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Third, we need to reorganize care delivery around medical conditions. Our system of uncoordinated, sequential visits to multiple providers, physicians, departments, and specialties works against value. Instead, we need to move to integrated practice units that encompass all the skills and services required over the full cycle of care for each medical condition, including common coexisting conditions and complications. Such units should include outpatient and inpatient care, testing, education and coaching, and rehabilitation within the same actual or virtual organization. This structure, organized around the patient's needs, will result in care with much higher value and a far better experience for patients. Government policies creating artificial obstacles to integrated, multidisciplinary care (e.g., the Stark laws) should be modified or eliminated. In a value-based system, the abuses that gave rise to such legislation will decline substantially.
First, we must change the nature of health insurance competition. Insurers, whether private or public, should prosper only if they improve their subscribers' health. Today, health plans compete by selecting healthier subscribers, denying services, negotiating deeper discounts, and shifting more costs to subscribers. This zero-sum approach has given competition — and health insurers — a bad name. Instead, health plans must compete on value. We must introduce regulations to end coverage and price discrimination based on health risks or existing health problems. In addition, health plans should be required to measure and report their subscribers' health outcomes, starting with a group of important medical conditions. Such reporting will help consumers choose health plans on the basis of value and discourage insurers from skimping on high-value services, such as preventive care. Health insurers that compete this way will drive value in the system far more effectively than government monopolies can.
Essay on education should be value based - …
To achieve a value-based delivery system, we need to follow a series of mutually reinforcing steps. First, measurement and dissemination of health outcomes should become mandatory for every provider and every medical condition. Results data not only will drive providers and health plans to improve outcomes and efficiency but also will help patients and health plans choose the best provider teams for their medical circumstances.
It is, of course, quite true that bits and pieces of the mediaeval traditionstill linger, or have been revived, in the ordinary school syllabus oftoday. Some knowledge of grammar is still required when learning a foreignlanguage--perhaps I should say, "is again required," for duringmy own lifetime, we passed through a phase when the teaching of declensionsand conjugations was considered rather reprehensible, and it was consideredbetter to pick these things up as we went along. School debating societiesflourish; essays are written; the necessity for "self- expression"is stressed, and perhaps even over-stressed. But these activities are cultivatedmore or less in detachment, as belonging to the special subjects in whichthey are pigeon-holed rather than as forming one coherent scheme of mentaltraining to which all "subjects"stand in a subordinate relation."Grammar" belongs especially to the "subject" of foreignlanguages, and essay-writing to the "subject" called "English";while Dialectic has become almost entirely divorced from the rest of thecurriculum, and is frequently practiced unsystematically and out of schoolhours as a separate exercise, only very loosely related to the main businessof learning. Taken by and large, the great difference of emphasis betweenthe two conceptions holds good: modern education concentrates on "teachingsubjects," leaving the method of thinking, arguing, and expressingone's conclusions to be picked up by the scholar as he goes along' mediaevaleducation concentrated on first forging and learning to handle the toolsof learning, using whatever subject came handy as a piece of material onwhich to doodle until the use of the tool became second nature.
Essay on education should be value based
Another quotation from the same issue of the TLS comes in fittinglyhere to wind up this random collection of disquieting thoughts--this timefrom a review of Sir Richard Livingstone's "Some Tasks for Education":"More than once the reader is reminded of the value of an intensivestudy of at least one subject, so as to learn the meaning of knowledge'and what precision and persistence is needed to attain it. Yet there iselsewhere full recognition of the distressing fact that a man may be masterin one field and show no better judgement than his neighbor anywhere else;he remembers what he has learnt, but forgets altogether how he learnedit."
Fifth, we must expect and require providers to compete for patients, based on value at the medical-condition level, both within and across state borders. This will allow excellent providers to grow and serve more patients while reducing hyperfragmentation and duplication of services. In order to achieve high value, providers need a sufficient volume of cases of a given medical condition to allow for the development of deep expertise, integrated teams, and tailored facilities. We may need to institute minimum-volume thresholds for complex medical conditions in order to jump-start consolidation and spur geographic expansion of qualified providers. At the same time, strict antitrust scrutiny must be applied to avoid excessive concentration among a small number of providers or health plans in a region.
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Essay Example On Importance Of Education In The Modern World
Lawrence S. Kim. . (2011) How Will Accreditation of Your Ambulatory Endoscopy Center Be an Essential Component of Showing Value-Based Health Care?. 9, 21-23.
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