The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending.
According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008.
The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment.
The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. https://doi.org/10.17226/12750.
|Synopsis and Overview||1-66|
|Section I: Excessive Healthcare Costs||67-68|
|1 The Healthcare Imperative||69-84|
|2 Unnecessary Services||85-108|
|3 Inefficiently Delivered Services||109-140|
|4 Excess Administrative Costs||141-174|
|5 Prices That Are Too High||175-218|
|6 Missed Prevention Opportunities||219-238|
|Section II: Strategies That Work||239-240|
|7 Strategies That Work||241-256|
|8 Knowledge Enhancement||257-280|
|9 Care Culture and System Redesign||281-334|
|10 Transparency of Cost and Performance||335-358|
|11 Payment and Payer-Based Strategies||359-406|
|12 Community-Based and Transitional Care||407-432|
|13 Entrepreneurial Strategies||433-452|
|Section III: The Policy Agenda||453-454|
|14 The Policy Agenda||455-472|
|15 Payments for Value Over Volume||473-492|
|16 Medically Complex Patients||493-516|
|17 Delivery System Integration||517-534|
|18 Delivery System Efficiency||535-546|
|19 Administrative Simplification||547-568|
|20 Consumers-Directed Policies||569-582|
|Section IV: Getting to 10 Percent||583-584|
|21 Taking Stock: Numbers and Policies||585-598|
|22 Getting to 10 Percent: Opportunities and Requirements||599-618|
|23 Common Themes and Next Steps||619-632|
|Appendix A: Workshop Discussion Background Paper:||635-754|
|Appendix B: Workshop Agendas||755-772|
|Appendix C: Planning Committee Biographies||773-778|
|Appendix D: Speaker Biographies||779-827|
|Other Publications in the Learning Healthcare System Series||828-828|
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