NOTES
ACKNOWLEDGMENTS
1. J. Wennberg and Alan Gittelsohn, “Small Area Variations in Health Care Delivery,” Science 182, no. 4117 (December 14, 1973): 1102-08, https://www.ncbi.nlm.nih.gov/pubmed/4750608.
2. Robert E. Andrews et al., Towards a New Model of Health Care Employer-Facilitated Care (Washington, DC: American Health Policy Institute, 2016), http://www.americanhealthpolicy.org/Content/documents/resources/Towards_a_New_Model_of_Health_Care.pdf.
CHAPTER 1
1. Miliard, Mike, “Geisinger CEO David Feinberg, MD, on patient satisfaction, population health, genomics and more”, Healthcare IT News, (2016, April 12), http://www.healthcareitnews.com/news/geisinger-ceo-david-feinberg-md-patient-satisfaction-population-health-genomics-and-more
2. Anthony Shih, Karen Davis, Stephen C. Schoenbaum, Anne Gauthier, Rachel Nuzum, and Douglas McCarthy, “Organizing the U.S. Health Care Delivery System for High Performance,” Commission on a High Performance Health System (New York: The Commonwealth Fund, August 2008), http://www.commonwealthfund.org/usr_doc/Shih_organizingushltcaredeliverysys_1155.pdf.
3. Reed Abelson, “In Bid for Better Care, Surgery with a Warranty,” New York Times, May 17, 2007, http://www.nytimes.com/2007/05/17/business/17quality.html?_r=0.
4. President Barack Obama, address, Joint Session of Congress on Healthcare, September 9, 2009, https://obamawhitehouse.archives.gov/the-press-office/remarks-president-a-joint-session-congress-health-care
5. President Barack Obama, remarks, town hall meeting, Southwest High School, Green Bay, Wisconsin, July 11, 2009, https://www.whitehouse.gov/blog/2009/06/11/a-town-hall-and-a-health-care-model-green-bay.
6. Joe Klein, “The Long Goodbye,” TIME, June 11, 2012, http://time.com/735/the-long-goodbye/.
7. Steve Sternberg, “Unsatisfied With Your Surgery? Get (Some of) Your Money Back,” U.S. News & World Report, November 11, 2015, http://www.usnews.com/news/articles/2015/11/11/unsatisfied-with-your-surgery-get-your-money-back.
CHAPTER 2
1. Gerard Anderson, Chronic Care: Making the Case for Ongoing Care (Princeton, New Jersey: Robert Wood Johnson Foundation, 2010), http://www.rwjf.org/en/research-publications/find-rwjf-research/2010/01/chronic-care.html.
2. Elizabeth A. McGlynn et al., “The Quality of Health Care Delivered to Adults in the United States,” New England Journal of Medicine, June 26, 2003, http://www.nejm.org/doi/full/10.1056/NEJMsa022615.
3. Arnold Milstein, “Perspective: Managing Utilization Management: A Purchaser’s View,” Health Affairs 16, no. 3 (1997): 87–90, http://content.healthaffairs.org/content/16/3/87.full.pdf+html.
CHAPTER 4
1. Glenn Steele Jr., Reinventing Health Care: The Geisinger Health System 2001–2015 (Danville, PA: privately published, 2015), 352.
2. Ibid, 353.
3. Ibid, 361–62.
4. Ibid. 364, 365, 371.
5. Lawrence F. Wolper, Healthcare Administration: Managing Organized Delivery Systems, 5th ed. (Burlington, MA: Jones & Bartlett Learning, 2010), 86.
6. Reinventing Health Care, 357–59.
CHAPTER 5
1. Pennsylvania Health Care Cost Containment Council, www.phc4.org.
2. A. S. Casale et al., “ProvenCare: A Provider-Driven Pay-for-Performance Program for Acute Episodic Cardiac Surgical Care,” Annals of Surgery 246, no. 4 (2007): 613–21.
3. G. Pang, “Central Teachers Gain $7,000 Average: Health Care Savings Balance Raises in Contract,” Press Enterprise (July 6, 2009).
4. Reed Abelson, “In Bid for Better Care, Surgery with a Warranty,” New York Times, May 17, 2007, http://www.nytimes.com/2007/05/17/business/17quality.html?_r=0.
5. Ibid.
CHAPTER 6
1. Glenn Steele Jr., MD, PhD, Reinventing Health Care: The Geisinger Health System 2001–2015, ©2015 Geisinger Health System.
2. Steele, Reinventing Health Care.
3. Steele, Reinventing Health Care.
4. Steele, Reinventing Health Care.
CHAPTER 7
1. Alexander Kulik, Marc Ruel, Hani Jneid, T. Bruce Ferguson, Loren F. Hiratzka, John S. Ikonomidis, Francisco Lopez-Jimenez, Sheila M. McNallan, Mahesh Patel, Véronique L. Roger, Frank W. Sellke, Domenic A. Sica, and Lani Zimmerman on behalf of the American Heart Association Council on Cardiovascular Surgery and Anesthesia, “Secondary Prevention After Coronary Artery Bypass Graft Surgery: A Scientific Statement From the American Heart Association,” Circulation (February 9, 2015): published online ahead of print, http://circ.ahajournals.org/content/early/2015/02/09/CIR.0000000000000182.
2. Mark R. Katlic, Matthew A. Facktor, Scott A. Berry, Karen E. McKinley, Albert Bothe Jr., Glenn D. Steele Jr., “ProvenCare Lung Cancer: A Multi-Institutional Improvement Collaborative,” CA: A Cancer Journal for Clinicians 61 no.6 (November–December 2011): 382–96.
CHAPTER 8
1. 2010 Diabetes Burden Report, Pennsylvania Department of Health, http://www.statistics.health.pa.gov/HealthStatistics/OtherHealthStatistics/Documents/2010_Diabetes_Burden_Report.pdf.
2. Thomas Nolan and Donald M. Berwick, “All-or-None Measurement Raises the Bar on Performance,” JAMA 295, no. 10 (2006): 1168–70, http://ow.ly/4n7Ktt.
3. Frederick J. Bloom Jr. et al., “Primary Care Diabetes Bundle Management: Three-Year Outcomes for Microvascular and Macrovascular Events,” American Journal of Managed Care 20, no. 6 (June 26, 2014), http://ow.ly/4n7I8m.
4. Daniel D. Maeng et al., “Value of Primary Care Diabetes Management: Long-Term Cost Impacts,” American Journal of Managed Care 22, no. 3 (February 29, 2016), http://ow.ly/4n7J5p.
5. xG Health Solutions, ProvenCare Process Guide, Chronic Disease Methodology Diabetes Mellitus Management.
6. Ibid.
7. ProvenCare codes are customized, best practice clinical codes. Their purpose is to optimize care plans, health management reminders, performance monitoring, and evidence-based alerts. These codes are not billing codes and are not used for any reimbursement purpose.
8. xG Health Solutions, ProvenCare Process Guide, Chronic Disease Methodology Diabetes Mellitus Management.
9. Jan Walker et al., “The Road Toward Fully Transparent Medical Records,” New England Journal of Medicine 370 (January 2, 2014), http://ow.ly/4n7JXG.
10. Bloom et al.
11. Maeng et al.
CHAPTER 9
1. “Reinventing American Healthcare,” WVIA original feature presentation, 56:44, April 23, 2015, http://on-demand.wvia.org/video/2365467227/.
2. Thomas Nolan and Donald M. Berwick, “All-or-None Measurement Raises the Bar on Performance,” JAMA 295, no. 10 (2006): 1168–70, http://ow.ly/4n7Ktt.
3. See Figures 6.1 and 6.2.
CHAPTER 10
1. The Institute for Healthcare Improvement’s “Triple Aim” is to improve the patient’s experience of care (including quality and satisfaction); to improve the health of populations; and to reduce the per capita cost of healthcare. See IHI Triple Aim Initiative, http://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx, accessed September 27, 2016.
CHAPTER 11
1. For a concise explanation of biological products and how they differ from conventional drugs, see “ ‘What Are Biologics’ Questions and Answers,” U.S. Food and Drug Administration, accessed August 8, 2016, http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CBER/ucm133077.htm.
2. Express Scripts Holding Company, Express Scripts 2015 Drug Trend Report. St. Louis: Express Scripts Holding Company, 2016, http://lab.express-scripts.com/lab/drug-trend-report.
3. Steven G. Ivey (vice president, specialty pharmacy programs, MedImpact Healthcare Systems, Inc.), in discussion with Geisinger Health Plan, November 19, 2015.
4. Aimee Tharaldson, “Specialty Drug Approvals in 2013,” (blog), Express Scripts Holding Company, March 26, 2014, http://lab.express-scripts.com/lab/insights/drug-options/specialty-drug-approvals-in-2013.
5. Dean M. Wingerchuk and Jonathan L. Carter, “Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies,” Mayo Clinic Proceedings 89, no. 2 (February 2014): 225–40.
6. Institute for Safe Medication Practices, “Cancer Risks of Biological Products for Psoriasis,” QuarterWatch (April 6, 2016), http://www.ismp.org/QuarterWatch/Default.aspx.
7. Deena Beasley, “Analysis: Drug Costs Become Bigger Issue in Cancer Care,” Reuters, June 14, 2012, http://www.reuters.com/article/us-cancer-cost-idUSBRE85E05B20120615.
8. Pharmaceutical Research and Manufacturers of America, “Cancer Chart Pack, Cancer Medicines: Value in Context,” 2014, http://www.phrma.org/sites/default/files/pdf/cancer-chart-pack-5-22-14.pdf.
CHAPTER 12
1. Press Ganey Associates works with more than 10,000 health care organizations nationwide, including more than half of U.S. hospitals, to improve patient care and experience.
2. Wendy Chaboyer, Anne McMurray, and Marianne Wallis, “Bedside Nursing Handover: A Case Study,” International Journal of Nursing Practice 16, no. 1 (January 2010): 27–34. See also Wendy Chaboyer, Anne McMurray, Joanne Johnson, et al., “Bedside Handover: Quality Improvement Strategy to ‘Transform Care at the Bedside’,” Journal of Nursing Care Quality 24, no. 2 (April 2009): 136–42.
3. From the Latin per os, or by mouth.
4. Margo A. Halm, “Hourly Rounds: What Does the Evidence Indicate?,” American Journal of Critical Care 18, no. 6 (November 2009): 581–84.
5. Geisinger study, “Access to Doctors’ Notes Increases Med Adherence,” PRNewswire, November 2, 2015, http://www.prnewswire.com/news-releases/geisinger-study-access-to-doctors-notes-increases-med-adherence-300170282.html.
CHAPTER 13
1. Health Care Payment Learning and Action Network, Alternative Payment Model Framework and Progress Tracking Work Group, “Alternative Payment Model Framework Final White Paper,” January 1, 2016, https://hcp-lan.org/workproducts/apm-whitepaper.pdf.
2. American Academy of Pediatrics, “Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report,” Pediatrics 128, supplement 5, December 2011, http://pediatrics.aappublications.org/content/128/Supplement_5/S213.
3. Kristin N. Ray, Amalavoyal V. Chari, John Engberg, Marnie Bertolet, and Ateev Mehrotra, “Opportunity Costs of Ambulatory Medical Care in the United States,” American Journal of Managed Care, August 18, 2015, http://www.ajmc.com/journals/issue/2015/2015-vol21-n8/Opportunity-Costs-of-Ambulatory-Medical-Care-in-the-United-States.
4. Chris Krepich, “Geisinger Staff Honors Hero; Nurse Bonds with Lightning-Strike Victim, His Family,” Bloomsburg Press Enterprise, July 29, 2016.