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A Hospital Is Not Just a Factory, but a Complex Adaptive System—Implications for Perioperative Care

Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories.

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APCs: an important primary care resource for value-based care

Value-based contracting and population health programs require a combination of access, choice, efficiency, and reasonable price. These are essential business requirements for the more than 750 clinically integrated networks (CINs) and the accountable care organizations (ACOs) in the nation, which have been created to lead the transition from volume to value from government and commercial payers.

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Will outcomes-based pricing arrangements between purchasers and pharmaceutical organizations become widespread, and will they have a material impact on prescription drug costs?

Outcomes-based contracting (OBC) is designed to bend the cost curve by putting the onus on drug manufacturers to provide rebates to payers and providers when outcomes from new medicines don’t match up with the results from clinical trials, or demonstrably improve patient outcomes.

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