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Health Care as a Right of CitizenshipThe Continuing Evolution of Reform$
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Gunnar Almgren

Print publication date: 2017

Print ISBN-13: 9780231170130

Published to Columbia Scholarship Online: January 2019

DOI: 10.7312/columbia/9780231170130.001.0001

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PRINTED FROM COLUMBIA SCHOLARSHIP ONLINE (www.columbia.universitypressscholarship.com). (c) Copyright University of Minnesota Press, 2019. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in CUPSO for personal use.date: 14 October 2019

A Principled Approach to Essential Health-Care Delivery System Reforms

A Principled Approach to Essential Health-Care Delivery System Reforms

Chapter:
(p.159) Chapter Six A Principled Approach to Essential Health-Care Delivery System Reforms
Source:
Health Care as a Right of Citizenship
Author(s):

Gunnar Almgren

Publisher:
Columbia University Press
DOI:10.7312/columbia/9780231170130.003.0006

The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.

Keywords:   Integrated Health Care Networks, Integrated Care Provider Organizations, Patient-Centered Primary Care Medical Home, Global Budgeting, Performance Based Contracting

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