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Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
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Appendix B
Workshop Agendas

THE HEALTHCARE IMPERATIVE:

LOWERING COSTS AND IMPROVING OUTCOMES


An Institute of Medicine Workshop Series

THE KECK CENTER OF THE NATIONAL ACADEMIES

WASHINGTON, DC 20001


WORKSHOP I AGENDA


Understanding the Targets


May 21-22

MEETING AGENDA


Objectives: To identify, characterize, and discuss the major causes of excess healthcare spending, waste, and inefficiency in the United States, to consider strategies that might reduce per capita health spending in the United States while improving health outcomes, and to explore policy options relevant to those strategies.


DAY 1

9:00 am

Welcome, Introductions and Overview

Harvey V. Fineberg, Institute of Medicine

Denis A. Cortese, Mayo Clinic and Chair, IOM Roundtable on Value & Science-Driven Health Care

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

David M. Walker, Peter G. Peterson Foundation

9:30 am

Keynote Address

Peter R. Orszag, Office of Management and Budget

What is the state of play of current spending on health care in the United States? What are the implications of unchecked spending on future generations?

10:15 am

Session 1: Unnecessary Services

Chair: Denis A. Cortese, Mayo Clinic and Chair, IOM Roundtable on Value & Science-Driven Health Care

Qualitative description and quantitative estimates on the contribution of unnecessary services to excess healthcare spending, waste and inefficiency.

 

Elliott S. Fisher, Dartmouth University

Use of services beyond benchmarks where evidence is not established

 

Amitabh Chandra, Harvard University

Overuse of services, beyond evidence-established benchmarks

 

David Wennberg, Health Dialog

Choice of higher cost services, over evidence-established equivalents

 

Mark B. McClellan, Brookings Institution

Defensive medicine

 

OPEN DISCUSSION

12:00 pm

Lunch Presentation

Eric Jensen, McKinsey & Co.

How does U.S. spending on health care compare to international benchmarks? What are areas of specific excess spending and opportunities for cost savings?

1:00 pm

Session 2: Inefficiently Delivered Services

Chair: Arnold Milstein, Pacific Business Group on Health

Qualitative description and quantitative estimates on the contribution of inefficiency in care organization

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

and delivery to excess healthcare spending, waste, and inefficiency.

 

Ashish Jha, Harvard University

Costs from mistakes (medical errors, preventable complications)

 

Mary Kay Owens, Southeastern Consultants, Inc.

Costs from care fragmentation (including duplicate services, treatment delays)

 

Gary S. Kaplan, Virginia Mason Medical Center

Costs from inefficient use of higher cost providers

 

William F. Jessee, Medical Group Management Association

Arnold Milstein, Pacific Business Group on Health

Costs from inefficiencies in physician offices and hospitals

 

OPEN DISCUSSION

3:30 pm

Session 3: Excess Administrative Costs

Chair: Nancy H. Nielsen, American Medical Association

Qualitative description and quantitative estimates on the contribution of excess administrative costs: (1) imposed on providers via external administrative requirements, and (2) incurred for health benefits plan administration.

 

James L. Heffernan, Massachusetts General Physicians Organization

Regulatory compliance-imposed costs beyond benchmarks

 

James G. Kahn, University of California–San Francisco

Lawrence P. Casalino, Cornell University

Plan-imposed costs beyond benchmarks

 

Andrew L. Naugle, Milliman

Plan-incurred costs beyond benchmarks

 

OPEN DISCUSSION

5:15 pm

Wrap-up Comments for the Day

Arnold Milstein, Pacific Business Group on Health

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

J. Michael McGinnis, Institute of Medicine

5:30 pm

Reception

DAY TWO

8:30 am

Welcome and Re-cap of First Day

Arnold Milstein, Pacific Business Group on Health

8:45 am

Session 4: Prices That Are Too High

Chair: Paul B. Ginsburg, Center for Studying Health System Change

Qualitative description and quantitative estimates on the contributions of prices that are too high to excess healthcare spending, waste, and inefficiency.

 

Cory S. Capps, Bates White

Service prices (beyond competitive market benchmarks)

 

Jack Hoadley, Georgetown Health Policy Institute

Thomas J. Hoerger, RTI International

Mark E. Wynn, Centers for Medicare & Medicaid Services

Jeffrey C. Lerner, ECRI Institute

Product prices (beyond competitive market benchmarks)

 

OPEN DISCUSSION

10:45 am

Session 5: Missed Prevention Opportunities

Chair: J. Michael McGinnis, Institute of Medicine

Qualitative description and quantitative estimates on the contribution of missed prevention opportunities, the treatment of which amounts to excess healthcare spending.

 

Steven H. Woolf, Virginia Commonwealth University

Economic implications of missed prevention opportunities

 

Thomas J. Flottemesch, HealthPartners Research Foundation

Costs from missed cost-saving primary and secondary prevention opportunities

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

Michael P. Pignone, University of North Carolina–Chapel Hill

Costs from missed tertiary cost-saving prevention opportunities

 

OPEN DISCUSSION

12:30 pm

Concluding Remarks, Upcoming Workshops and Adjournment

Arnold Milstein, Pacific Business Group on Health

J. Michael McGinnis, Institute of Medicine

WORKSHOP II AGENDA


Strategies that Work


July 16-17

MEETING AGENDA


Objectives: To identify, characterize, and discuss the major causes of excess healthcare spending, waste, and inefficiency in the United States, to consider strategies that might reduce per capita health spending in the United States while improving health outcomes, and to explore policy options relevant to those strategies.


DAY ONE

8:00 am

Welcome, Introductions and Overview

J. Michael McGinnis, Institute of Medicine

David M. Walker, Peter G. Peterson Foundation

8:30 am

Keynote Address

Glenn Steele, Jr., Geisinger Health System

What strategies have been demonstrated to lower cost expenditures and improve health outcomes? What are the key success elements and the near- and long-term changes necessary?

9:00 am

Reviewing the Targets

Chair: J. Michael McGinnis, Institute of Medicine

This session will review the analytics from the May workshop, which assessed the amount of potentially controllable waste and efficiency in five broad categories:

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

Unnecessary services,

Inefficiently delivered services,

Excess administrative costs,

Prices that are too high, and

Missed prevention opportunities.

 

Panelists:

Len Nichols, The New America Foundation

Robert D. Reischauer, Urban Institute

 

OPEN DISCUSSION

10:30 am

Session 1: Knowledge Enhancement-Based Strategies

Chair: Nancy H. Nielsen, American Medical Association

Discussion of knowledge-focused strategies for reducing waste and inefficiency, an assessment of their effectiveness and potential impact on health system efficiency, and a review of the specific opportunities for their implementation.

 

Peter K. Smith, Duke University

Enhancing clinical data as a knowledge utility

 

Lucy A. Savitz, Intermountain Healthcare

Evidence-based clinical protocols

 

Rainu Kaushal, Weill-Cornell Medical College

Electronic health records with decision support

 

Carolyn M. Clancy, Agency for Healthcare Research and Quality

Comparative effectiveness research

 

OPEN DISCUSSION

12:30 pm

Lunch

1:00 pm

Session 2: Care Culture and System Redesign-Based Strategies

Chair: Reed V. Tuckson, UnitedHealth Group

Discussion of culture and system redesign-focused strategies for reducing waste and inefficiency, an assessment of their effectiveness and potential impact on health system

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

efficiency, and a review of the specific opportunities for their implementation.

 

Michelle J. Lyn, Duke University

Caregiver profile, efficiency and team care

 

Kim R. Pittenger, Virginia Mason Medical Center

Care site efficiency and productivity initiatives and incentives

 

Timothy G. Ferris, Massachusetts General Hospital

Care site integration initiatives

 

BREAK

 

Roger Feldman, University of Minnesota

Antitrust interventions

 

Ashish Jha, Harvard University

Promoting information technology interoperability/connectivity

 

Frank A. Sloan, Duke University

Service capacity restrictions

 

Randall R. Bovbjerg, Urban Institute

Medical liability reform

 

OPEN DISCUSSION

3:30 pm

Session 3: Transparency of Cost and Performance

Chair: Robert S. Galvin, Global Healthcare/General Electric

Discussion of transparency-based strategies for reducing waste and inefficiency, an assessment of their effectiveness and potential impact on health system efficiency, and a review of the specific opportunities for their implementation.

 

John Santa, Consumer’s Union

Transparency in prices

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

G. Scott Gazelle, Institute for Technology Assessment

Transparency in comparative value of treatment options

 

Paul B. Ginsburg, Center for Studying Health System Change

Transparency in comparative value of providers

 

Peter K. Lindenauer, Tufts University

Transparency in comparative value of hospitals and integrated systems

 

Margaret E. O’Kane, National Committee for Quality Assurance

Transparency in comparative value of health plans

 

OPEN DISCUSSION

5:30 pm

Wrap-up Comments for the Day

Arnold Milstein, Pacific Business Group on Health

J. Michael McGinnis, Institute of Medicine

5:45 pm

Reception

DAY TWO

8:00 am

Welcome and Re-cap of First Day

Arnold Milstein, Pacific Business Group on Health

8:30 am

Session 4: Payment and Payer-Based Strategies

Chair: Paul B. Ginsburg, Center for Studying Health System Change

Discussion of payment and payer-based strategies for reducing waste and inefficiency, an assessment of their effectiveness and potential impact on health system efficiency, and a review of the specific opportunities for their implementation.

 

Amita Rastogi, Bridges to Excellence

Bundled and fee-for-episode payments

 

Harold D. Miller, Center for Healthcare Quality and Payment Reform

Value-based payment

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

David R. Riemer, Community Advocates

Managed competition

 

Niteesh K. Choudhry, Harvard University

Lisa Carrara, Aetna

Value-based insurance design

 

Robin J. Thomashauer, Council for Affordable Quality Healthcare

 

David S. Wichmann, UnitedHealth Group

Payer harmonization, coordination and/or consolidation

 

OPEN DISCUSSION

10:45 am

Session 5: Community-Based and Transitional Care Strategies

Chair: Gail Shearer, Consumers Union

Discussion of community-based and transitional care strategies for reducing waste and inefficiency, an assessment of their effectiveness and potential impact on health system efficiency, and a review of the specific opportunities for their implementation.

 

Kenneth E. Thorpe, Emory

Care management for medically complex patients

 

Diane E. Meier, Mt. Sinai Hospital

Reform in end-of-life care

 

Jeffrey Levi, Trust for America’s Health

Wellness/community programs

 

OPEN DISCUSSION

12:00 pm

Lunch

12:30 pm

Session 6: Entrepreneurial Strategies and Potential Changes in the State of Play

Chair: Kathleen Buto, Johnson & Johnson

Discussion of entrepreneurial initiatives that may change the state of play in ways that substantially reduce waste and inefficiency, an assessment of their potential

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

effectiveness and impact on health system efficiency, and a review of the specific opportunities for their implementation.

 

Sandeep Green Vaswani, Institute for Healthcare Optimization

N. Marcus Thygeson, HealthPartners

Highest known yield clinical service engineering applications (e.g., smoothing, retail clinics)

 

Jason Hwang, Innosight

Lower barriers to entry in health care (e.g. competency-based rather than credential-based clinical licensing)

 

Adam Darkins, Department of Veterans Affairs

Technological innovation

 

Gerard F. Anderson, Johns Hopkins University

Strategies importable from abroad

 

OPEN DISCUSSION

2:30 pm

Concluding Remarks, Upcoming Workshops and Adjournment

Arnold Milstein, Pacific Business Group on Health

J. Michael McGinnis, Institute of Medicine

WORKSHOP III AGENDA


The Policy Agenda


September 9-10

MEETING AGENDA


Objectives: To identify, characterize, and discuss the major causes of excess healthcare spending, waste, and inefficiency in the United States; to consider strategies that might reduce per capita health spending in the United States while improving health outcomes; and to explore policy options relevant to those strategies.

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

DAY ONE

8:00 am

Welcome, Introductions and Overview

J. Michael McGinnis, Institute of Medicine

Arnold Milstein, Pacific Business Group on Health

8:30 am

Keynote Address

Karen Davis, The Commonwealth Fund

The keynote will explore what we have learned about the relative contributions of the major sources of excessive, unnecessary, and wasteful U.S. healthcare expenditures; what we know about the forces in play, the key strategies necessary to address the problem, and the policy initiatives most likely to make a difference in the near-and longer-term; and how the necessary support might be mobilized.

9:00 am

Session 1: Reviewing the Targets and Strategies

Chair: J. Michael McGinnis, Institute of Medicine

Opening Remarks: David M. Walker, Peter G. Peterson Foundation

This session provides an overview of the state of understanding from the May and July workshops assessing the sources of excess costs (and some prominent examples) and the potential gains from various initiatives.

Estimates of excess costs, by source:

 

Unnecessary services,

Inefficiently delivered services,

Excess administrative costs,

Prices that are too high, and

Missed prevention opportunities.

 

Estimates of potential gains, by initiative:

 

Payment-based strategies,

Care delivery efficiency-based strategies,

Payer harmonization-based strategies,

Transparency-based strategies,

Tort reform,

Knowledge enhancement-based strategies, and

Community-based strategies.

 

Joseph Antos, American Enterprise Institute

CBO scoring methods and results

 

OPEN DISCUSSION

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

10:45 am

Session 2: Policies Targeting Payments Bundled by Condition, Episode, or Outcome

Chair: Arnold Milstein, Pacific Business Group on Health

Opening Remarks: Harvey V. Fineberg, Institute of Medicine

This session addresses the nature, status, and implementation issues for bundled payment strategies, the pivotal co-factors necessary to maximize the savings potential, and the options to minimize political barriers.

 

John M. Bertko, The Brookings Institution

Linda M. Magno, Centers for Medicare & Medicaid Services

State of the science, implementation course, and cadence in bundling payments

 

George J. Isham, HealthPartners

Provider engagement issues

 

Nancy Davenport-Ennis, National Patient Advocate Foundation

Patient engagement issues

 

OPEN DISCUSSION

12:15 pm

Lunch

12:45 pm

Session 3: Policies Targeting Care for Medically Complex Patients

Chair: Peter M. Neupert, Microsoft

This session considers policies that might foster delivery system innovations, ranging from care coordination and more efficient caregiver profiles, to shared services arrangements, and patient/family engagement initiatives, including consideration of policies promoting reform of palliative and end-of-life care.

 

Arnold Milstein, Pacific Business Group on Health

State-of-the-art initiatives

 

Ronald A. Paulus, Geisinger Health System

Provider perspective

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

R. Sean Morrison, Mt. Sinai School of Medicine

Anand K. Parekh, Department of Health and Human Services

Policy perspective

 

OPEN DISCUSSION

2:15 pm

Session 4: Policies Targeting Delivery System Integration

Chair: Helen Darling, National Business Group on Health

This session addresses the current state and consequences of the fragmentation of health care, and considers the organizational, technical, and financial incentives for integrated and virtually integrated care.

 

John Toussaint, ThedaCare Center for Healthcare Value

Profile of system fragmentation and elements of integration

 

Mark E. Miller, Medicare Payment Advisory Commission

Harold S. Luft, Palo Alto Medical Foundation Research Institute

Payment to promote integration

 

Andrew M. Wiesenthal, The Permanente Foundation

Health information technology to promote integration

 

OPEN DISCUSSION

3:45 pm

Session 5: Policies Targeting Other Delivery System Innovations

Chair: Paul B. Ginsburg, Center for Studying Health System Change

This session considers policies that might lower barriers to introduction of delivery system innovations, ranging from design of more efficient delivery systems to more efficient use of alternate caregivers.

 

Steven J. Spear, Massachusetts Institute of Technology

Policies to improve system efficiencies

 

Mary D. Naylor, University of Pennsylvania

Policies to improve provider profile and use

 

OPEN DISCUSSION

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

4:45 pm

Wrap-up Comments for the Day

Arnold Milstein, Pacific Business Group on Health

DAY TWO

8:00 am

Welcome and Re-cap of First Day

Arnold Milstein, Pacific Business Group on Health

8:30 am

Session 6: Policies Targeting Administrative Simplification

Chair: Nancy H. Nielsen, American Medical Association

This session considers policies aimed at harmonizing and standardizing payer plans, and billing and reporting requirements, including review of current initiatives, experiences, barriers, and possibilities.

 

Lewis G. Sandy, UnitedHealth Group

Payer perspective

 

Linda L. Kloss, American Health Information Management Association

Provider perspective

 

Harry Reynolds, Blue Cross/Blue Shield of North Carolina

Policy engagement issues

 

OPEN DISCUSSION

10:00 am

Session 7: Policies Targeting Consumer Preferences for Higher Value Care

Chair: Robert S. Galvin, Global Healthcare/General Electric

This session considers policies that aim to sharpen consumer awareness, focus, and choice of care that delivers higher value.

Jennifer Sweeney, National Partnership for Women and Families

Consumer engagement issues

 

Dick Salmon, Cigna

Payer perspective

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

Dolores L. Mitchell, Group Insurance Commission

Purchaser perspective

 

OPEN DISCUSSION

11:30 am

Lunch

12:00 pm

Session 8: Pulling It All Together—Getting to 10 Percent

Chair: Arnold Milstein, Pacific Business Group on Health

This session will engage key analysts in the task of each reflecting on the summary estimates from the previous meetings and related sources, and offering their views of the gains possible and the most important issues and strategies to reach the possible.

 

Elizabeth A. McGlynn, RAND

David O. Meltzer, University of Chicago

Peter J. Neumann, Tufts University

 

OPEN DISCUSSION

1:30 pm

Session 9: Pulling It All Together—The Policy Priorities and Strategies

Chair: J. Michael McGinnis, Institute of Medicine

This session will engage participants in an open discussion of the policy priorities, how to mobilize support, and possible strategy approaches in the contemporary political environment.

 

Mark B. McClellan, Brookings Institution

Joseph Onek, Office of the Speaker of the House of Representatives

Dean Rosen, Mehlman Vogel Castagnetti Short-term possibilities and goals Long-term possibilities and goals

 

OPEN DISCUSSION

2:30 pm

Concluding Remarks and Adjournment

Arnold Milstein, Pacific Business Group on Health

J. Michael McGinnis, Institute of Medicine

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

WORKSHOP IV AGENDA


Reaching 10 Percent: Options and Requirements


December 15-16

MEETING AGENDA


Objectives: To consider, identify, and characterize practical strategies to reduce per capita health spending in the United States by at least 10 percent within 10 years, without compromising health status, quality of care, or valued innovation.


DAY ONE

9:30 am

Coffee and light breakfast available

10:00 am

Welcome, Introductions and Overview

J. Michael McGinnis, Institute of Medicine

10:30 am

Looking Back at The Healthcare Imperative Workshop Series

Pierre L. Yong, Institute of Medicine

Review the framework and estimates from the workshop series, and reflections on further needs to improve the numbers going forward.

 

OPEN DISCUSSION

11:15 am

Identifying the Primary Opportunities

Develop the priority list of the domains of highest importance to target, the cost saving strategies of highest yield and importance.

 

OPEN DISCUSSION

12:30 pm

Lunch

1:00 pm

Consideration of Different Strategy Scenarios—Reaching 10 Percent

Presentation and discussion of different strategic scenario for reaching 10 percent, including the stakeholders affected and the relative savings potentially achievable in the current delivery system milieu.

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

 

OPEN DISCUSSION

2:30 pm

Break Out Discussions

Three groups, each working on details of a different approach.

4:00 pm

Group Discussion

Report and feedback from each of the three break out groups.

 

OPEN DISCUSSION

5:00 pm

Wrap-up Comments for the Day

J. Michael McGinnis, Institute of Medicine

DAY TWO

8:00 am

Coffee and light breakfast available

8:30 am

Welcome and Re-cap of First Day

J. Michael McGinnis, Institute of Medicine

9:00 am

Identification of Strategic Options to Reach 10 Percent

Development of strategic roadmap for achieving 10 percent health expenditure savings, including the policies needed to implement the strategies, the potential barriers to implementations, the critical co-factors needed to maximize success.

 

OPEN DISCUSSION

11:00 am

Cadence Issues

Considerations of timing of implementation of the identified strategic options.

 

OPEN DISCUSSION

12:00 pm

Summary and Adjournment

J. Michael McGinnis, Institute of Medicine

Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×

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Suggested Citation:"Appendix B: Workshop Agendas." Institute of Medicine. 2010. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, DC: The National Academies Press. doi: 10.17226/12750.
×
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×
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×
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×
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×
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×
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×
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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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