This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.

Peter Kongstvedt provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well.

Economics of Health and Medical Care is an introduction to population-based health economics as well as the traditional, market-oriented approach to health care economics. The book examines economics through the lens of descriptive, explanatory, and evaluative economics. The Seventh Edition is an extensive revision that reflects the vast changes that have been occurring in the health care industry and in the economy, most notably in the areas for payment systems and quality improvement. Additionally, the text offers expanded discussion of the impact of the Affordable Care Act on the demand for healthcare services and health insurance, particularly regarding Medicare and Medicaid programs. Evolving issues in healthcare as well as discussion of the implication for efficiency in the production and consumption of healthcare services are covered throughout the text.

Praise for the previous edition: "This comprehensive multi-authored text contains over 450 pages of highly specific and well-documented information that will be interest to physicians in private practice, academics, and in medical management. . . [Chapters are] readable, concise yet complete, and well developed. I could have used a book like this in the past, I will certainly refer to it frequently now." 4 stars Carol EH Scott-Conner, MD, PhD, MBA American College of Physician Executives Does Health 2.0 enhance or detract from traditional medical care delivery, and can private practice business models survive? How does transparent business information and reimbursement data impact the modern competitive healthcare scene? How are medical practices, clinics, and physicians evolving as a result of rapid health- and non-health-related technology change? Does transparent quality information affect the private practice ecosystem? Answering these questions and more, this newly updated and revised edition is an essential tool for doctors, nurses, and healthcare administrators; management and business consultants; accountants; and medical, dental, business, and healthcare administration graduate and doctoral students. Written in plain language using nontechnical jargon, the text presents a progressive discussion of management and operation strategies. It incorporates prose, news reports, and regulatory and academic perspectives with Health 2.0 examples, and blog and internet links, as well as charts, tables, diagrams, and Web site references, resulting in an all-encompassing resource. It integrates various medical practice business disciplines-from finance and economics to marketing to the strategic management sciences-to improve patient outcomes and achieve best practices in the healthcare administration field. With contributions by a world-class team of expert authors, the third edition covers brand-new information, including: The impact of Web 2.0 technologies on the healthcare industry Internal office controls for preventing fraud and abuse Physician compensation with pay-for-performance trend analysis Healthcare marketing, advertising, CRM, and public relations eMRs, mobile IT systems, medical devices, and cloud computing and much more!