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A complex adaptive healthcare system (CAHS) is a care delivery enterprise with diverse clinical and administrative agents acting spontaneously, interacting in nonlinear networks where agents and patients are information processors, and actively co-evolve with their environment with the purposed to produce safe and reliable patient-centered outcomes.
Value-based health care (VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. [1] The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg , though implementation efforts on aspects of value-based care began ...
The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...
Increasing or decreasing one results in changes to one or both of the other two. For example, a policy that increases access to health services would lower quality of health care and/or increase cost. The desired state of the triangle, high access and quality with low cost represents value in a health care system. [3]
In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for ...
The guiding business model and philosophical goal of the IDN is to serve as a self-contained healthcare ecosystem, with the ability to contain the entirety of the patient experience to coordinate care and manage population health. [2] Examples of IDNs include Highmark Health, [3] Kaiser Permanente, [4] UPMC, Mayo Clinic, Cleveland Clinic ...
The 5% Value at Risk of a hypothetical profit-and-loss probability density function. Value at risk (VaR) is a measure of the risk of loss of investment/capital. It estimates how much a set of investments might lose (with a given probability), given normal market conditions, in a set time period such as a day.
The term "Professional Caregiver Insurance Risk" [39] [40] explains the inefficiencies in health care finance that result when insurance risks are inefficiently transferred to health care providers who are expected to cover such costs in return for their capitation payments. As Cox (2006) demonstrates, providers cannot be adequately compensated ...