FREE HEALTH CARE REFERENCES 2014 Q1-Q2

(1D) MOSTLY FREE HEALTH CARE REFERENCES (2014 Q1-Q2)
David A. Butz PhD, CareEvolution, U. of Michigan Ross School of Business, DABAnalytics LLC
The basic aim here is to provide (free) data troves, subject primers, quick references, and background.

BACKGROUND/GENERAL
Examples of how medical schools and academics might approach this subject matter
[1] What is value in health care? M. Porter. N Engl J Med. 2010 Dec 23;363(26):2477-81. doi:
10.1056/NEJMp1011024. Epub 2010 Dec 8.
http://www.nejm.org/doi/full/10.1056/NEJMp1011024

[2] Cost consciousness in patient care--what is medical education's responsibility? Cooke M. N Engl J Med.
2010 Apr 8;362(14):1253-5. doi: 10.1056/NEJMp0911502. Epub 2010 Mar 31.

[3] Teaching high-value, cost-conscious care to residents: the Alliance for Academic Internal Medicine–
American College of Physicians Curriculum. Smith CD; Alliance for Academic Internal Medicine–
American College of Physicians High Value; Cost-Conscious Care Curriculum Development Committee.
Ann Intern Med. 2012 Aug 21;157(4):284-6.
http://www.nationalahec.org/pdfs/HighValueCostConsciousCareCurriculum.pdf
Companion article - http://annals.org/article.aspx?articleid=746773
Overview of the AAIM-ACP Curriculum - http://www.acponline.org/education_recertification/education/curriculum/hvccc_curriculum_overview.pdf
See Also http://www.im.org/Publications/Insight/Archives/v11i1/Documents/hvccc.pdf

[4] Cost consciousness in patient care--what is medical education's responsibility? M. Cooke. N Engl J
Med. 2010 Apr 8;362(14):1253-5. doi: 10.1056/NEJMp0911502. Epub 2010 Mar 31.

[5] ACGME Competencies: Systems Based Practice. University of Maryland Medical Center. 2013-0712. (GME = graduate medical education. Also see the other ACGME competencies and related links!)
http://umm.edu/professionals/gme/competencies/systems-based

[6] ACGME Competencies. The University of Texas Health Science Center at San Antonio. Accessed
Online Jan. 2014.
http://www.uthscsa.edu/gme/educationalassessment.asp

[7] American Medical Association Section on Medical Schools Business Meeting/Educational Program.
J. Fogarty et al. American Association of Medical Colleges (Annual Meeting 2013). 2013-11-01.
https://event.crowdcompass.com/aamc2013/activity/t1xjkUcRhT
Presentation 1 of 4 - S. Skochelak: https://s3.amazonaws.com/v3-app_crowdc/assets/events/UnQaEpCgx8/activities/200Skochelak111.original.1383450490.pdf
Presentation 2/4 - A. Feldman: https://s3.amazonaws.com/v3-app_crowdc/assets/events/UnQaEpCgx8/activities/1400_Feldman_AMA-AAMC.original.1383450329.pdf
Presentation 3/4 - S. Weinberger: https://s3.amazonaws.com/v3-app_crowdc/assets/events/UnQaEpCgx8/activities/Weingberger_medical_student_group_talk_on_HVC.original.1383041415.pdf
Presentation 4/4 - D. Price: https://s3.amazonaws.com/v3-app_crowdc/assets/events/UnQaEpCgx8/activities/0800Price112.original.1383566017.pdf

Coding and Scoring (The USA uses ICD-9; the rest of the world has long used ICD-10; and ICD-11 is coming!)
[8] List of ICD-9 Diagnosis (Dx) codes. Wikipedia.
First-time coders can find background here: http://en.wikipedia.org/wiki/International_Classification_of_Diseases
http://en.wikipedia.org/wiki/List_of_ICD-9_codes

[9] List of ICD-9 Procedure (Px) codes (ICD-9-CM Volume 3). Wikipedia.
http://en.wikipedia.org/wiki/ICD-9-CM_Volume_3

[10] The Differences Between ICD-9 and ICD-10. American Medical Association. 2012-09-25.
http://www.ama-assn.org/ama1/pub/upload/mm/399/icd10-icd9-differences-fact-sheet.pdf
Also See: http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portabilityaccountability-act/transaction-code-set-standards/icd10-code-set.page

[11] Understanding the ICD-10. R. Kaplan and D. Finney. Finney Learning Systems. 2012.
http://therightway.com/downloads/ICD-10.pdf

Nearly All Free Health Care References, 2014 Q1 and Q2, © David A. Butz

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[12] Evaluation of ICD-11 as a New Diagnostic Coding System. S. Stack. Report to the American Medical
Association Board of Trustees. May 2013.
http://134.147.247.42/han/JAMA/www.ama-assn.org/assets/meeting/2013a/a13-bot-25.pdf

[13] Rollups of ICD9 Dx’s and ICD9 Px’s. Healthcare Utilization Project (HCUP) Clinical Classification
Software (CCS).
http://www.hcup-us.ahrq.gov/toolssoftware/ccs/AppendixASingleDX.txt AND http://www.hcup-us.ahrq.gov/toolssoftware/ccs/AppendixBSinglePR.txt
HCUP Front Page - http://www.hcup-us.ahrq.gov/

[14] Diagnosis Related Group (DRG) Codes for FY2010. CMS (Version 27)
http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/FY_2010_FR_Table_5.zip

The Burden of Disease
[15] The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. US Burden of
Disease Collaborators. 2013 Aug 14;310(6):591-608. doi:10.1001/jama.2013.13805.
http://www.ncbi.nlm.nih.gov/pubmed/23842577

[16] Ten Leading Causes of Death and Injury: by Age Group (2010). Centers for Disease Control.
http://www.cdc.gov/injury/wisqars/pdf/10LCID_All_Deaths_By_Age_Group_2010-a.pdf

[17] Top 10 Most Costly Conditions among Men and Women, 2008: Estimates for the U.S. Civilian
Noninstitutionalized Adult Population, Age 18 and Older. Soni. AHRQ/MEPS Brief 331. 07/2011.
http://207.188.212.220/mepsweb/data_files/publications/st331/stat331.pdf

[18] Chronic Conditions Among Medicare Beneficiaries, Chartbook (2012 Edition). CMS. 2013-04-25.
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/2012ChartBook.html

[19] A user’s guide to selecting a comorbidity index for clinical research. S. Hall SF. J Clin Epidemiol.
2006 Aug;59(8):849-55. Epub 2006 May 23.
http://qcri.queensu.ca/CCE_Pub_Hall_2006_59_pp_926-933.pdf

[20] Concept: Charlson Index. Manitoba Centre for Health Policy. 2009-10-22.
http://mchp-appserv.cpe.umanitoba.ca/viewConcept.php?conceptID=1098

[21] Adult Smoking in the US. Centers for Disease Control. September 2012.
http://www.cdc.gov/VitalSigns/AdultSmoking/index.html

[22] New evidence that cigarette smoking remains the most important health hazard. Schroeder SA. N
Engl J Med. 2013 Jan 24;368(4):389-90. doi: 10.1056/NEJMe1213751.
http://www.nejm.org/doi/full/10.1056/NEJMe1213751

[23] 21st-century hazards of smoking and benefits of cessation in the United States. Jha P et. al. N Engl J
Med. 2013 Jan 24;368(4):341-50. doi: 10.1056/NEJMsa1211128.
http://www.nejm.org/doi/full/10.1056/NEJMsa1211128

[24] 50-year trends in smoking-related mortality in the United States. Thun MJ et al. N Engl J Med. 2013
Jan 24;368(4):351-64. doi: 10.1056/NEJMsa1211127.

[25] Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.
Flegal KM, Carroll MD, Kit BK, Ogden CL. JAMA. 2012 Feb 1;307(5):491-7.
http://jama.jamanetwork.com/article.aspx?articleid=1104933

Summarized here: CDC Reports Obesity Rates In U.S. Level Off, KHN, 18 January 2012.
http://www.kaiserhealthnews.org/Daily-Reports/2012/January/18/obesity-rates.aspx

Big Picture Statistics
[26] Data Book: Health Care Spending and the Medicare Program. MedPAC. June 2013.
http://www.medpac.gov/documents/Jun13DataBookEntireReport.pdf


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[27] Health, United States, 2012. (Especially the Executive Summary and “At a Glance” Table)
National Center for Health Statistics. Hyattsville (MD). 2012 May.
http://www.ncbi.nlm.nih.gov/books/NBK98752/

[28] Statistical Abstract of the United States, 2010 (Section 3: Health and Nutrition). U.S. Census Bureau.
http://www.census.gov/prod/2009pubs/10statab/health.pdf

[29] Death in the United States, 2010. Miniño. National Center for Health Statistics. July 2012. More here.
http://www.cdc.gov/nchs/data/databriefs/db99.htm

[30] The State of Health Care Quality Report. National Committee for Quality Assurance. Fall 2013.
http://www.ncqa.org/Directories/HealthPlans/StateofHealthCareQuality.aspx

[31] Healthcare Utilization Project (HCUP) Statistical Briefs by Topic Area
http://www.hcup-us.ahrq.gov/reports/statbriefs/sbtopic.jsp

[32] National Vital Statistics System. Centers for Disease Control.
http://www.cdc.gov/nchs/nvss.htm

[33] National health spending in 2011: overall growth remains low, but some payers and services show
signs of acceleration. Hartman M, Martin AB, Benson J, Catlin A; National Health Expenditure
Accounts Team. Health Aff (Millwood). 2013 Jan;32(1):87-99. doi: 10.1377/hlthaff.2012.1206.
http://content.healthaffairs.org/content/32/1/87.long

[34] In Hopeful Sign, Health Spending Is Flattening Out. New York Times. A. Lowrey. 2012-04-28.
http://www.nytimes.com/2012/04/29/health/policy/in-hopeful-sign-health-spending-is-flattening-out.html?_r=2&nl=todaysheadlines&emc=edit_th_20120429

[35] National Health Expenditure Data. CMS. Accessed Online Jan. 2014.
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/index.html?redirect=/NationalHealthExpendData/

[36] The value of medical spending in the United States, 1960-2000.Cutler DM, Rosen AB, Vijan S. N
Engl J Med. 2006 Aug 31;355(9):920-7.
http://www.nejm.org/doi/pdf/10.1056/NEJMsa054744

[37] Morbidity & Mortality: Chart Book on Cardiovascular, Lung, and Blood Diseases. National Heart,
Lung, and Blood Institute (NHLBI). February 2012.
http://www.nhlbi.nih.gov/resources/docs/cht-book.htm

[38] Cancer Facts and Statistics. American Cancer Society. Accessed Online Jan. 2014.
http://www.cancer.org/research/cancerfactsstatistics/index

[39] The Changing Geography of Outpatient Procedures. G. David and M. Neuman. Leonard Davis
Institute of Health Economics. U. of Pennsylvania. March 2011.
http://ldi.upenn.edu/policy/issue-briefs/2011/03/29/the-changing-geography-of-outpatient-procedures

[40] Health at a Glance 2013: OECD Indicators. OECD. 2013-11-22.
http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf
Also see here: http://www.who.int/research/en/
Also see here: http://www.oecd.org/health/health-systems/

A Few Hospital and Insurance Company Rankings/Lists
[41] 25 Largest Nonprofit Hospital Systems. M. Gamble. Becker’s Hospital Review. 2013-07-08.
http://www.beckershospitalreview.com/lists/26-largest-nonprofit-hospital-systems-2013.html
Also see 50 Largest Hospitals – http://www.beckershospitalreview.com/lists/50-largest-hospitals-in-america-2013.html

[42] For-Profit Hospital Breakdown: What to Know About the 10 Largest Companies. B. Herman.
Becker’s Hospital Review. 2013-09-04.
http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/for-profit-hospital-breakdown-what-to-know-about-the-10-largest-companies.html

[43] Teaching Hospitals. CMS. (Scroll down for the 2014 list of all 1,188 hospitals!)
http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Teaching-Hospitals.html

[44] The Top 25 Health Insurance Companies. USNews. Accessed Online Jan. 2014.
http://health.usnews.com/health-plans/national-insurance-companies


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Random Primers, Guides, Lists, and Summaries
[45] Summary of the Affordable Care Act. Henry J. Kaiser Family Foundation. April 25, 2013.
http://kff.org/health-reform/fact-sheet/summary-of-new-health-reform-law/

[46] Health Reform Implementation Timeline (Affordable Care Act). Henry J. Kaiser Family Foundation.
2013-07-08.
http://kff.org/interactive/implementation-timeline/

[47] Medpage’s Guide to Biostatistics
http://www.medpagetoday.com/lib/content/Medpage-Guide-to-Biostatistics.pdf

[48] Primer on Population Health. The Association of Faculties of Medicine of Canada. 2009.
http://www.afmc.ca/pdf/AFMC-Primer-on-Population-Health-2013-08-14.pdf

1. HOW PROVIDERS GET PAID
A Terrific (But Rather Long) Summary of Payment Methdologies
[49] Health Care Payment in Transition: A California Perspective. S. Oberlin et. al. Kurt Salmon for the
California HealthCare Foundation. Jan. 2012.
http://www.chcf.org/publications/2012/01/payment-reform-transition

Revenue Cycle  Generating a Bill and Getting Paid
[50] Revenue Cycle Management. (A simple graphic) ALN Medical Management. Accessed Jan. 2014.
http://alnmm.com/_library/2009/11/rcm%20chart.pdf

[51] Form CMS-1500 At A Glance. Medicare Learning Network. February 2011.
http://www.audiology.org/practice/reimbursement/medicare/Documents/201105_CMS_1500_Form_At_A_Glance.pdf

[52] Fact Sheet: Medicare Billing: 837P and Form CMS-1500. Medicare Learning Network. March 2013.
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/form_cms-1500_fact_sheet.pdf

[53] Fact Sheet: Medicare Billing: 837I and Form CMS-1450. Medicare Learning Network. March 2013.
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/ub04_fact_sheet.pdf

[54] Prepare that Claim. American Medical Association. Accessed 2013-10-15.
http://www.ama-assn.org/resources/doc/psa/prepare-that-claim.pdf

[55] Follow that Claim. American Medical Association. Accessed 2013-10-15.
http://www.ama-assn.org/resources/doc/psa/follow-that-claim.pdf

[56] AMA: Insurers processing claims faster, more accurately. D. Overland. FierceHealth. 2013-06-19.
http://www.fiercehealthpayer.com/story/ama-insurers-processing-claims-faster-more-accurately/2013-06-19#ixzz2d0DAb35c
Direct Link to the AMA National Health Insurer Report Card - http://www.ama-assn.org/ama/pub/physician-resources/practice-management-center/health-insurerpayer-relations/national-health-insurer-report-card.page

[57] The Health Care Revenue Cycle: How Money is Generated for the Business of Health Care Delivery.
R. Kaplan. Finney Learning Systems. 2009.
http://therightway.com/downloads/Revenue-Cycle.pdf

[58] HFMA Issues Advisory on Financial Communication With Patients. J. McLaughlin. Becker’s
Hospital Review. 2013-06-17. Specifically: The emergency department, non-emergency settings,
before receiving medical care and when resolving outstanding balances.
http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/hfma-issues-advisory-on-financial-communication-with-patients.html
ED: http://pfibestpractices.com/wp-content/uploads/2013/05/Best-Practice-Scenario-1-Patient-Financial-Interactions-in-the-ED11.pdf
Non-ED: http://pfibestpractices.com/wp-content/uploads/2013/06/Best-Practice-Scenario-2-Patient-Financial-Interactions-at-Time-of-Service-Outside-the-ED.pdf
Before Receiving Care: http://pfibestpractices.com/wp-content/uploads/2013/05/Best-Practice-Scenario-3-Patient-Financial-Interactions-in-Advance-of-Service11.pdf
Resolving Outstanding Balances: http://pfibestpractices.com/wp-content/uploads/2013/05/Best-Practices-for-all-Patient-Financial-Interactions11.pdf


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Health Insurance: Medicare and Medicaid
[59] Medicare at a Glance. Henry J. Kaiser Family Foundation. 2012. (With Additional Resources.)
http://www.kff.org/medicare/talkingaboutmedicare/ataglance.cfm

[60] Medicare Made Clear. United Healthcare. 2012.
http://www.uhc.com/live/uhc_com/Assets/Documents/Medicare_Made_Clear.pdf

[61] Medicare Spending and Financing Fact Sheet. Henry J. Kaiser Family Foundation. Sept 2011.
http://www.kff.org/medicare/upload/7305-06.pdf

[62] Fact Sheet: Medicare Shared Savings Program and the Pioneer ACO Program. American Academy of
Actuaries. 2012-12-19.
http://www.actuary.org/files/ACO_Fact_Sheet_FINAL_121912.pdf

[63] Medicare Payment Basics. CMS. 2012-10-13.
http://medpac.gov/payment_basics.cfm

[64] Medicare 2013 Costs at a Glance. CMS. 2013.
http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

[65] Medicare Primer. P. Davis, et al. Congressional Research Service. 2013-01-21.
http://www.fas.org/sgp/crs/misc/R40425.pdf

[66] Visualizing Health Policy: Medicare’s Role and Future Challenges. Henry J. Kaiser Family
Foundation. Nov. 2012.
http://kff.org/infographic/visualizing-health-policy-medicares-role-and-future-challenges/

[67] The Green Book, Chapter 2 (Medicare). US House of Representatives, Ways and Means Committee.
http://greenbook.waysandmeans.house.gov/2012-green-book

[68] Medicare Advantage Plans. S. Jatte. Health Affairs (Policy Brief). 2009-04-29.
http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=1

[69] CMS Reimbursement Methodologies. American Health Information Management Association.
Undated (accessed online Jan. 2014).
http://www.ahima.org/resources/reimbursemethod.aspx

[70] Hospital Outpatient Prospective Payment System. Medicare Learning Network.
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/HospitalOutpaysysfctsht.pdf

[71] The Independent Payment Advisory Board. J. Haberkorn. Health Affairs (Policy Brief). 2012-04-05.

[72] Medicaid: A Primer. Kaiser Commission on Medicaid and the Uninsured. March 2013.
http://kaiserfamilyfoundation.files.wordpress.com/2010/06/7334-05.pdf

[73] Care for Dual Eligibles. A. Cassidy. Health Affairs (Policy Brief). 2012-06-13.

[74] Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries. Henry J. Kaiser Family
Foundation. 2011-05-01.
http://kff.org/medicaid/fact-sheet/dual-eligibles-medicaids-role-for-low-income-2/

Health Insurance: Private
[75] How Private Insurance Works: A Primer. Claxton, G. Paper prepared for the Kaiser Family
Foundation: 1-15. 2002
http://kaiserfamilyfoundation.files.wordpress.com/2013/01/how-private-insurance-works-a-primer-report.pdf

[76] Definitions of Health Insurance Terms. Bureau of Labor Statistics. 2002.
http://www.bls.gov/ncs/ebs/sp/healthterms.pdf


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[77] Medical Loss Ratios. J. Haberkorn. Health Affairs (Policy Brief). 2010-11-17.

[78] How Do Hospitals Get Paid? A Primer. U. Reinhardt. New York Times. 2009-01-23.
http://economix.blogs.nytimes.com/2009/01/23/how-do-hospitals-get-paid-a-primer/

[79] Bundled Payment. American Hospital Association (Research Synthesis Report). May 2010.
http://www.aha.org/research/cor/bundled-payment/index.shtml

[80] Employer Heath Benefits: 2013 Summary of Findings. Kaiser Family Foundation. 2013-08-20.
http://kaiserfamilyfoundation.files.wordpress.com/2013/08/8466-employer-health-benefits-2013_summary-of-findings1.pdf
Full Report, ChartPack, and Additional Resources: http://kff.org/private-insurance/report/2013-employer-health-benefits/

[81] Employer-Sponsored Health Insurance in the United States – Origins and Implications. D Blumenthal.
N Engl J Med 355(1), 2006: 82-88.
http://www.nejm.org/doi/pdf/10.1056/NEJMhpr060703

[82] Beyond pay for performance--emerging models of provider-payment reform. MB Rosenthal. N Engl J
Med. 2008 Sep 18;359(12):1197-200. doi: 10.1056/NEJMp0804658.
http://www.nejm.org/doi/pdf/10.1056/NEJMp0804658

How Physicians Are Reimbursed
[83] Relative Value Units (RVUs). National Health Policy Forum. 2009-02-12.
http://www.nhpf.org/library/the-basics/Basics_RVUs_02-12-09.pdf

[84] The Nuts and Bolts of RVUs and Reimbursement (Video). M. Granovsky. American College of
Emergency Physicians. 2012. (This is how physicians are paid in the US.)
http://www.acep.org/content.aspx?id=46017

[85] Medicare Payments to Physicians. M. Merlis. Health Affairs (Policy Brief). 2013-02-13.
http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_85.pdf

[86] Physician and other health professionals paymentbasics payment system. Medicare Payment Basics.
CMS. 2012-10-13.
http://www.medpac.gov/documents/MedPAC_Payment_Basics_13_Physician.pdf

[87] Adding value to relative-value units. E. Stecker and S. Schroeder. N Engl J Med. 2013 Dec
5;369(23):2176-9. doi: 10.1056/NEJMp1310583. Epub 2013 Nov 20.

[88] American Medical Group Association 2012 Medical Group Compensation and Financial Survey
(Executive Summary). SullivanCotter. August 2012.
http://www.amga.org/Research/2013ExecSummary.pdf

2. HEALTH CARE COSTS AND COST ACCOUNTING
[89] The Problem with Knowing How Much Your Health Care Costs. L. Rosenbaum. New Yorker. 2013-12-23.
http://www.newyorker.com/online/blogs/elements/2013/12/price-transparency-health-care-costs.html
Also see S. Brill in March 2013 Time Magazine – http://content.time.com/time/magazine/article/0,9171,2136864,00.html
Also see P. Ubell et al. in NEJM on Full Disclosure — Out-of-Pocket Costs as Side Effects: http://www.nejm.org/doi/full/10.1056/NEJMp1306826
Also see D. Dranove, May 2013, The Rest of the Story About Hospital Pricing – http://thehealthcareblog.com/blog/2013/05/09/the-rest-of-the-story-about-hospital-pricing/

[90] Why Medical Bills Are a Mystery. R. Kaplan and M. Porter. New York Times. 14 April 2012.
http://www.nytimes.com/2012/04/15/opinion/sunday/why-medical-bills-are-a-mystery.html?_r=3&

[91] Health Care Costs: A Primer. Henry J. Kaiser Family Foundation. May 2012.
http://www.kff.org/insurance/upload/7670-03.pdf

[92] 2013 Milliman Medical Index. L. Mayne, C. Girod, S. Weltz. Milliman. 2013-05-22.
http://insight.milliman.com/article.php?cntid=8359&utm_source=search&utm_medium=web&utm_content=8359&utm_campaign=Search


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[93] HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2009. LM Wier, A
Pfuntner, J Maeda, E Stranges, K Ryan, P Jagadish, B Collins Sharp, A Elixhauser. Rockville, MD:
Agency for Healthcare Research and Quality, 2011
http://www.hcup-us.ahrq.gov/reports.jsp

[94] Components of Growth in Inpatient Hospital Costs, 1997–2009. Stranges et al. HCUP Statistical
Brief [Agency for Healthcare Research and Quality], no. 123, Nov. 2011.
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb123.pdf

3. HEALTH CARE OPERATIONS AND UTILIZATION
[95] The triple aim: Care, health, and cost. Berwick DM, Nolan TW, Whittington J. Health Aff [Internet].
2008 May 1;27(3):759-69.

[96] Hospital Operations: Principles of High Efficiency Health Care. W. Hopp and W. Lovejoy. FT Press
Operations Management. (The whole book is excellent, but for a great overview, see Appendix A.)
http://www.amazon.com/Hospital-Operations-Principles-Efficiency-Management/dp/0132908662/ref=sr_1_1?ie=UTF8&qid=1373080089&sr=81&keywords=lovejoy+hospital

[97] Define patient panels to improve practice flow, patient care. K. Ziehler. Medical Group Management
Association In Practice Blog, 2013-02-21.
http://www.mgma.com/blog/define-patient-panels-to-improve-practice-flow-patient-care/

[98] Ambulatory Health Care Data: Factsheets. Centers for Disease Control and Prevention.
http://www.cdc.gov/nchs/ahcd/factsheets.htm#2009

[99] Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames. US
General Accounting Office. GAO-09-347, Apr 30, 2009.
http://www.gao.gov/new.items/d09347.pdf

Examples in the Emergency Department
[100] The ER, 50 years on. A. Kellermann AL, Martinez R. N Engl J Med. 2011 Jun 16;364(24):2278-9.
doi: 10.1056/NEJMp1101544.

[101] The growing role of emergency departments in hospital admissions. Schuur JD, Venkatesh AK. N
Engl J Med. 2012 Aug 2;367(5):391-3. doi: 10.1056/NEJMp1204431. Epub 2012 Jul 11.

[102] The Evolving Role of Emergency Departments in the United States. K. Gonzalez Morganti et. al.
Rand Health. 2013-05-20.
http://www.rand.org/pubs/research_reports/RR280.html

[103] Mentally Ill Languish In Hospital Emergency Rooms. J. Gold. National Public Radio. 2011-04-2013.
http://www.npr.org/2011/04/13/135351760/mentally-ill-languish-in-hospital-emergency-rooms

[104] Mandating care in the ER but not payment: Why that’s a problem. T. Pane. MedPage Today. 200808-18.
http://www.kevinmd.com/blog/2012/08/mandating-care-er-payment-problem.html

[105] The Surge in Urgent Care Centers: Emergency Department Alternative or Costly Convenience? T.
Yee, A. Lechner, and E. Boukus. Center for Studying Health System Change. July 2013.
http://www.hschange.org/CONTENT/1366/1366.pdf

[106] Mail Order Meds Tied to Fewer ER Visits. C. Petrochko. KevinMD. 2013-11-22.
http://www.medpagetoday.com/Endocrinology/Diabetes/43071


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Rehospitalizations
[107] Rehospitalizations among Patients in the Medicare Fee-for-Service Program. Jencks et al., New
England Journal of Medicine. 04/12/2009.
HTTP://WWW.NEJM.ORG/DOI/FULL/10.1056/NEJMSA0803563

[108] Medicare Hospital Readmissions Reduction Program. J. James. Health Affairs (Policy Brief). 2013-11-12.

[109] The Revolving Door: A Report on U.S. Hospital Readmissions. D. Goodman, E. Fisher, C. Chang.
Dartmouth Atlas Project and Robert Wood Johnson Foundation. February 2013.
http://www.rwjf.org/en/research-publications/find-rwjf-research/2013/02/the-revolving-door--a-report-on-u-s--hospital-readmissions.html

[110] Risk Prediction Models for Hospital Readmission: A Systematic Review, D. Kansagara et al., Journal
of the American Medical Association, 2011;306(15):1688-1698. doi: 10.1001/jama.2011.1515
HTTP://JAMA.JAMANETWORK.COM/ARTICLE.ASPX?ARTICLEID=110451

[111] Project RED (Re-Engineered Discharge). Boston University Medical School. Accessed 2013-12-30.
http://www.bu.edu/fammed/projectred/index.html

Systematic Ways to Reduce Utilization
[112] Choosing wisely: helping physicians and patients make smart decisions about their care. C. Cassel
and J. Guest. JAMA. 2012 May 2;307(17):1801-2. doi: 10.1001/jama.2012.476. Epub 2012 Apr 4.
http://www.cmu.edu/dietrich/sds/docs/loewenstein/ChoosingWisely.pdf

[113] Choosing Wisely. ABIM Foundation.
http://choosingwisely.org/?page_id=13

Choosing Wisely Explained: Do You Need That Test? New York Times. 8 April 2012.
http://www.nytimes.com/2012/04/09/opinion/do-you-really-need-that-medical-test.html?_r=2&hp&

Wellness and Prevention
[114] Quick Reference Information: The ABCs of Providing the Annual Wellness Visit. Medicare Learning
Network. January 2012.
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/AWV_Chart_ICN905706.pdf
Also: Providing the AWV – http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/AnnualWellnessVisit-ICN907786.pdf
And: Medicare Preventive Services Quick Reference Chart – http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS_QuickReferenceChart_1.pdf

[115] The history of vaccines and immunization: familiar patterns, new challenges. A. Stern and H. Markel.
Health Aff (Millwood). 2005 May-Jun;24(3):611-21.

[116] The Guide to Clinical Preventive Services 2012: Recommendations of the U.S. Preventive Services
Task Force. Accessed Jan. 2014.
http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/abstract.html

[117] Rankings of Preventive Services for the US Population. Partnership for Prevention. 2013.
http://www.prevent.org/National-Commission-on-Prevention-Priorities/Rankings-of-Preventive-Services-for-the-US-Population.aspx
Executive Summary - http://www.prevent.org/data/files/initiatives/prioritiesforamericashealthexecutivesummary.pdf

[118] Preventing Chronic Disease. Centers for Disease Control. 2013.
http://www.cdc.gov/pcd/collections/pdf/PCD_MCC_Collection_5-17-13.pdf

[119] Workplace Wellness Programs. J. James. Health Affairs (Policy Brief). 2013-05-16.

Care Redesign and Patient Safety
[120] Care redesign--a path forward for providers. Lee TH. N Engl J Med. 2012 Aug 2;367(5):466-72. doi:
10.1056/NEJMhpr1204386. Epub 2012 Jul 29.
http://www.nejm.org/doi/full/10.1056/NEJMhpr1204386
Alternate Link: http://www.acponline.org/about_acp/chapters/vt/careredesignarticle_aug12.pdf


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[121] Balancing "no blame" with accountability in patient safety. Wachter RM, Pronovost PJ. N Engl J
Med. 2009 Oct 1;361(14):1401-6. doi: 10.1056/NEJMsb0903885.
http://www.nejm.org/doi/full/10.1056/NEJMsb0903885
Alternate Link: http://www.mayorswellnesscampaign.org/wp-content/uploads/2010/04/Balancing-No-Blame.pdf

4. FINANCE, FINANCIAL ACCOUNTING, GOVERNANCE, AND STRATEGY
[122] A Primer on Hospital Accounting and Finance, 4th Edition. F. Kaufman. Kaufman Hall. March 2009.
https://www.kaufmanhall.com/DocumentDetails.aspx?did=49c8b592-c9dd-4725-8492-c9bf987a1ced

[123] Essentials of corporate governance. Bergeson PT. J Physician Assist Educ. 2011;22(3):33-4.
http://www.paeaonline.org/index.php?ht=action/GetDocumentAction/i/130775

[124] Governance in Large Nonprofit Health Systems: Current Profile and Emerging Patterns. American
Hospital Association’s Center for Healthcare Governance. 2012.
http://www.americangovernance.com/resources/reports/governance-reports/2012/
Also see other Center Publications: http://www.americangovernance.com/
See Also: Handbook for Directors of Nonprofit Corporations in the United States. K&L Gates. 2013 – http://www.klgates.com/files/Publication/0515f7b7-d3d1-4a51b993-3873d9c88634/Presentation/PublicationAttachment/8754fe58-e646-458c-b6fe-8aaa75e77330/TEO_Handbook_for_Directors_Nonprofit_Corporations_2013.pdf
Also: Section 501(c)3 in Plain English – http://501c3.org/what-is-a-501c3/
The IRS’s Explanation of 501(c)3 – http://www.irs.gov/Charities-%26-Non-Profits/Charitable-Organizations/Exemption-Requirements-Section-501(c)(3)-Organizations
All Sections of 501(c) (NonProfit Tax Exempt Organizations) – http://www.taxfreecharity.com/types.htm

[125] The Guide to Not-for-Profit Governance 2012. Weil, Gotshal & Manges LLP. Accessed Jan. 2014.
http://www.pbpatl.org/wp-content/uploads/2012/10/NFPGuide_2012.pdf

[126] Understanding the Federal Community Benefit Standard. Catholic Health Association of the United
States. Accessed Online Jan. 2014.
http://www.chausa.org/communitybenefit/resources/understanding-the-federal-community-benefit-standard
Also see: Community Benefit New Assessment Tool - http://www.chausa.org/publications/health-progress/article/january-february-2011/community-benefit---newassessment-tool

[127] Provision of community benefits by tax-exempt U.S. hospitals. Young GJ, Chou CH, Alexander J,
Lee SY, Raver E. N Engl J Med. 2013 Apr 18;368(16):1519-27. doi: 10.1056/NEJMsa1210239.

[128] The economics of for-profit and not-for-profit hospitals. Reinhardt UE. Health Aff (Millwood). 2000
Nov-Dec;19(6):178-86.

[129] Community Benefit and Not-for-Profit Status. American Association of Medical Colleges (Annual
Meeting 2013). J. Erwin and R. Christie. 2013-11-02.
https://event.crowdcompass.com/aamc2013/activity/RtO7wwgRAR
Presentation 1 of 2 - J. Erwin: https://s3.amazonaws.com/v3-app_crowdc/assets/events/UnQaEpCgx8/activities/1100Erwin112.original.1383531818.pdf
Presentation 2/4 – R. Christie: https://s3.amazonaws.com/v3-app_crowdc/assets/events/UnQaEpCgx8/activities/1100Christie112.original.1383531577.pdf

[130] Nonprofit Hospitals: Variation in Standards and Guidance Limits Comparison of How Hospitals Meet
Community Benefit Requirements. GAO-08-880, Sep 12, 2008.
http://www.gao.gov/products/GAO-08-880

[131] Health Care and Profits, a Poor Mix, E. Porter, NYTimes, 8 Jan 2013.
http://www.nytimes.com/2013/01/09/business/health-care-and-pursuit-of-profit-make-a-poor-mix.html?partner=rss&emc=rss&_r=0

[132] Kaufman Hall: Many good primers and briefs, easily accessible to non-financial readers, including:
Taking Care of Your Organization’s Financial Health. K. Kaufman. Healthcare Executive. Jan/Feb. 2007.
https://www.kaufmanhall.com/SitePages/DocumentDetails.aspx?ProductName=Capital%20Advisor&ProductName=Capital+Advisor&did=1231b8ac-0352-4021986a-12b223047fa9

Capital Allocation the Right Way. J. Sussman. 2012.
https://www.kaufmanhall.com/SitePages/DocumentDetails.aspx?ProductName=Capital%20Advisor&ProductName=Capital+Advisor&did=d8d9c096-9b94-470ebc89-50eebc6af388

A Guide to Financing Strategies for Hospitals. J. Sussman, E. Jordahl. (American Hospital Association).
http://www.hret.org/financial-strategies/index.shtml


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A Trustee’s Primer on Bonds. A. Majka and T. Wareham. Trustee. October 2009.
https://www.kaufmanhall.com/Products/Capital%20Advisor/DocumentDetails.aspx?did=6b20ac6f-73a0-440d-b76a-2beeda0b7280

Other recent Kaufman Hall articles include:
Transforming America’s Hospitals: What’s Working. J. Collins et al. Kaufman Hall. Winter 2013.
https://www.kaufmanhall.com/NewsDetail.aspx?NewsID=af597ca4-8715-4fd5-901c-95139a35508d

Decline in Utilization Rates Signals a Change in the Inpatient Business Model. M. Grube, K.
Kaufman, R. York. Kaufman Hall. April 2013.
https://www.kaufmanhall.com/SitePages/DocumentDetails.aspx?did=d011941d-7f79-46ae-9fde-5d794856816a

[133] Understanding New York City’s Budget: A Guide to The Capital Budget. NYC Independent Budget
Office. June 2013.
http://www.ibo.nyc.ny.us/iboreports/IBOCBG.pdf

Examples of Strategy
[134] The Strategy That Will Fix Health Care. M. Porter and T. Lee. Harvard Business Review. Oct2013,
Vol. 91 Issue 10, p50-70.
http://www.iqg.com.br/uploads/biblioteca/the_strategy.pdf

[135] The Future of the Academic Medical Center: Strategies to Avoid a Margin Meltdown. PwC Health
Research Institute. Feb2012.
http://healthsciences.utah.edu/hcr/2012/resources/the-future-of-academic-medical-centers.pdf

[136] Hospitals, market share, and consolidation. Cutler DM, Scott Morton F. JAMA.
2013 Nov 13;310(18):1964-70. doi: 10.1001/jama.2013.281675.
Alternative Link: http://www.cultureofdoubt.net/download/docs_cod/24219952_%20Hospitals,%20market%20share,%20and%20consolidation.pdf

5. WORKFORCE/HUMAN RESOURCES/PROFESSIONAL EDUCATION-DEVELOPMENT
Undergaduate and Graduate Medical Education (UGME/GME) for Physicians
[137] Quick Answers to Common Questions About Getting into Medical School. Association of American
Medical Colleges. 2013.
http://www.greenvillemed.sc.edu/doc/GettingIntoMedicalSchool.pdf
See also: Your Path to a Career in Medicine. AAMC. 2013. https://www.aamc.org/students/download/330592/data/16-questions.pdf
See also: AAMC Resources for Pre-Med Students. AAMC. 2013.

[138] Medicare Payments for Graduate Medical Education: What Every Medical Student, Resident, and
Advisor Needs to Know. Association of American Medical Colleges. January 2013.
https://members.aamc.org/eweb/upload/Medicare%20Payments%20for%20Graduate%20Medical%20Education%202013.pdf

[139] Graduate Medical Education. C. Dower. Health Affairs (Policy Brief). 2012-08-31.

[140] Graduate medical education, 2011-2012. SE Brotherton, SI Etzel. JAMA. 2012 Dec 5;308(21):226479. doi: 10.1001/jama.2012.7913.

[141] Osteopathic graduate medical education 2013. A DeRosier, TA Lischka, B Martinez. J Am Osteopath
Assoc. 2013 Apr;113(4):303-10.
http://www.jaoa.org/content/113/4/303.long

 A 13-page manuscript covering NYC municipal government (rather than health care) requires an explanation. This is a lovely
document, written in plain English to a general audience, real-world, and rigorous without being too focused on numbers-crunching. For
those unfamiliar with capital budgeting, this offers an intuitive and helpful introduction to the topic. It offers a good template.


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[142] Graduate medical education financing: Focusing on educational priorities. Medicare Payment
Advisory Commission. Report to Congress (Chapter 4). June 2010.
http://www.medpac.gov/chapters/Jun10_Ch04.pdf

[143] The uncertain future of Medicare and graduate medical education. Iglehart JK. N Engl J Med. 2011
Oct 6;365(14):1340-5. doi: 10.1056/NEJMhpr1107519. Epub 2011Sep 7.

[144] General competencies and accreditation in graduate medical education. Batalden P, Leach D, Swing
S, Dreyfus H, Dreyfus S. Health Aff (Millwood). 2002 Sep-Oct;21(5):103-11.

[145] Medical schools in the United States, 2011-2012. B Barzansky, SI Etzel. JAMA. 2012 Dec
5;308(21):2257-63. doi: 10.1001/jama.2012.13425.
This is a Link to the Appendix, which is freely accessible and has much of the data: http://jama.jamanetwork.com/data/Journals/JAMA/929415/jax130003.pdf
Alternate List from the Liaison Committee on Medical Education: http://www.lcme.org/directory.htm
And Wikipedia: http://en.wikipedia.org/wiki/List_of_medical_schools_in_the_United_States
Also See – U.S. Medical School Applicants and Students 1982-1983 to 2011-2012: https://www.aamc.org/download/153708/data/

[146] Osteopathic Medical College Information Book, Entering Class 2014. American Association of
Colleges of Osteopathic Medicine. 2013.
http://www.aacom.org/resources/bookstore/cib/Documents/2014cib/2014%20CIB%20Complete%20Small.pdf

[147] UMDNJ- New Jersey Medical School Student Handbook, Academic Year 2012-2013. (Especially the
curriculum overview beginning page 31.) 2012.
http://njms.rutgers.edu/education/office_education/documents/StudentHandbookcomplete.pdf

[148] Results of the 2012 Medical School Enrollment Survey. Center for Workforce Studies. Association of
American Medical Colleges. May 2013.
https://members.aamc.org/eweb/upload/12-237%20EnrollmSurvey2013.pdf

[149] Residency Slots: A Crisis in the Making? D. Pittman. MedPage Today. 2013-11-07.
http://www.medpagetoday.com/PublicHealthPolicy/MedicalEducation/42786

[150] The residency mismatch. J. Iglehart. N Engl J Med. 2013 Jul 25;369(4):297-9.
doi: 10.1056/NEJMp1306445. Epub 2013 Jun 19.

[151] Orthopaedic Surgery Residency Program Handbook, 2013–2014. Loma Linda Univ. Medical Center.
http://lomalindahealth.org/media/medical-center/departments/orthopaedics/pdfs/handbook.pdf

[152] Medical School Enrollment on Pace to Reach 30 Percent Increase by 2017. Association of American
Medical Colleges. 2013-05-02.
https://www.aamc.org/newsroom/newsreleases/335244/050213.html

[153] U.S. graduate medical education and physician specialty choice. P Jolly, C Erikson, G Garrison. Acad
Med. 2013 Apr;88(4):468-74. doi:10.1097/ACM.0b013e318285199d.

[154] American Board of Medical Specialties Web Site.
http://www.abms.org
Organizational Brochure - http://www.abms.org/About_ABMS/pdf/ABMS_Corp_Brochure.pdf
ABMS History - http://www.abms.org/About_ABMS/ABMS_History/Extended_History/default.aspx
Specialties and Subspecialties - http://www.abms.org/who_we_help/physicians/specialties.aspx
What Board Certification Means - http://www.abms.org/About_Board_Certification/means.aspx
Maintenance of Certification Competencies and Criteria - http://www.abms.org/Maintenance_of_Certification/MOC_competencies.aspx

[155] Accreditation Council for Graduate Medical Education: At a Glance. Accessed Online Jan. 2014.
http://www.acgme.org/acgmeweb/tabid/120/About/ACGMEataGlance.aspx
Most Recent (2000-2001) Graduate Medical Education Directory (“Green Book”) - http://www.acgme.org/acgmeweb/Portals/0/PDFs/2000-01.pdf
ACGME History - http://www.acgme.org/acgmeweb/tabid/122/About/ACGMEHistory.aspx
Common Program Requirements - http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf
Graduate Medical Education Data Resource Book - https://www.acgme.org/acgmeweb/Publications/GraduateMedicalEducationDataResourceBook.aspx
Glossary of Terms - http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/ab_ACGMEglossary.pdf


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[156] International medical graduates in American medicine: Contemporary challenges and opportunities.
American Medical Association. Jan. 2013.
http://www.ama-assn.org/resources/doc/img/international-medical-graduates-in-american-medicine.pdf

[157] United States Medical Licensing Examination. Tufts Univ. School of Medicine. Accessed Jan. 2014.
http://medicine.tufts.edu/Who-We-Are/Administrative-Offices/Office-of-International-Affairs/Required-Qualifications/Medical-Licensing-Examination

[158] Office of Educational Programs, University of Texas Medical School at Houston. Many great links!
http://med.uth.tmc.edu/administration/edu_programs/index.html

Physician Workforce
[159] Annual Address on the State of the Physician Workforce. C. Erikson et al. AAMC's Center for
Workforce Studies. 2013-11-02.
https://event.crowdcompass.com/aamc2013/activity/KmcfgpcRiJ

[160] Physician Workforce Projections in an Era of Health Care Reform. D. Kirch, M. Henderson, and M.
Dill. Annual Review of Medicine, Vol. 63: 435 -445. February 2012.
http://www.annualreviews.org/doi/full/10.1146/annurev-med-050310-134634?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

[161] Primary Care Health Workforce in the United States. C. Dower, E. O'Neil. Robert Wood Johnson
Foundation. 2011-07-01.
http://www.rwjf.org/en/research-publications/find-rwjf-research/2011/07/primary-care-health-workforce-in-the-united-states0.html

[162] Specialization, subspecialization, and subsubspecialization in internal medicine. C. Cassel and D.
Reuben. N Engl J Med. 2011 Mar 24;364(12):1169-73.
http://www.nejm.org/doi/full/10.1056/NEJMsb1012647

[163] International medical graduates in American medicine: Contemporary challenges and opportunities.
American Medical Association – IMG Section Governing Council. January 2013.
http://www.ama-assn.org/resources/doc/img/international-medical-graduates-in-american-medicine.pdf

[164] 2012 Physician Specialty Data Book. Center for Workforce Studies. American Association of
Medical Colleges. November 2012.
https://members.aamc.org/eweb/upload/2012%20Physician%20Specialty%20Data%20Book.pdf

[165] Physician Compensation: Where the Market is Going. Sullivan, Cotter and Associates for the
American Medical Group Association. 2013-03-13.
https://www.eiseverywhere.com/file_uploads/5f5dedc5323d81d666261a4e9a6436bf_2013_AMGA_Presentation_CFO_3-13-13_to_AMGA_Print.pdf
2013 Survey Results, 2013-08-12, AMGA Press Release: http://www.amga.org/AboutAMGA/News/article_news.asp?k=675
News Account and Physician Compensation Averages: http://cejka.force.com/physiciancompensation

[166] Trends in the earnings of health care professionals in the United States, 1987-2010. SA Seabury, AB
Jena, A Chandra. JAMA. 2012 Nov 28;308(20):2083-5. doi: 10.1001/jama.2012.14552.

Nurse, Nurse Practitioner, and Physician Assistant Workforce
[167] Nursing in the United States. Wikipedia.
http://en.wikipedia.org/wiki/Nursing_in_the_United_States

[168] The U.S. Nursing Workforce: Trends in Supply and Education – Results in Brief. AHRQ National
Center for Health Workforce Analysis. April 2013.
http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcebrief.pdf

[169] Quick Facts: Registered Nurses. Bureau of Labor Statistics.
http://www.bls.gov/ooh/Healthcare/Registered-nurses.htm

[170] The nursing workforce in an era of health care reform. DI Auerbach, DO Staiger, U Muench, PI
Buerhaus. N Engl J Med. 2013 Apr 18;368(16):1470-2. doi: 10.1056/NEJMp1301694.


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[171] Nurse Practitioners and Primary Care. A. Cassidy. Health Affairs (Policy Brief). 2013-05-15.

[172] Broadening the scope of nursing practice. Fairman JA, Rowe JW, Hassmiller S, Shalala DE. N Engl J
Med. 2011 Jan 20;364(3):193-6. Epub 2010 Dec 15.

[173] Nurses' Scope of Practice. C Wilson, K Nichols, R Goertz, O Burton. N Engl J Med. 2010 Dec 15.
http://www.nejm.org/doi/full/10.1056/NEJMc1013895

[174] Future of Nursing Report Briefs: Focus on Scope of Practice; Leading Change, Advancing Health;
and Focus on Education. Institute of Medicine. October 2010.
http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Scope%20of%20Practice%202010%20Brief.pdf
http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf
http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Education%202010%20Brief.pdf

[175] Nursing Labor Markets Tutorial. J Spetz. KaiserEDU.org. June 2012.
http://www.kaiseredu.org/Tutorials-and-Presentations/Nursing-Labor-Markets.aspx

[176] Physician assistant education in the United States. Jones PE. Acad Med. 2007
Sep;82(9):882-7.
http://www.academia.edu/1535167/Physician_assistant_education_in_the_United_States

[177] Physician Assistants in the US Health Workforce. (Slide Show.) J. Cawley. George Washington
University. 2013-11-15.
http://www.nhpf.org/uploads/Handouts/Cawley-slides_11-15-13.pdf

6. INFORMATION SYSTEMS
Clinical Foundations: Problem Lists, Registries, and Metrics
[178] The Problem-Oriented Medical Record. L. Kernisan. The Health Care Blog. 2013-05-10.
http://thehealthcareblog.com/blog/2013/05/10/the-problem-oriented-medical-record/

[179] Using a simple patient registry to improve your chronic disease care. Ortiz DD. Fam Pract Manag.
2006 Apr;13(4):47-8, 51-2.
http://www.aafp.org/fpm/2006/0400/p47.pdf

[180] Registries: Powerful tools to track, manage chronic disease. J. Jalkiewicz. Medical Economics. 201305-10.
http://medicaleconomics.modernmedicine.com/medical-economics/news/registries-powerful-tools-track-manage-chronic-disease

[181] Registries for Evaluating Patient Outcomes: A User’s Guide. (Perhaps just the Executive Summary!)
Gliklich RE, Dreyer NA, eds. AHRQ Publication No. 07-EHC001-1. Rockville, MD: Agency for Healthcare
Research and Quality. April 2007.
http://www.effectivehealthcare.ahrq.gov/repFiles/PatOutcomes.pdf

[182] The Problem List beyond Meaningful Use. C. Holmes. Journal of AHIMA. 2011-04-06.
http://journal.ahima.org/2011/04/06/the-problem-list-beyond-meaningful-use/

[183] Types and origins of diagnostic errors in primary care settings. Singh H, Giardina TD, Meyer AN,
Forjuoh SN, Reis MD, Thomas EJ. JAMA Intern Med. 2013 Mar 25;173(6):418-25. doi:
10.1001/jamainternmed.2013.2777.
http://archinte.jamanetwork.com/article.aspx?articleid=1656540

[184] Ethical and quality pitfalls in electronic health records. Bernat JL. Neurology. 2013 Mar
12;80(11):1057-61. doi: 10.1212/WNL.0b013e318287288c. Review.
Alternate Link: http://www.neurology.org/content/81/17/1558.1.full.pdf+html


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[185] Meaningful use glossary and requirements table. American Medical Association. 2011-2012.
http://www.ama-assn.org/resources/doc/hit/meaningful-use-table.pdf.iwnew

Health Care IT
[186] From The Office Of The National Coordinator: The Strategy For Advancing The Exchange Of Health
Information. Claudia Williams, Farzad Mostashari, Kory Mertz, Emily Hogin, and Parmeeth Atwal
Health Aff March 2012 31:3527-536; doi:10.1377/hlthaff.2011.1314 (Cornell Library)
Alternate Link: http://www.healthit.gov/sites/default/files/acceleratinghieprinciples_strategy.pdf

[187] Health Information Technology Primer. And Glossary. Academy of Managed Care Pharmacy.
http://amcp.org/HITPrimer/ and http://www.amcp.org/HITGlossary.pdf

[188] Health Information Technology in the United States 2013. Robert Wood Johnson Foundation. 2013-07-08.
http://www.rwjf.org/en/research-publications/find-rwjf-research/2013/07/health-information-technology-in-the-united-states-2013.html

[189] Electronic Health Records Data and Metadata: Challenges for Big Data in the United States. L Sweet
and HL Moulaison. Big Data. (Forthcoming) Accessed January 2014.
http://online.liebertpub.com/doi/pdf/10.1089/big.2013.0023

[190] New paradigms for measuring clinical performance using electronic health records. Weiner JP,
Fowles JB, Chan KS. Int J Qual Health Care. 2012 Jun;24(3):200-5. doi: 10.1093/intqhc/mzs011.
http://intqhc.oxfordjournals.org/content/24/3/200.long

Health Information Exchange (From the IT, legal, and functional perspectives)
[191] An IT Primer for Health Information Exchange. S. Durkin and B. Just. Journal of AHIMA 79, no.1
(January 2008): 38-42.
http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_036239.hcsp?dDocName=bok1_036239

[192] Personal Health Records: An Industry Primer from the Privacy and Security Perspective. Workgroup
for Electronic Data Interchange. July 2007.
http://privacyoffice.med.miami.edu/documents/WEDI_PHR_Security.pdf

[193] A Primer on Electronic Health Information Exchange Contracting Issues and Concepts. J.
Christiansen. HIT News. March 2012.
http://christiansenlaw.net/wp-content/uploads/2011/10/Christiansen-HIEs-AHLA-HIT-March12.pdf

[194] Health Information Exchange Functions Primer. Pennsylvania Office of Administration Information
Technology. 2011-07-27.
http://www.paehealthcollab.com/assets/pdfs/HIE%20Functions%20Primer.pdf

Some Basic Issues Around Scoring and Risk-Adjusting
[195] Defining comorbidity: implications for understanding health and health services. Valderas JM, Starfield B,
Sibbald B, Salisbury C, Roland M. Ann Fam Med. 2009 Jul-Aug;7(4):357-63. doi: 10.1370/afm.983.
http://www.annfammed.org/content/7/4/357.long

[196] Issues for risk adjustment in Medicare Advantage. Medicare Payment Advisory Commission. Report to
Congress (Chapter 4). June 2012.
http://www.medpac.gov/chapters/Jun12_Ch04.pdf

[197] Health-Based Risk Assessment: Risk-Adjusted Payments and Beyond. K. Martin, D. Rogal, S. Arnold.
Academy Health. January 2004.
http://www.hcfo.org/pdf/riskadjustment.pdf

[198] Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge
abstracts using data from 6 countries. Quan H, et al. Am J Epidemiol. 2011 Mar 15;173(6):676-82. doi:
10.1093/aje/kwq433. Epub 2011 Feb 17.
http://aje.oxfordjournals.org/content/173/6/676.long


15

7. HOW HEALTH CARE PROVIDERS ORGANIZE AND PRACTICE
The Medical Staff and Physician-Hospital Collaboration
[199] Medical Staff Bylaws, 4th Edition. American Medical Association.
http://www.ama-assn.org/ama1/pub/upload/mm/395/medicalstaffbylaws4.pdf

[200] Medical Staff Bylaws. University of Michigan Hospitals and Health Centers. Accessed July 4, 2013.
http://www.med.umich.edu/mss/pdf/bylaws.pdf

[201] History of Physician-Hospital Collaboration: Obstacles and Opportunities. L. Burns, J. Goldsmith,
and R. Muller. In Partners in Health: How Physicians and Hospitals Can Be Accountable Together,
Kaiser Permanente Institute for Health Policy. May 2010. Chapter 2.
http://www.ahrmm.org/ahrmm/resources_and_tools/academic_council/files/burns_physician_hospital_collaboration.pdf

[202] Hospitals' Race to Employ Physicians - The Logic Behind a Money-Losing Proposition Kocher R.
and Sahni N.R. N Engl J Med 2011; 364:1790 – 1793, 05/12/ 2011.
Also see: D. Williams on The Stunning Shift Toward Employed Physicians (Health Care Blog). 14 June 2011.
http://thehealthcareblog.com/blog/2011/06/14/the-stunning-shift-toward-employed-physicians/

[203] American Medical Association Code of Ethics. And … AMA Principles for Physician Employment.
http://www.acaai.org/about/pages/code-of-ethics.aspx and http://www.ama-assn.org/resources/doc/hod/ama-principles-for-physician-employment.pdf

From the Journal Chest  Articles in Medical Ethics: Core Curriculum (A Sample. All Free.)
http://journal.publications.chestnet.org/collection.aspx?categoryID=9185&page=1

[204] The inescapable relevance of bioethics for the practicing clinician. J. Carrese and J. Sugarman. Chest.
2006 Dec;130(6):1864-72.
http://journal.publications.chestnet.org/article.aspx?articleid=1084870

[205] Informed consent in clinical medicine. P. Terry. Chest. 2007 Feb;131(2):563-8.

[206] Conflict of interest in clinical practice. M. Tonelli. Chest. 2007 Aug;132(2):664-70.

[207] Accountability for medical error: moving beyond blame to advocacy. S. Bell et al. Chest. 2011.
Aug;140(2):519-26. doi: 10.1378/chest.10-2533.

[208] Assorted legal issues affecting medical practice. M. Kapp. Chest. 2010 May;137(5):1190-4. doi:
10.1378/chest.09-2392.

[209] Role of the ethics committee: helping to address value conflicts or uncertainties. M. Aulisio and R.
Arnold. Chest. 2008 Aug;134(2):417-24. doi: 10.1378/chest.08-0136.

[210] The ethical foundations of professionalism: a sociologic history. H. Sox. Chest. 2007
May;131(5):1532-40.

[211] Responsibility for quality improvement and patient safety: hospital board and medical staff
leadership challenges. C. Goeschel, R. Wachter, and P. Pronovost. Chest. 2010 Jul;138(1):171-8.
http://journal.publications.chestnet.org/data/Journals/CHEST/22087/092051.pdf


16

Also See …
[212] The new CMSS code for interactions with companies managing relationships to minimize conflicts.
Kahn NB Jr, Lichter AS, Council of Medical Specialty Societies. J Vasc Surg. 2011 Sep;54(3
Suppl):34S-40S. doi: 10.1016/j.jvs.2011.05.109.
http://www.cmss.org/uploadedFiles/Site/CMSS_Policies/CMSS%20Code%20for%20Interactions%20with%20Companies%20Approved%20Revised%20Version%203
-19-11CLEAN.pdf
Alternate Link -- http://www.sciencedirect.com/science/article/pii/S074152141101370X

[213] An introduction to medical malpractice in the United States. Clin Orthop Relat Res. 2009
Feb;467(2):339-47. doi: 10.1007/s11999-008-0636-2. Epub 2008 Nov 26.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628513/pdf/11999_2008_Article_636.pdf

Two Leading Examples of Clinical Programs and Regional Systems of Care: Trauma and Stroke
[214] American College of Surgeons Committee on Trauma (Web Site). Accessed Jan. 2014.
http://www.facs.org/trauma/index.html

[215] Regional Trauma Systems: Optimal Elements, Integration, and Assessment, Systems Consultation
Guide. American College of Surgeons Committee on Trauma. 2009. Accessed Jan. 2014.
https://www.socialtext.net/acs-demo-wiki/regional_trauma_systems_optimal_elements_integration_and_assessment_systems_consultation_guide

[216] Model Trauma System Planning and Evaluation. US Dept of Health and Human Services. 2006.
http://www.ncdhhs.gov/dhsr/ems/trauma/pdf/hrsatraumamodel.pdf

[217] AAMC Members Brief Congressional Staffers on Importance of Trauma Care. Association of
American Medical Colleges. 2012-05-09. (Also see speaker presentations to the right.)
https://www.aamc.org/newsroom/newsreleases/335778/traumabriefing.html

[218] Establishing Stroke Centers. Brain Attack Coalition. Accessed Jan. 2014.
http://www.stroke-site.org/coalition/stroke_center.html

[219] Recommendations for the establishment of stroke systems of care: recommendations from the
American Stroke Association's Task Force on the Development of StrokeSystems. L. Schwamm et al.
Stroke. 2005 Mar;36(3):690-703. Epub 2005 Feb 2.
http://stroke.ahajournals.org/content/36/3/690.long

[220] Recommendations for comprehensive stroke centers: a consensus statement from the Brain Attack
Coalition. M.Alberts, et al.. Stroke. 2005 Jul;36(7):1597-616. Epub 2005 Jun 16.

[221] Interactions within stroke systems of care: a policy statement from the American Heart
Association/American Stroke Association. R. Higashida, et. al. American Heart Association. Stroke.
2013 Oct;44(10):2961-84. doi: 10.1161/STR.0b013e3182a6d2b2. Epub 2013 Aug 29.

[222] About Primary Stroke Center Certification. American Heart Association. Accessed Jan. 2014.
http://www.heart.org/HEARTORG/HealthcareResearch/MissionLifelineHomePage/Primary-Stroke-Center-Certification_UCM_439155_SubHomePage.jsp
About Comprehensive Stroke Center Certification -- http://www.heart.org/HEARTORG/HealthcareResearch/MissionLifelineHomePage/Comprehensive-StrokeCenter-Certification_UCM_455446_SubHomePage.jsp

[223] Facts on Primary Stroke Center Certification. The Joint Commission. Accessed Jan. 2014.
http://www.jointcommission.org/assets/1/6/Facts_about_Primary_Stroke_Center_Certification.pdf

[224] Building the Case for a Primary Stroke Center: A Resource Guide. M. Alberts and J. Baranski.
Rxperience (with the National Stroke Association). 2007.
To clinicians: Caveat emptor! I am only qualified to judge this document on its business merits.
http://www.stroke.org/site/DocServer/Resource_Guide.pdf


17

Accountable Care Organizations (ACOs) and Patient-Centered Medical Homes (PCMHs)
[225] Accountable care organizations: a primer for surgeons. I. Ganske, M. Abbott, J Meara. Bull Am Coll
Surg. 2011 Sep;96(9):27-35.
http://www.facs.org/fellows_info/bulletin/2011/iganske0911.pdf

[226] Getting to There from Here: Evolving to ACOs Through Clinical Integration Programs. J. Pizzo, M.
Grube. Kaufman, Hall & Associates. 2011.
http://www.advocatehealth.com/documents/app/ci_to_aco.pdf

[227] Patient-Centered Medical Homes. A. Cassidy. Health Affairs (Policy Brief). 2010-09-14.

[228] No place like home--testing a new model of care delivery. JK Iglehart. N Engl J Med. 2008 Sep
18;359(12):1200-2. doi: 10.1056/NEJMp0805225.

[229] Building a medical neighborhood for the medical home. ES Fisher. N Engl J Med. 2008 Sep
18;359(12):1202-5. doi: 10.1056/NEJMp0806233.

[230] Patient-centered medical homes in Ontario. Rosser WW, Colwill JM, Kasperski J, Wilson L. N Engl J
Med. 2010 Jan 21;362(3):e7. doi: 10.1056/NEJMp0911519. Epub 2010 Jan 6.

[231] Medical homes: challenges in translating theory into practice. E Carrier, MN Gourevitch, NR Shah.
Med Care. 2009 Jul;47(7):714-22. doi:10.1097/MLR.0b013e3181a469b0. Review.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790523/pdf/nihms155497.pdf

Other
[232] Medicine > Professional Organizations. Yahoo Directory. Accessed online Jan. 2014.
http://dir.yahoo.com/health/medicine/organizations/professional/

8. GLOBAL HEALTH
[233] International Profiles of Health Care Systems, 2012. S. Thomas, et al. The Commonwealth Fund.
November 2012.
http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2012/N ov/1645_Squires_intl_profiles_hlt_care_systems_2012.pdf

[234] The Basics of Global Health. Henry J. Kaiser Family Foundation. 2013-01-01.
http://kff.org/report-section/the-basics-of-global-health/

[235] Global Health 101. K. Moss. Henry J. Kaiser Family Foundation. 2011.
http://kff.org/archived-kaiseredu-org-tutorials/

[236] Global Burden of Disease Study 2010. Lancet. 2012-12-13.
http://www.thelancet.com/themed/global-burden-of-disease

[237] The U.S. Government Engagement in Global Health: A Primer. Kaiser Family Foundation. 2013-01-30.
http://kff.org/global-health-policy/issue-brief/the-u-s-government-engagement-in-global-health-a-primer/

[238] The US Global Health Initiative: where does it stand? J Kates, J. Michaud. Lancet. 2012 May
26;379(9830):1925-6.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60783-1/fulltext#article_upsell

[239] World Health Statistics 2013. World Health Organization.
http://www.who.int/gho/publications/world_health_statistics/2013/en/index.html


18

[240] The U.S. Infant Mortality Rate: International Comparisons, Underlying Factors, and Federal Programs.
E. Heisler. Congressional Research Service. 2012-04-04.
http://www.fas.org/sgp/crs/misc/R41378.pdf

[241] Explore findings from the new report: U.S. Health in International Perspectives. Committee on
Populations of the National Academies.
http://sites.nationalacademies.org/DBASSE/CPOP/DBASSE_080393#deaths-from-all-causes

[242] The Millennium Development Goals: Eight Goals for 2015. United Nations Development
Programme. Accessed Online Jan. 2014.
http://www.undp.org/content/undp/en/home/mdgoverview/

[243] Millennium Development Goals Reports. United Nations Development Programme. Accessed Jan. 2014.
http://www.un.org/millenniumgoals/reports.shtml

[244] Report Brief: U.S. Health in International Perspective: Shorter Lives, Poorer Health. Institute of
Medicine. January 2013.
http://www.iom.edu/Reports/2013/US-Health-in-International-Perspective-Shorter-Lives-Poorer-Health/Report-Brief010913.asp

[245] Decade of Vaccines ― Global Vaccine Action Plan 2011-2020. World Health Organization. May 2012.
http://www.who.int/immunization/global_vaccine_action_plan/GVAP_doc_2011_2020/en/index.html

[246] Healthcare in China: Entering uncharted waters. By F. Le Deu, et al. McKinsey & Company. July 2012.
http://www.mckinseychina.com/2012/09/03/healthcare-in-china-entering-uncharted-waters-2/

9. MACROECONOMICS
[247] Health care spending--a giant slain or sleeping? Blumenthal D, Stremikis K, Cutler D. N Engl J Med.
2013 Dec 26;369(26):2551-7. doi: 10.1056/NEJMhpr1310415.

[248] National Health Spending In 2011: Overall Growth Remains Low, But Some Payers And Services Show
Signs Of Acceleration. National Health Expenditure Accounts Team. Health Aff January 2013 32:87-99.
http://content.healthaffairs.org/content/32/1/87.abstract

[249] Growth in Medicare Spending Per Beneficiary Continues to Hit Historic Lows. R. Kronick and R. Po.
ASPE Issue Brief, ASPE Office of Health Policy, U.S. Dept of Health and Human Services, 2013-01-07.
http://aspe.hhs.gov/health/reports/2013/medicarespendinggrowth/ib.pdf

[250] National Health Expenditures Projections 2012-2022. Centers for Medicare and Medicaid Services,
Office of the Actuary.
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Proj2012.pdf

[251] Is this time different? The Slowdown in Healthcare Spending. A. Chandra, J. Holmes, J. Skinner.
National Bureau of Economic Research. Jan. 2014.
http://www.nber.org/papers/w19700.pdf?new_window=1

[252] Slower Growth of Health Costs Eases Budget Deficit. A. Lowrey. NYTimes. 2013-02-11.
http://www.nytimes.com/2013/02/12/us/politics/sharp-slowdown-in-us-health-care-costs.html?_r=2&

[253] Employment-Based Retiree Health Benefits: Trends in Access and Coverage, 1997-2010. P. Fronstin
and N. Adams. Issue Brief No. 377, Employee Benefit Research Institute (ebri.org), October 2012.
http://www.ebri.org/pdf/briefspdf/EBRI_IB_10-2012_No377_RetHlth.pdf

[254] Wells Fargo Monthly Outlook. (Updated Monthly.) Also: Weekly Economic & Financial Commentary.
https://www.wellsfargo.com/com/insights/economics/monthly-outlook and https://www.wellsfargo.com/com/insights/economics/weekly-commentary


19

10. ALSO OF INTEREST
[255] CPT and ICD-9 Coding for Surgical Residents and New Surgeons. American College of Surgeons.
2004. Accessed Jan. 2014.
http://www.facs.org/ahp/codingmanual.pdf

[256] Group Purchasing Organizations: Services Provided to Customers and Initiatives Regarding Their
Business Practices. General Accounting Office, August 2010.
http://www.gao.gov/new.items/d10738.pdf

[257] Research and Development in the Pharmaceutical Industry. Congressional Budget Office. Oct 2006.
http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/76xx/doc7615/10-02-drugr-d.pdf

[258] Drug Discovery and Development. The Pharmaceutical Research and Manufacturers of America,
February 2007.
http://www.phrma.org/sites/default/files/159/rd_brochure_022307.pdf
See Also: 2013 Profile of the Biopharmaceutical Research Industry - http://phrma.org/sites/default/files/pdf/PhRMA%20Profile%202013.pdf
See Also Chartpack of Biopharmaceuticals in Perspective - http://phrma.org/sites/default/files/pdf/CHART%20PACK_online%20version_13APR04_forweb.pdf

[259] The Changing Demographic Profile of the United States. L. Shrestha and E. Heisler. Congressional
Research Service, Washington, D.C., March 31, 2011.
http://www.fas.org/sgp/crs/misc/RL32701.pdf

[260] Healthy People 2020: Topics & Objectives. US Dept. of Health and Human Services. Accessed Jan. 2014.
http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx

[261] 50 Things to Know About the Hospital Industry. L. Dunn and S. Becker. Beckers Hospital Review.
2013-07-23.
http://www.beckershospitalreview.com/hospital-management-administration/50-things-to-know-about-the-hospital-industry.html

[262] Atlas of the Human Body. American Medical Association. Accessed Jan. 2013.
http://www.ama-assn.org/ama/pub/physician-resources/patient-education-materials/atlas-of-human-body.pag

[263] Addressing overutilization in medical imaging. Hendee WR, Becker GJ, Borgstede JP, Bosma J,
Casarella WJ, Erickson BA, Maynard CD, Thrall JH, Wallner PE. Radiology. 2010 Oct;257(1):240-5.
Epub 2010 Aug 24.
http://radiology.rsna.org/content/257/1/240.full.pdf+html

Biography
David Butz received his PhD in Economics in 1985 from Northwestern University. After eight
years on the Economics faculty at UCLA, he moved to Ann Arbor, MI, where he has served in
various capacities on the faculty of the University of Michigan’s Business and Medical
Schools. He is presently adjunct faculty at the University’s Ross School of Business.
Butz now spends the bulk of his time working for CareEvolution, an Ann Arbor-based health
information exchange.
Other research interests lie in health care outcomes research, industrial organization, law and
economics, antitrust, and supply chain contracting, where he has published numerous peerreviewed papers.
Reach Butz at dabutz@DABAnalytics.com.

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