/interesting news and teaching notes/class discussion suggestions for instructors who use the book as a text. The U.S. Health Care System: Origins, Organization and Opportunities is an ideal textbook for healthcare courses in MBA, MPH, MHA, and public policy/administration programs. In piloting the content, over the past several years the author has successfully used drafts of chapters in his Healthcare Systems course for MBA and MPH students at Northwestern University. The book is also useful for novice or seasoned suppliers, payers and providers who work across the healthcare field and want a wider or deeper understanding of the entire system.


Book Synopsis The U.S. Healthcare System by : Joel I. Shalowitz

Download or read book The U.S. Healthcare System written by Joel I. Shalowitz and published by John Wiley & Sons. This book was released on 2019-09-04 with total page 720 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides a diverse, multi-faceted approach to health care evaluation and management The U.S. Health Care System: Origins, Organization and Opportunities provides a comprehensive introduction and resource for understanding healthcare management in the United States. It brings together the many “moving parts” of this large and varied system to provide both a bird’s-eye view as well as relevant details of the complex mechanisms at work. By focusing on stakeholders and their interests, this book analyzes the value propositions of the buyers and sellers of healthcare products and services along with the interests of patients. The book begins with a presentation of frameworks for understanding the structure of the healthcare system and its dynamic stakeholder inter-relationships. The chapters that follow each begin with their social and historical origins, so the reader can fully appreciate how that area evolved. The next sections on each topic describe the current environment and opportunities for improvement. Throughout, the learning objectives focus on three areas: frameworks for understanding issues, essential factual knowledge, and resources to keep the reader keep up to date. Healthcare is a rapidly evolving field, due to the regulatory and business environments as well as the advance of science. To keep the content current, online updates are provided at: www.HealthcareInsights.MD. This website also offers a weekday blog of important/interesting news and teaching notes/class discussion suggestions for instructors who use the book as a text. The U.S. Health Care System: Origins, Organization and Opportunities is an ideal textbook for healthcare courses in MBA, MPH, MHA, and public policy/administration programs. In piloting the content, over the past several years the author has successfully used drafts of chapters in his Healthcare Systems course for MBA and MPH students at Northwestern University. The book is also useful for novice or seasoned suppliers, payers and providers who work across the healthcare field and want a wider or deeper understanding of the entire system.

Big Med

Big Med

Author: David Dranove

Publisher: University of Chicago Press

Published: 2022-11-18

Total Pages: 344

ISBN-13: 022682392X

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There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.


Book Synopsis Big Med by : David Dranove

Download or read book Big Med written by David Dranove and published by University of Chicago Press. This book was released on 2022-11-18 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

Just Enough Healthcare

Just Enough Healthcare

Author: Sivakumaran Raman

Publisher:

Published: 2020-07-10

Total Pages: 118

ISBN-13:

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Healthcare is complex, and occupies a critically important space in American political, social, and financial conversations. There is no other sector poised to be of more consequence and significance than healthcare, especially in light of the recent viral pandemic and the political center-stage accorded to healthcare delivery and access.As a physician and informatician, having worked in healthcare for more than two decades and served as Vice President and Chief Analytics Officer in health insurance and health information technology firms, I have been astounded by the lack of understanding of this sector. I put it down to the fact that healthcare is broad and its segments are isolated from each other in terms of the knowledge of their functioning.To address this, I created a first-of-its-kind resource for anyone wanting to get an overview of the US healthcare system in less than a day while reading fewer than 100 pages. This book's unique ability to connect diverse points in the system will allow the reader to understand all perspectives in this domain.After reading this book, you will be able to answer questions like:- Why can't I get an estimate at the physician's office and the hospital about what my visit and treatments will cost?- What are healthcare data and analytics?- How do I make sense of my medical bills and the Explanation of Benefits documents?- How does a physician treat patients?- How do physicians, hospitals, health insurance companies, pharmaceutical companies, and pharmacies make money?- What are generics and biosimilars?- What is a PBM?Topics covered include:- Healthcare Systems and Providers- Health Insurance and Payers- The Life Science Industry including Pharmaceutical Companies- Medical Billing and Payment, Healthcare Data and Analytics- The Government Role in US Healthcare


Book Synopsis Just Enough Healthcare by : Sivakumaran Raman

Download or read book Just Enough Healthcare written by Sivakumaran Raman and published by . This book was released on 2020-07-10 with total page 118 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare is complex, and occupies a critically important space in American political, social, and financial conversations. There is no other sector poised to be of more consequence and significance than healthcare, especially in light of the recent viral pandemic and the political center-stage accorded to healthcare delivery and access.As a physician and informatician, having worked in healthcare for more than two decades and served as Vice President and Chief Analytics Officer in health insurance and health information technology firms, I have been astounded by the lack of understanding of this sector. I put it down to the fact that healthcare is broad and its segments are isolated from each other in terms of the knowledge of their functioning.To address this, I created a first-of-its-kind resource for anyone wanting to get an overview of the US healthcare system in less than a day while reading fewer than 100 pages. This book's unique ability to connect diverse points in the system will allow the reader to understand all perspectives in this domain.After reading this book, you will be able to answer questions like:- Why can't I get an estimate at the physician's office and the hospital about what my visit and treatments will cost?- What are healthcare data and analytics?- How do I make sense of my medical bills and the Explanation of Benefits documents?- How does a physician treat patients?- How do physicians, hospitals, health insurance companies, pharmaceutical companies, and pharmacies make money?- What are generics and biosimilars?- What is a PBM?Topics covered include:- Healthcare Systems and Providers- Health Insurance and Payers- The Life Science Industry including Pharmaceutical Companies- Medical Billing and Payment, Healthcare Data and Analytics- The Government Role in US Healthcare

The Business of Healthcare Innovation

The Business of Healthcare Innovation

Author: Lawton R. Burns

Publisher: Cambridge University Press

Published: 2005-08-25

Total Pages: 400

ISBN-13: 9780521838986

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The first wide-ranging analysis of business trends in the manufacturing segment of the health care industry.


Book Synopsis The Business of Healthcare Innovation by : Lawton R. Burns

Download or read book The Business of Healthcare Innovation written by Lawton R. Burns and published by Cambridge University Press. This book was released on 2005-08-25 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first wide-ranging analysis of business trends in the manufacturing segment of the health care industry.

Understanding Value Based Healthcare

Understanding Value Based Healthcare

Author: Vineet Arora

Publisher: McGraw Hill Professional

Published: 2015-04-03

Total Pages: 417

ISBN-13: 007181700X

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Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .


Book Synopsis Understanding Value Based Healthcare by : Vineet Arora

Download or read book Understanding Value Based Healthcare written by Vineet Arora and published by McGraw Hill Professional. This book was released on 2015-04-03 with total page 417 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .

Redefining Health Care

Redefining Health Care

Author: Michael E. Porter

Publisher: Harvard Business Press

Published: 2006-04-24

Total Pages: 540

ISBN-13: 1422133362

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The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.


Book Synopsis Redefining Health Care by : Michael E. Porter

Download or read book Redefining Health Care written by Michael E. Porter and published by Harvard Business Press. This book was released on 2006-04-24 with total page 540 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.

Essentials of Managed Health Care

Essentials of Managed Health Care

Author: Peter Reid Kongstvedt

Publisher: Jones & Bartlett Learning

Published: 2003

Total Pages: 918

ISBN-13: 9780763724962

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Book Synopsis Essentials of Managed Health Care by : Peter Reid Kongstvedt

Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2003 with total page 918 pages. Available in PDF, EPUB and Kindle. Book excerpt:

China's Healthcare System and Reform

China's Healthcare System and Reform

Author: Lawton Robert Burns

Publisher: Cambridge University Press

Published: 2017-01-26

Total Pages: 744

ISBN-13: 1316738396

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This volume provides a comprehensive review of China's healthcare system and policy reforms in the context of the global economy. Following a value-chain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China's system. It also provides a detailed analysis of the historical development of China's healthcare system, the current state of its broad reforms, and the uneasy balance between China's market-driven approach and governmental regulation. Most importantly, it devotes considerable attention to the major problems confronting China, including chronic illness, public health, and long-term care and economic security for the elderly. Burns and Liu have assembled the latest research from leading health economists and political scientists, as well as senior public health officials and corporate executives, making this book an essential read for industry professionals, policymakers, researchers, and students studying comparative health systems across the world.


Book Synopsis China's Healthcare System and Reform by : Lawton Robert Burns

Download or read book China's Healthcare System and Reform written by Lawton Robert Burns and published by Cambridge University Press. This book was released on 2017-01-26 with total page 744 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume provides a comprehensive review of China's healthcare system and policy reforms in the context of the global economy. Following a value-chain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China's system. It also provides a detailed analysis of the historical development of China's healthcare system, the current state of its broad reforms, and the uneasy balance between China's market-driven approach and governmental regulation. Most importantly, it devotes considerable attention to the major problems confronting China, including chronic illness, public health, and long-term care and economic security for the elderly. Burns and Liu have assembled the latest research from leading health economists and political scientists, as well as senior public health officials and corporate executives, making this book an essential read for industry professionals, policymakers, researchers, and students studying comparative health systems across the world.