Health Care Finance: Economic Incentives and Productivity Enhancement

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Greenwood Publishing Group, 1992 - Business & Economics - 540 pages

This book is a thorough, balanced, and insightful study of what is happening and what should be happening in health care financing. Americans want unlimited access to the best care at affordable prices. Fiscal pressures in American health care point in all different directions, like a pile of jackstraws. This important book analyzes how new payment incentives stimulate planned competition or reregulation; and the far-reaching impact these changes have on hospitals, physicians, long-term care facilities, HMOs, public health clinics, and multihospital systems. Tools for survival include better financial planning, productivity improvement, better scheduling systems, and total quality management.

Steven R. Eastaugh begins his book with a general overview of cost management, accounting, product-line selection, and new payment incentives. Part II provides an in-depth survey of fiscal trends in long-term care, managed care, HMOs, and PPOs. Part III analyzes five basic strategies that a provider may consider; with special focus on market analysis, diversification, and pricing. The next part reviews physician payment options, the new Medicare 1992 payment systems for hospitals and physicians, and cost analysis of hospital patient care, research, and education. Part V considers productivity enhancement methods, incentives to assist productivity programs, and the Deming method of total quality management. Part VI focuses on investment, financing, and capital structure decisions in health care institutions and also in large multifacility systems. The last part summarizes major strategies for success in the 1990s, future policy alternatives, and suggests a number of alternative roads to universal entitlement and national health care reform. As Eastaugh suggests in this book, Our health system faces . . . immense opportunity and danger in a reformation on four fronts: access, efficiency, effectiveness, and quality of life. The challenge for providers and managers during this period of unparalleled opportunity is to win a clear victory on all four fronts, and not erode either access or quality in the name of efficiency. The range of coverage in Health Care Finance is extremely wide and detailed--making it essential and useful reading for health care professionals and students alike.

 

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Contents

Payment Incentives Provider Behavior and the Need for Better Cost Management
3
Hospital Accounting Purchasing and Product Specialization
37
ACCESS TO LONGTERM CARE AND PREPAID MANAGED CARE
77
HMOs PPOs and Competition Health Plans
79
LongTerm Care Issues and Options
119
STRATEGY SELECTION MARKET ANALYSIS DIVERSIFICATION AND PRICING
159
Diversification for the Single Hospital
161
Marketing Pricing and Specialization
193
Hospital Productivity Managing Cost Reductions without Harm to Quality or Access
315
Incentives for Productivity Improvement
349
Quality Measurement Value Shopping and the Deming Method
369
INVESTMENT FINANCING AND CAPITALSTRUCTURE DECISIONS
403
Taxexempt and ForProfit Multihospital Systems
405
Evaluation of Financing Alternatives
435
Access to Capital and Debt Financing
465
THE BUMPY ROAD AHEAD
491

MANAGING PHYSICIANS MEDICAL SCHOOLS AND TEACHING HOSPITALS
235
Paying the Doctor
237
Graduate Medical Education and the Teaching Hospital
265
QUALITY ASSURANCE AND PRODUCTIVITY CONTROL
313
Future Policy Options What Form Could Universal Entitlement Take?
493
Author Index
523
Subject Index
539
Copyright

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About the author (1992)

STEVEN R. EASTAUGH is Professor of Health Economics and Finance at George Washington University. The winner of numerous awards, including the American College of Healthcare Executives Edgar Hayhow Award, Eastaugh has published widely in the areas of health care finance and economics. His companion volume, Health Economics: Efficiency, Quality, and Equity, will also be issued by Auburn House in 1992.

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