Jonas and Kovner’s Health Care Delivery in the United States, 12th Edition

This fully updated and revised 12th edition of the highly acclaimed textbook on health care delivery provides graduate and undergraduate students with a comprehensive survey of health care in the United States ranging in topics from the organization of care, the politics surrounding healthcare in the United States, to population health and vulnerable populations, healthcare costs and value, health care financing, and health information technology. Chapters provide thorough coverage of the rapid changes that are reshaping our system and the extent of our nation’s achievement of health care value and the Triple Aim: better health and better care at a lower cost. With an emphasis on population health and public health, this text includes a timely focus on how social and physical environments influence health outcomes. Prominent scholars, practitioners, and educators within public health, population health, health policy, healthcare management, medical care, and nursing present the most up-to-date evidence-based information on social and behavioral determinants of health and health equity, immigrant health, healthcare workforce challenges, preventative medicine, innovative approaches to control health care costs, initiatives to achieve high quality and value-based care, and much more.

Designed for graduate and advanced undergraduate students of health care management and administration, nursing, and public health, the text addresses all complex core issues surrounding our health care system and health policy, such as the challenges to health care delivery, the organization and politics of care, and comparative health systems. Organized in a readable and accessible format, contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, healthcare management, and public health. The 12th edition features the contributions of such luminaries as former editor Anthony R. Kovner, Michael K. Gusmano, Carolyn M. Clancy, Marc N. Gourevitch, Joanne Spetz, James Morone, Karen DeSalvo, and Christy Harris Lemak, among others. Chapters include audio chapter summaries with discussion of newsworthy topics, learning objectives, discussion questions, case exercises, and new charts and tables with concrete health care data. Included for instructors are an Instructor’s Manual, PowerPoint slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on a Visual Overview of Health Care Delivery, access to an annual ACA update and health policy changes, extra cases and syllabi specifically for nurses, and a transition guide bridging the 11th and 12th editions.

Key Features:

• Three completely revised chapters on the politics of health care, vulnerable populations, and health information technology
• Chapter authors with expertise in Health Administration and Management, Public Health, Health Policy, Medical Care and Nursing
• Expanded coverage on population health and population health management, health equity, influences of social determinants on health behavior and outcomes, health education planning, health workforce challenges, national and regional quality improvement initiatives and more
• Revised e-Chapters providing a Visual Overview of Health Care Delivery with image bank and Springer Publishing’s annual ACA update
• Audio podcasts provide summaries for each chapter and provide real-world context of topics featured in the news
• New Appendix on Overview of U.S. Public Health Agencies
• Access to fully searchable eBook, including extra e-chapters and student ancillaries on Springer Connect
• Full Instructor Packet including Instructor’s Manual, Test Bank, PowerPoint slides, Image Bank, Case Exercises for Nursing Instructors

CONTENTS

List of Features

Foreword by Anthony R. Kovner, PhD

Acknowledgments

Organization of This Book

Contributors

PART I HEALTH POLICY

Chapter 1 The Challenge of Health Care Delivery and Health Policy

Brian Elbel and James R. Knickman

Introduction

The Importance of Good Health to American Life

Defining Characteristics of the U.S. Health System

Major Issues and Concerns

Key Stakeholders Influencing the Health System

Organization of This Book

Conclusion

Case Exercise—Health Care Delivery Plan

Discussion Questions

Reference

Chapter 2 Organization of Care

Amy Yarbrough Landry and Cathleen O. Erwin

Introduction

Description of the Current Care Delivery System

The Future of the Delivery System

Best Practices

Conclusion

Case Exercise—Innovative Ideas

Discussion Questions

References

Chapter 3 The Politics of Health Care in the United States

Rogan Kersh and James Morone

Introduction

Health Care Infrastructure and Spending: Many Dollars, to What Effect?

Who Pays? The Politics of Medicare, Medicaid, and Much More

The Politics of Providing Equitable Health Services

How Personal Health Decisions Become Public: The Case of Obesity

Conclusion: Better National Health Ahead?

Case Exercise—Insurance Plans

Discussion Questions

References

Chapter 4 Comparative Health Systems

Michael K. Gusmano and Victor G. Rodwin

Introduction

Health System Models

NHS and NHI Systems Compared With the United States

The Health Systems in England, Canada, France, and China

Lessons

Case Exercise—European Lessons Learned

Discussion Questions

References

PART II KEEPING AMERICANS HEALTHY

Chapter 5 Population Health

Pamela G. Russo and Marc N. Gourevitch

Introduction

The Population Health Model

The Medical Model

Comparing the Medical and Population Health Models

The Influence of Social Determinants on Health Behavior and Outcomes

Leading Determinants of Health: Weighting the Different Domains

Health Policy and Returns on Investment

Conclusion

Case Exercise—Sodium and its Effects on Our Health

Discussion Questions

References

Chapter 6 Public Health: A Transformation in the 21st Century

Laura C. Leviton, Paul L. Kuehnert, and Kathryn E. Wehr

Overview of a Complex Infrastructure

Public Health Requires a Collective Response from Society

Public Health is Different from Individual Health Care

The Core Functions of Public Health Define Essential Public Health Activities

Governmental Agencies Have Legal Authority for the Core Functions

Social, Economic, and Political Forces are Transforming Public Health

Conclusion

Case Exercise—Cure For Birth Defects Policy Options

Discussion Questions

References

Chapter 7 Health and Behavior

Brian Elbel, Elaine F. Cassidy, Matthew D. Trujillo, and C. Tracy Orleans

Introduction

Behavioral Risk Factors: Overview and National Goals

Changing Health Behavior: Closing the Gap Between Recommended and Actual Health Lifestyle Practices

The Role and Impact of Primary Care Interventions

Multilevel Models For Population-Based Health Behavior Change

Changing Provider Behavior: Closing the Gap Between Best Practice and Usual Care

Conclusion

Case Exercise—Comprehensive Plan for Addressing Risk Factors

Discussion Questions

References

Chapter 8 Vulnerable Populations: Meeting the Health Needs of Populations Facing Health Inequities

Monique J. Vasquez, Jacqueline Martinez Garcel, Elizabeth A. Ward, and Lourdes J. Rodríguez

Introduction

Understanding Factors and Systems that Impact People Disproportionately Affected by Health Inequities

The Growing Number of Health Inequities

Uneven Footing After the Great Recession and a Strained Social Service Sector

Organization and Financing of Health Care, Population/Public Health/Prevention, and Other Services for Populations Experiencing Health Inequities

Rural Health Clinics and Rural Health Networks

Social Service Needs

Federal and State Financing of Care for Vulnerable Populations

Challenges for Service Delivery and Payment

Emerging and Tested Ideas for Better Health Delivery

Case Exercise 8.1—Patient Engagement: Bronx-Lebanon Hospital Department of Family Medicine’s Patient-Centered Medical Home

Case Exercise 8.2—Integrated Care: Camden Coalition of Health Care Providers

Opportunities in the ACA to Meet Health Care Needs of Vulnerable Populations

Conclusion

Case Exercise 8.3—Plan for Refugees

Discussion Questions

References

PART III MEDICAL CARE: TREATING AMERICANS’ MEDICAL PROBLEMS

Chapter 9 The Health Workforce

Joanne Spetz and Susan A. Chapman

Introduction

Who Is Part of the Health Workforce?

Traditional Approaches to Health Workforce Planning

Health Workforce Education

Critical Issues for the Health Workforce

Conclusion: Building the Future Health Care Workforce

Case Exercise—Workforce Recruitment Plan

Discussion Questions

References

Chapter 10 Health Care Financing

James R. Knickman

Introduction

General Overview of Health Care Financing

What the Money Buys and Where It Comes From

How Health Insurance Works

How Providers are Paid for the Health Services They Deliver

Specialized Payment Approaches Used by Payers

Conclusion

Case Exercise—Becoming an Accountable Care Organization Versus Not Becoming an Accountable Care Organization

Discussion Questions

References

Chapter 11 Health Care Costs and Value

David C. Radley and John Marchica

Introduction

Spending Levels and Cost Growth

Defining and Measuring Value in Health Care

Cost Drivers and Barriers to Value

Initiatives to Address Expenditure/Value Tradeoffs

Delivery System Reform

State-Driven Value-Based Initiatives

Conclusion

Case Exercise—Monitoring of Value

Discussion Questions

References

Chapter 12 High-Quality Health Care

Carolyn M. Clancy and Irene Fraser

Introduction

Defining Quality

How are We Doing?

How Do We Improve Quality?

How Do We Incentivize Quality Care?

What are Major Recent Developments Affecting Quality?

Core Competencies for Health Administrators

Conclusion

Case Exercise—Using Data to Support Sustainability

Discussion Questions

References

Chapter 13 Health Care Management

Anthony R. Kovner and Christy Harris Lemak

Introduction

Governance, Performance and Accountability

The Complex Tasks of Leadership and Management

Evidence-Based Management

Challenges Managers Face

Conclusion

Case Exercise—Strategic Plan Report

Discussion Questions

References

Chapter 14 Health Information Technology

Karen B. DeSalvo and Y. Claire Wang

Introduction

Health Data Needs and IT Use Cases

Case Exercise 14.1—NYC Macroscope

HIT Interoperability

Standards

Driving Forces Shaping the Use of Data and HIT

Case Exercise 14.2—Avera Health

Challenges to More Effective Use of Information and Data

Privacy and Security

Current Marketplace and Emerging Opportunities

Conclusion

Case Exercise 14.3—Electronic Health Records

Discussion Questions

References

PART IV FUTURE OF U.S. HEALTH CARE

Chapter 15 The Future of Health Care Delivery and Health Policy

James R. Knickman and Brian Elbel

Introduction

Forces Shaping Change in the Health System

Key Challenges that Will Receive Attention in Upcoming Years

Future Prospects for Different Stakeholders in the Health Enterprise

Conclusion

Case Exercise—Payments and Budget Caps in Medicare

Discussion Questions

References

Appendix U.S. Government Public Health Agencies

Glossary

Index