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Showing 1-10 of 35 reviews(Verified Purchases). See all 64 reviews
on December 10, 2015
Redundant book gets to one single point, competition is good for health care. The redundancy is really making the same point from different perspectives within the industry. Probably good for swaying different factions of the industry, not so much a good general business read.
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on August 31, 2007
This book has received probably disproportionate attention due to Prof. Porter's notoriety as a strategic thinking theorist. There are better overall books on healthcare policy available. In particular I recommend the Bodenheimer/Grumbach books, one on healthcare policy and one on primary care, Dr. Arnold Relman's book, A Second Opinion, Strained Mercy, an outstanding and thorough analysis of healthcare economics with particular regard to Canada's healthcare system and Pricing the Priceless a more technically-oriented economic analysis by Prof. Joseph Newhouse, among other books.

I find the analysis of the USA healthcare system by Profs. Porter and Teisberg to generally be excellent, although I find it wanting in regard to their disparagement of a single-payer/single-insurer system and to their description and analysis of healthcare systems outside the USA. From my perspective private health plans play only a net negative role in the system. The authors' analysis of how the health insurance market works is quite good. However their recommendation that a system of private insurers should persist is refuted by their own analysis! A single payer/insurer system will not cure many problems of the USA system, as they clearly point out, but it does remove the inherently dysfunctional characteristics of private insurance, not least of which is its failure to meet the needs of the uninsured - a very large number - and its inherent propensity to exclude the very people who need coverage and care. The authors rightly point out that mandatory health insurance along with risk-pooling among insurers to spread the costs of those insured individuals who generate the highest costs is a "solution" to the current non-functioning system, but the same result, at lower cost and with much greater simplicity, can be achieved through a single payer/insurer.

The other key aspect of healthcare - how it is delivered - is ultimately more important than the financing/insurance side. The authors provide excellent analysis and recommendations in this regard. They correctly address the aspects of the healthcare market that prevent its functioning as a "competitive" market, specifically the abysmal lack of patient information on prices for services, on outcomes of actions by providers, comparative statistics on provider performance and similar. They also provide an interesting report by the Cleveland Clinic on outcomes, i.e. results, of the Clinic's heart surgery activity. They appropriately use this as an example of the kind of reporting that is needed.

The authors' analysis of healthcare systems outside the USA is skimpy and inaccurate in my opinion. The authors underplay the demonstrated efficacy of government-funded systems that outperform the USA system almost across the board in gross measures of outcomes (infant mortality and longevity) and vastly outperform the US system in regard to cost. They gloss over the fact that per capita costs in the USA are 2.5 times! the average per capita costs in other OECD countries. It is not as though the costs are say 10% above the average with comparable outcomes. They are 150% higher with worse outcomes. Instead of noting this and analyzing it thoroughly, the authors assert that waiting times and rationing of care are significant problems in those countries, assertions which are simply not borne out by the facts. Also the fact that (mostly) single-payer/insurer systems function well universally does not fit the authors' main thesis, so rather than revise the thesis based on this evidence they choose to ignore the evidence.

As a consequence of these limitations I rate the book with 4 stars rather than 5. Too bad, because most of the book is excellent.
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on July 20, 2010
Why doesn't it follow the progression to higher quality and lower prices as most other industries do? These are some of the questions that authors Michael Porter of Harvard Business School and Elizabeth Teisberg of University of Virginia School of Business attempt to answer. The book paints an accurate portrait of the shortcomings of the US health care system, which fails to identify and scale up providers who provide the highest quality health care at the lowest cost.

Health care providers, health plans, payers, and consumers are responsible for our low performing, high cost health care system. Real reform of the system has implications for all stakeholders and, optimistically, this reform is already underway. Improvements in health care quality reporting and access to these data by consumers and payers is increasing, providers are consolidating from solo private practices to medical groups wherein health plans are supporting transformations to patient center medical homes that actively manage patient health status through preventive care and case management. Employers are expecting that health plans augment their provider contracting discounts and claims processing with health and wellness programs, including disease management. Health care technology, including electronic medical records and telemedicine, are improving the portability of health information and enabling remote hospitals to instantly access medical specialists at nationally and internationally recognized hospital centers.

The authors do an excellent job of highlighting the levers in the domains of each stakeholder that must be switched on for transformation to a value based market place to happen. I argue that it will happen out of economic and technological developments, as well as the influence of globalization, rather than via any significant policy changes, with the exception of a government mandate for individual health insurance coverage that has now been passed at the federal level.

Even though I share the opinion of several other reviewers that the book is unnecessarily lengthly and redundant, I do recommend it for its broad viewpoints and substantial supporting case studies.
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on September 4, 2013
This book is an excellent opinion piece - defining and clarifying some important ideas which are still as un-tested today as they were when it was written.

The main criticisms of this book are that there are few data to support their concepts. The reason for this is no one has tried anything like the approaches they suggest in either quality improvement or safety (if we accept, for the moment that these are separate areas of activity).

The whole point is that they are suggesting one point, which, I agree, they hammer and re-hammer over and over: health care *must* be devaluated, measured, paid for on the basis of outcome measured over the entire cycle of the patient's disease.

Unfortunately, the best we have so far is to measure mini-outcomes. And when it comes to many kinds of cancer of CAD or stroke, etc., one procedure, one O.R. episode, or even one hospitalization is a TINY portion of the health care that the patient in question will receive.

It is the wrong (narrow) focus in time and other incorrect foci that they discuss.

If their ideas were in place, then someone (maybe they) will write a book evaluating how effective their ideas are. There are no data - at best we have data on very short term result. Often evaluations are based on process variables, intermediate variables, or whatever name you want for them.

I'm waiting for some data to analyze.
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HALL OF FAMEon August 2, 2006
"Redefining Health Care" begins with data detailing the failures of America's "health system" - the highest and most rapidly rising costs among modern nations, combined with millions of uninsured, high error rates, and an average 17 years for the results of clinical trials to become standard clinical practice. Thus, the puzzle: "Why is competition failing in health care?"

Porter and Teisberg's answer is that it focuses far too much on cost-reduction, increasing negotiating power, providing broad-lines of service, and cost-shifting, and instead should focus on long-term value (results vs. costs) for patients. Key to accomplishing this is the collection of standardized patient outcome data (preferably risk-adjusted) that are used to identify providers needing improvement and sources from which that improvement can be gleaned, as well as in guiding patient decision-making.

"Redefining Health Care" also asserts that its recommendations are not just theories, but also supported by a number of cited examples.

This book provides a clear vision of how the U.S. can reduce health care costs while improving patient outcomes - without increased complexity. It should be read by legislators at both the state and national level, as well as by health care providers.
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on October 5, 2012
Although this book contains fantastic information and data about the state of the current healthcare system, it gives very little specific guidance on how to improve it other than to state the obvious; that there needs to be a way to judge the value of healthcare for the patient per dollar spent, and utilize that information to improve competition. A much more novel approach to reforming healthcare is found through the Innovator's Prescription for Change, which outlines specific, step-by-step methods to achieve a measurable value for patients while improving access and lowering costs. For those who are looking to understand the current healthcare system to a greater degree, and who are wondering where the healthcare system will take us in 20+ years, the Innovator's Prescription for Change is a fantastic read.
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on February 15, 2017
Misses the reality in the trenches. Health care delivery is mostly controlled by insurance companies and health care costs are high because of regulatory burden, overcharging by big pharmaceuticals and expensive technology. Access to care is a major problem in the current system, an issue not dealt with much in this book.
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on August 24, 2006
Porter is probably the most respected writer on "strategy," today. In "Redefining Healthcare" he applies his strategic thinking to a serious issue...healthcare. This is not just an academic treatment of the issue, but Porter gives real world examples of healthcare providers who are changing the way they measure quality at the level of the patient and the impact of what authors Porter and Teisberg define as Integrated Practice Units.

The authors examine single payer, governmental systems strengths and weaknesses; what to do about the large number of uninsured in the US; patient responsibility; and most importantly, how to it is possible to build healthcare relationships that can show real, measurable quality at the level of the patient.

Porter and Teisberg also examine the parts that insurers, hospitals, doctors, pharmaceutical/biotech companies, diagnostic equipment suppliers, and patients play in impacting both the quality and cost of healthcare.

There are ways to fix healthcare, not just for the US, but on an international scope. And if you are at all concerned about the direction US healthcare is going and what true value competition in healthcare should look like, then you need to read this book.
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on March 28, 2012
Michael Porter is masterful in using his corporate strategic management techniques and applying them to healthcare. A must-read for anyone in any sector of the healthcare industry. I have been on the payer, provider, and EMR side of healthcare and have learned a great deal about all three.
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on July 3, 2016
Useful - I am not American and this is based on American health care - however there are enough similarities to make it a worthwhile read.
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