The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary
2010

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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.

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852 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-14433-7
ISBN Ebook: 0-309-14434-5
DOI: https://doi.org/10.17226/12750

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Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press.

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Front Matter i-xxiv
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
Appendixes 633-634
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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The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary (2010)

Chapter: Appendixes

Appendixes