Why nobody believes the numbers : distinguishing fact from fiction in population health management /
Lewis, Alfred.
Hoboken, N.J. : Wiley,
c2012.
"The health care industry is fraught with numbers that both human resource professionals and health plan executives cannot believe or understand. Health care vendors routinely show you outcomes reports for your Population Health Improvement programs whose numbers are much closer to fiction than fact. But you don't know why these numbers are fictional, do you? You leaf through these vendor outcomes reports, and wonder the best way to save money for your business while providing an optimal service. Measurement of savings, whether described as Return on Investment or another term, is the most contentious issue in disease management.Why Nobody Believes the Numbers provides information on benefits decisions that can be estimated without math, using observational data to figure out whether you are "moving the needle" or not. Better decisions can be made by looking critically at the data and using the information to make smart decisions in the future. For example, you can look at actual event rates over time (heart attacks, asthma attacks, etc.) and ask whether the return-on-investment (ROI) that a vendor is insisting you received is plausible given the changes in event rates over time in your population. Why Nobody Believes the Numbers counsels the opposite of the health care industry standard. You check every piece of arithmetic you see because in this field most calculations are wrong, often to the point of being impossible. With the information provided, health plan providers and benefits departments will be able to better understand the numbers in outcome measurement reports to provide quality services and save money"--
"The health care industry is fraught with numbers that both human resource professionals and health plan executives cannot believe or understand. Health care vendors routinely show you outcomes reports for your Population Health Improvement programs whose numbers are much closer to fiction than fact. But you don't know why these numbers are fictional, do you? You leaf through these vendor outcomes reports, and wonder the best way to save money for your business while providing an optimal service. Measurement of savings, whether described as Return on Investment or another term, is the most contentious issue in disease management.Why Nobody Believes the Numbers provides information on benefits decisions that can be estimated without math, using observational data to figure out whether you are "moving the needle" or not. Better decisions can be made by looking critically at the data and using the information to make smart decisions in the future. For example, you can look at actual event rates over time (heart attacks, asthma attacks, etc.) and ask whether the return-on-investment (ROI) that a vendor is insisting you received is plausible given the changes in event rates over time in your population. Why Nobody Believes the Numbers counsels the opposite of the health care industry standard. You check every piece of arithmetic you see because in this field most calculations are wrong, often to the point of being impossible. With the information provided, health plan providers and benefits departments will be able to better understand the numbers in outcome measurement reports to provide quality services and save money"--
IntroductionChapter One: Actuaries Behaving BadlyChapter Two: Plausibility-testing: How to Measure Outcomes Using IngredientsChapter Three: Case Studies that Flunk Every Plausibility Test Known to MankindChapter Four: Case Studies that Flunk Every Plausibility Test Known to Mankind and Then SomeChapter Five: Case Studies of Where, When, and How Wellness Programs Have Actually WorkedChapter Six: Yes, Virginia, There Is a Savings ClauseChapter Seven: Disease Management Programs That Actually Work (Pinch Me)Chapter Eight: Contracting/RFP Checklist of Do's and Don'ts (Mostly Don'ts)Appendix: The Keys to the Numerical KingdomAuthor's Note on SourcesEndnotesGlossaryAbout the Author.
Health maintenance organizations
Managed care plans (Medical care)