This fully updated and revised 12th edition of the highly acclaimed textbook on health care delivery provides graduate and undergraduate students with a comprehensive survey of health care in the United States ranging in topics from the organization of care, the politics surrounding healthcare in the United States, to population health and vulnerable populations, healthcare costs and value, health care financing, and health information technology. Chapters provide thorough coverage of the rapid changes that are reshaping our system and the extent of our nation’s achievement of health care value and the Triple Aim: better health and better care at a lower cost. With an emphasis on population health and public health, this text includes a timely focus on how social and physical environments influence health outcomes. Prominent scholars, practitioners, and educators within public health, population health, health policy, healthcare management, medical care, and nursing present the most up-to-date evidence-based information on social and behavioral determinants of health and health equity, immigrant health, healthcare workforce challenges, preventative medicine, innovative approaches to control health care costs, initiatives to achieve high quality and value-based care, and much more.
Designed for graduate and advanced undergraduate students of health care management and administration, nursing, and public health, the text addresses all complex core issues surrounding our health care system and health policy, such as the challenges to health care delivery, the organization and politics of care, and comparative health systems. Organized in a readable and accessible format, contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, healthcare management, and public health. The 12th edition features the contributions of such luminaries as former editor Anthony R. Kovner, Michael K. Gusmano, Carolyn M. Clancy, Marc N. Gourevitch, Joanne Spetz, James Morone, Karen De Salvo, and Christy Harris Lemak, among others. Chapters include audio chapter summaries with discussion of newsworthy topics, learning objectives, discussion questions, case exercises, and new charts and tables with concrete health care data. Included for instructors are an Instructor’s Manual, Power Point slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on a Visual Overview of Health Care Delivery, access to an annual ACA update and health policy changes, extra cases and syllabi specifically for nurses, and a transition guide bridging the 11th and 12th editions.
Key Features:
- Three completely revised chapters on the politics of health care, vulnerable populations, and health information technology
- Chapter authors with expertise in Health Administration and Management, Public Health, Health Policy, Medical Care and Nursing
- Expanded coverage on population health and population health management, health equity, influences of social determinants on health behavior and outcomes, health education planning, health workforce challenges, national and regional quality improvement initiatives and more
- Revised e-Chapters providing a Visual Overview of Health Care Delivery with image bank and Springer Publishing’s annual ACA update
- Audio podcasts provide summaries for each chapter and provide real-world context of topics featured in the news
- New Appendix on Overview of U.S. Public Health Agencies
- Access to fully searchable e Book, including extra e-chapters and student ancillaries on Springer Connect
- Full Instructor Packet including Instructor’s Manual, Test Bank, Power Point slides, Image Bank, Case Exercises for Nursing Instructors
Table of Content
CONTENTS
List of Features
Foreword by Anthony R. Kovner, Ph D
Acknowledgments
Organization of This Book
Contributors
PART I HEALTH POLICY
Chapter 1 The Challenge of Health Care Delivery and Health Policy
Brian Elbel and James R. Knickman
Introduction
The Importance of Good Health to American Life
Defining Characteristics of the U.S. Health System
Major Issues and Concerns
Key Stakeholders Influencing the Health System
Organization of This Book
Conclusion
Case Exercise—Health Care Delivery Plan
Discussion Questions
Reference
Chapter 2 Organization of Care
Amy Yarbrough Landry and Cathleen O. Erwin
Introduction
Description of the Current Care Delivery System
The Future of the Delivery System
Best Practices
Conclusion
Case Exercise—Innovative Ideas
Discussion Questions
References
Chapter 3 The Politics of Health Care in the United States
Rogan Kersh and James Morone
Introduction
Health Care Infrastructure and Spending: Many Dollars, to What Effect?
Who Pays? The Politics of Medicare, Medicaid, and Much More
The Politics of Providing Equitable Health Services
How Personal Health Decisions Become Public: The Case of Obesity
Conclusion: Better National Health Ahead?
Case Exercise—Insurance Plans
Discussion Questions
References
Chapter 4 Comparative Health Systems
Michael K. Gusmano and Victor G. Rodwin
Introduction
Health System Models
NHS and NHI Systems Compared With the United States
The Health Systems in England, Canada, France, and China
Lessons
Case Exercise—European Lessons Learned
Discussion Questions
References
PART II KEEPING AMERICANS HEALTHY
Chapter 5 Population Health
Pamela G. Russo and Marc N. Gourevitch
Introduction
The Population Health Model
The Medical Model
Comparing the Medical and Population Health Models
The Influence of Social Determinants on Health Behavior and Outcomes
Leading Determinants of Health: Weighting the Different Domains
Health Policy and Returns on Investment
Conclusion
Case Exercise—Sodium and its Effects on Our Health
Discussion Questions
References
Chapter 6 Public Health: A Transformation in the 21st Century
Laura C. Leviton, Paul L. Kuehnert, and Kathryn E. Wehr
Overview of a Complex Infrastructure
Public Health Requires a Collective Response from Society
Public Health is Different from Individual Health Care
The Core Functions of Public Health Define Essential Public Health Activities
Governmental Agencies Have Legal Authority for the Core Functions
Social, Economic, and Political Forces are Transforming Public Health
Conclusion
Case Exercise—Cure For Birth Defects Policy Options
Discussion Questions
References
Chapter 7 Health and Behavior
Brian Elbel, Elaine F. Cassidy, Matthew D. Trujillo, and C. Tracy Orleans
Introduction
Behavioral Risk Factors: Overview and National Goals
Changing Health Behavior: Closing the Gap Between Recommended and Actual Health Lifestyle Practices
The Role and Impact of Primary Care Interventions
Multilevel Models For Population-Based Health Behavior Change
Changing Provider Behavior: Closing the Gap Between Best Practice and Usual Care
Conclusion
Case Exercise—Comprehensive Plan for Addressing Risk Factors
Discussion Questions
References
Chapter 8 Vulnerable Populations: Meeting the Health Needs of Populations Facing Health Inequities
Monique J. Vasquez, Jacqueline Martinez Garcel, Elizabeth A. Ward, and Lourdes J. Rodríguez
Introduction
Understanding Factors and Systems that Impact People Disproportionately Affected by Health Inequities
The Growing Number of Health Inequities
Uneven Footing After the Great Recession and a Strained Social Service Sector
Organization and Financing of Health Care, Population/Public Health/Prevention, and Other Services for Populations Experiencing Health Inequities
Rural Health Clinics and Rural Health Networks
Social Service Needs
Federal and State Financing of Care for Vulnerable Populations
Challenges for Service Delivery and Payment
Emerging and Tested Ideas for Better Health Delivery
Case Exercise 8.1—Patient Engagement: Bronx-Lebanon Hospital Department of Family Medicine’s Patient-Centered Medical Home
Case Exercise 8.2—Integrated Care: Camden Coalition of Health Care Providers
Opportunities in the ACA to Meet Health Care Needs of Vulnerable Populations
Conclusion
Case Exercise 8.3—Plan for Refugees
Discussion Questions
References
PART III MEDICAL CARE: TREATING AMERICANS’ MEDICAL PROBLEMS
Chapter 9 The Health Workforce
Joanne Spetz and Susan A. Chapman
Introduction
Who Is Part of the Health Workforce?
Traditional Approaches to Health Workforce Planning
Health Workforce Education
Critical Issues for the Health Workforce
Conclusion: Building the Future Health Care Workforce
Case Exercise—Workforce Recruitment Plan
Discussion Questions
References
Chapter 10 Health Care Financing
James R. Knickman
Introduction
General Overview of Health Care Financing
What the Money Buys and Where It Comes From
How Health Insurance Works
How Providers are Paid for the Health Services They Deliver
Specialized Payment Approaches Used by Payers
Conclusion
Case Exercise—Becoming an Accountable Care Organization Versus Not Becoming an Accountable Care Organization
Discussion Questions
References
Chapter 11 Health Care Costs and Value
David C. Radley and John Marchica
Introduction
Spending Levels and Cost Growth
Defining and Measuring Value in Health Care
Cost Drivers and Barriers to Value
Initiatives to Address Expenditure/Value Tradeoffs
Delivery System Reform
State-Driven Value-Based Initiatives
Conclusion
Case Exercise—Monitoring of Value
Discussion Questions
References
Chapter 12 High-Quality Health Care
Carolyn M. Clancy and Irene Fraser
Introduction
Defining Quality
How are We Doing?
How Do We Improve Quality?
How Do We Incentivize Quality Care?
What are Major Recent Developments Affecting Quality?
Core Competencies for Health Administrators
Conclusion
Case Exercise—Using Data to Support Sustainability
Discussion Questions
References
Chapter 13 Health Care Management
Anthony R. Kovner and Christy Harris Lemak
Introduction
Governance, Performance and Accountability
The Complex Tasks of Leadership and Management
Evidence-Based Management
Challenges Managers Face
Conclusion
Case Exercise—Strategic Plan Report
Discussion Questions
References
Chapter 14 Health Information Technology
Karen B. De Salvo and Y. Claire Wang
Introduction
Health Data Needs and IT Use Cases
Case Exercise 14.1—NYC Macroscope
HIT Interoperability
Standards
Driving Forces Shaping the Use of Data and HIT
Case Exercise 14.2—Avera Health
Challenges to More Effective Use of Information and Data
Privacy and Security
Current Marketplace and Emerging Opportunities
Conclusion
Case Exercise 14.3—Electronic Health Records
Discussion Questions
References
PART IV FUTURE OF U.S. HEALTH CARE
Chapter 15 The Future of Health Care Delivery and Health Policy
James R. Knickman and Brian Elbel
Introduction
Forces Shaping Change in the Health System
Key Challenges that Will Receive Attention in Upcoming Years
Future Prospects for Different Stakeholders in the Health Enterprise
Conclusion
Case Exercise—Payments and Budget Caps in Medicare
Discussion Questions
References
Appendix U.S. Government Public Health Agencies
Glossary
Index
About the author
Brian Elbel, Ph D, MPH, is a professor of Population Health and Health Policy at the NYU Grossman School of Medicine, where he heads the Section on Health Choice, Policy and Evaluation within the Department of Population Health, and at the NYU Wagner Graduate School of Public Service. He is the Associate Dean for Research Mission Strategy and Administration at NYU Langone Health. He studies how individuals make decisions that influence their health, with a particular emphasis on evaluation, obesity, and food choice. His work uses behavioral economics to understand health decision-making among vulnerable groups, and the role and influence of public policy on these decisions. His research has been funded by the National Institutes of Health, Centers for Disease Control and Prevention, the National Science Foundation, and the Robert Wood Johnson Foundation and has been featured in national television, radio, and print media. Dr. Elbel earned his bachelor’s degree from the University of Texas at Austin and his master’s and doctorate in Health Policy/Health Economics from Yale University.
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