Interested in healthcare? Buy this book.

Just held a talk for 25+ MBA who are heading into healthcare this summer and told them to buy this book. I even gave them a money-back guarantee, saying that I would buy the book from them, if not satisfied. BOOM.

If you are new-ish to healthcare, start here. This is a smart, no non-sense way to understand the edges of the massive puzzle called US healthcare. Buy this book here (affiliate link). In my healthcare strategy class – we essentially read it cover-to-cover.

Hospitals + Payers + Pharma + Quality + Providers

Yes, the NY Times called it a “user manual”. Yes, it is deliberately broad; it covers the breadth of industries, government, and non-profit entities that make up 17%+ of the US economy. More importantly, it puts things into buckets to make it easy to understand. It provides the mental scaffolding so when you learn new stuff, you know where to put it. Namely, it helps you answer the most important, and basic questions on big topics.

Helps answer the top 5 questions. . .

We’ve all been to hospitals, so what are some potential questions?

• Difference between inpatient and outpatient facilities? (pg 2)
• How many hospitals are there? (5,500+)
• What % of hospitals are for profit? (less than 1/3)
• Different kinds of hospitals ownership, services, network? (pg 3)
• Different type of outpatient care facilities (pg 9)

So you can dig deeper yourself . . .

This provides the main ingredients for you to think critically about a lot of the more difficult, nuanced, and critical questions. After you orient yourself with the industry description and economic drivers, you’ll have tons of additional questions. Yes, curiosity is your #1 asset. Askins and Moore say this directly in the preface, “Everything is always more complicated than you think.”

So, here’s a few good, tough questions (in red) which of course are not answered comprehensively by this book. That’s okay, this is a resource for you to start your healthcare consulting journey.

~ If 6 out of the 10 diseases are chronic conditions (no vaccine or quick cure) that rely more on prevention, then how can we optimize the 900,000 inpatient beds we currently have in the US? Discuss. . .

Or how about this one?

~ The average hospital profit margin is 7% (improved significantly by charitable donations). With 1/4 of hospitals unprofitable, it’s somewhat inevitable that hospital M&A will continue. Does that pose a risk to the quality, and access of care in more remote areas? Discuss. . .

Or this one?

~ As Medicare, private payers, employers are pushing for more outcomes-based quality performance, how do leaders manage their portfolio of fee-for-service (old way of getting paid) vs. fee-for-value (new way of getting paid)? Yes, incrementalism can work. . . until it doesn’t. Discuss. . .

Want to see the breadth of topics covered? From their website, you can see a link to all their reference here.

Written by 2 Physicians = Useful and Credible

This book would be less useful and less credible if it were not written by clinicians. It is useful – not because it discerns the differences between an angiogram and angioplasty. No, this book is decidedly not medical or surgical. It’s useful because two medical students (Askins and Moore) had a bunch of questions and put their findings on paper. They self-published this with their medical school.

It’s credible because – well – they’re physicians.

Change. Change. Change.

US healthcare is largely broken. It needs change. I believe this requires enormous leadership to crack through the status quo of administrative complexity, changing regulation, misaligned incentives, outdated norms, poor data quality, and Wall Street’s drive to profits.

I also believe this change needs to be physician-led. This book is a great start. It is written simply. Lots of headings, graphs, and bullet points. It level-sets the discussion on the triple aim, and the inherently complex trade offs between cost, access, and quality.

From the very beginning, let’s agree that it is impossible to have perfect quality + unlimited access + zero cost. That said, let’s also agree that the US can do better than this:

• High Cost: 17% of the US GDP, averaging $9K per American, growing faster than any other OECD country.
• Uneven Access: “A quarter of Americans encounter difficulty accessing the healthcare system.”
• Variable Quality: “Americans only receive 55-70% of the recommended care they need.” US infant mortality rates are the worst among 19 wealthiest OECD countries.

“Everything is more complicated than you think.”

This is something bolded in the preface of the book. Askins and Moore admit that this may be considered an oversimplification – but frankly, that’s what is needed. In my mind, this helps you get less ignorant about the economic drivers, business model, and trade-offs, and expanding scope of US healthcare. It’s 240+ pages long, only 1/10 the length of the Affordable Care Act (ACA, Obamacare).

Last week, I recommended this book to an undergraduate student, and he has gotten through 90 pages already. Yes, Emory students crush.

1. If you are new to Healthcare, buy it here (affiliate link).
2. Next post will be a list of YouTube videos and website links.
3. Readers – what are other “have to buy” books on healthcare?

Related posts:

• US Healthcare Strategy?
• IT Implementation worst practices? Healthcare.gov
• Links