James S. Powers Livres

It is time to listen to the voices of wisdom from our collective past before it is too late.

Focusing on geriatric care, this book outlines a value proposition aimed at enhancing care quality and delivering specific benefits to healthcare systems. It explores strategies for overcoming incentives and barriers to change while providing numerous examples and outcomes. Integrating insights from various disciplines, including medicine, sociology, and economics, it serves as a guide for incorporating geriatric principles into mainstream healthcare, ultimately striving to improve the quality of life for older adults across all systems.

Healthcare Changes Reach Main Street: A Call to Action for Physicians provides guidance, examples, and information on processes and time lines for physicians based on the implementation of The Affordable Care Act (ACA) that was established in 2010. This volume focuses on how geriatricians and other healthcare professionals can be engaged in responding to the roll-out of the ACA in their communities, and through this engagement assume leadership roles in local hospitals, healthcare organizations, and medical societies to advance quality improvement and new models of care for older adults. In-depth chapters provide an update on quality improvement efforts at the state level, as well as changes in Medicaid financing and the significant impact this will have for older adults, particularly dual-eligibles. Many elements of the ACA are yet to be rolled out and many healthcare decisions are yet to be made. Healthcare Changes Reach Main Street: A Call to Action for Physicians will guide healthcare decision makers and help them to play a leadership role in advancing quality care for older adults in our changing healthcare environment.​

"In 2015, the United States and partner governments in the F-35 program began considering the use of a three-year block buy (BB) contract for procurement of F-35 aircraft during fiscal years 2018-2020. A BB contract (which is similar to a multiyear procurement contract) can save money by providing prime contractors and their suppliers the incentive and ability to leverage quantity and schedule certainty and economies of scale, thus generating savings that would not be available under three annual single-lot contracts. This report presents an assessment of potential cost savings available through a BB contract for F-35 procurement. The research independently assessed savings for the aircraft's air vehicle and engine, consistent with the way contracting is handled in the program, and focused on recurring flyaway costs. For the air vehicle, the estimated savings is $1.8 billion, or 5.2 percent of the cost of contracting annually for three lots. For the engine, the estimated savings is $280 million, or 3.8 percent of the cost of contracting annually. Thus, the combined BB savings is approximately $2.1 billion, or 4.9 percent of the cost of annual contracting. These savings are estimated relative to an annual contracting baseline computed by RAND and are roughly comparable to those estimated for historical multiyear contracts for other fighter aircraft."--Publisher's description.

Value-driven healthcare is the enduring legacy of the Affordable Care Act, which aimed to enhance access to healthcare, improve patient experience and care quality, and curb rising healthcare costs. Regardless of financing or policy changes, value-based purchasing will remain a fundamental aspect of healthcare. This approach rewards quality in healthcare delivery through a demand-side strategy that involves employers, public sectors, health plans, and consumers in their healthcare decisions. It incentivizes effective services and high-performing providers to deliver quality outcomes while controlling costs. Publicly reported quality metrics are essential levers for transforming healthcare delivery. Geriatric patients, who utilize a significant portion of healthcare resources, are a focus for CMS, which shapes Medicare and geriatric care models that other insurers typically follow. Innovative models demonstrating improved outcomes and cost efficiency are scaled, with lessons applied to develop new healthcare frameworks. The best data for broader value-driven healthcare comes from geriatric models, which currently offer the most robust information. This work explores the origins of value-based purchasing and contemporary geriatric care models, discussing their implications for today’s evolving health system, accountability, and risk-sharing. It targets geriatric healthcare professionals and a wider audience interested in healthc