Table of Contents

I. Introduction to Value in Healthcare
1. The Current State of Healthcare Costs and Waste in the United States
2. Paying For Healthcare in the United States: The Private and Public Insurance Systems
3. Charges, Costs, and Payments: The Challenges of Understanding Healthcare Pricing
4. Defining Value: Connecting Quality and Safety to the Costs of Care
5. A Changing Landscape: The History of Cost Consciousness and Value in Healthcare Delivery
6. Ethics of Cost Conscious Care

II. Types and Sources of Waste
7. Variation in Resource Utilization and the Dartmouth Atlas
8. Stents, Robots, and the Role of Technology Diffusion
9. From the Pharmacy to the Supply Closet: Variable Costs and Single-use Equipment
10. Operative Times and the Management of Surgical Turnover
11. Too Many Hospital Beds: Fixed Costs and Excess Capacities
12. Imbalanced Workforce: Lots of Specialists, Few Primary Care Providers
13. Comparative Health Systems: Free markets vs. Coordinated Economies
14. Societal Spending Thresholds: How Do We Know When Expensive Care is Worth It
15. Barriers to Providing High Value Care

III. Solutions and Tools
16. A Framework for Approaching Value in Healthcare
17. Cost-effectiveness Analysis and Other Tools To Guide Appropriate Care
18. Shifting Incentives: Moving Reimbursement from Volume to Value
19. The Role of Regulation and Oversight
20. Learning From Other Industries: Applying Lean and Other Waste Reduction Strategies To Healthcare Organizations
21. Screening and Prevention: Balancing Benefits with Harms and Costs
22. High Value Medication Prescribing: One Size Does Not Fit All
23. The Role of Medical Educators: Teaching About Cost Awareness and Evidence-Based Medicine
24. The Role of Patients: ePatient Movement and Consumer Driven Healthcare
25. Implementing Value-Based Initiatives: A New Challenge for Healthcare Systems

About the Author

Christopher Moriates Assistant Clinical Professor of Medicine, University of California, San Francisco, San Francisco, California, Director of Implementation Initiatives, Costs of Care, Inc.
Vineet Arora Associate Professor and Director of GME Clinical Learning Environment Innovation, University of Chicago, Chicago, Illinois, Director of Education Initiatives, Costs of Care, Inc.
Neel Shah Assistant Professor, Harvard Medical School, Cambridge, Massachusetts, Founder and Executive Director, Costs of Care, Inc.