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Value-Based Healthcare and Payment Models: Including Frontline Strategies for 20 Clinical Subspecialties

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Value-Based Care and Payment Models

As value-based care is coming of age, deciding how to start can be an overwhelming task. Risks are high and success with the new models is challenging and time-consuming. This book fills an important need by providing concrete and proven strategies to aid in an organization’s successful transformation.

Also available in these eBook formats:


Grace E. Terrell, MD, MMM, CPE, FACP, FACPE and Julian D. (Bo) Bobbitt Jr., JD

The book is filled with practical, no-nonsense advice on the shift to value-based care in both the private and public healthcare sectors. This is the time when healthcare stakeholders need to rethink their own added-value strategies in a manner that best serves patients and providers alike.

In the complicated world of payment and delivery system reform, this book deconstructs the most challenging concepts for the novice yet provides sophisticated insights for even the most seasoned executive.

BONUS! The authors also lay out high-value strategies for 20 different subspecialties with specialty-specific changes in the way medicine is practiced and paid for.

From the Foreword

“With this manual, leaders of health systems and medical groups can achieve these goals and align their physicians, management, care teams, payers, and patients to deliver exceptional care that will improve quality while lowering costs, resulting in better care, better patient experience, and more affordable health care.”

Jerry Penso, MD, MBA
President and Chief Executive Officer, AMGA

Part I: Introduction

  • The move to value isn't going away
  • This is an opportunity to lead and drive change positively
  • A new set of skills is required for physicians and other health care leaders
  • This book is a manual to help develop those skills

Part II: Elements of Value-Based Health Care

  • Payment Models
  • Care Models
  • Building Teams and Finding Strategic Partners

Part III: The Thorniest Problems Facing ACOs and Solutions to these Obstacles

  • Obstacle 1: Resistance to Change
  • Obstacle 2: Inadequate Technology
  • Obstacle 3: Failure to Integrate Care Models and Business Models

Part IV: A Deeper Dive into Building Sustainable Value-Based Care

  • Assessing Organizational Readiness
    • Characteristics of a High Performing Health System
    • Culture and Systems Thinking
    • Leadership
    • Professionalism
    • Strategy
    • Execution
    • Innovation and Design Thinking
    • Change Management
  • Implementing New Models of Care
    • Clinical Model Design and Management
    • Core Clinical Technology Infrastructure
    • Financial and Network Management
    • Integrated Data Exchange and Aggregation
    • Performance Management
    • Patient Engagement
    • Population and Clinical Risk Management
    • Components of New Care Model Design
    • Development of Care Models
    • Information Integration

Part V: Value-Based Payment Models

  • Categories of Payment Models
  • Payment Model Redesign
  • Design Considerations in Value-based Payment Models

Part VI: Optimizing Value

  • Social Determinants of Health
  • Strategic Partnerships
  • Community Ecosystems and Reinvestment

Part VII: Front-line strategies from sub-specialists

  • Anesthesiologists
  • Cardiologists
  • Child Psychiatrists
  • Dermatologists
  • Emergency Medicine Physicians
  • Gynecologists
  • Hospitalists
  • Nephrologists
  • Neurologists
  • Obstetricians
  • Oncologists
  • Pediatricians
  • Primary Care Physicians
  • Pulmonologists
  • Radiologists
  • Rheumatologists
  • Urologists

Part VIII: Conclusion

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