Purchasing Population Health

Paying for Results
David A. Kindig
Presents a model that fosters improved health outcomes through financial incentives


David Kindig's training as a physician, a health care executive, and his academic work in the field of health policy came together to inspire this innovative approach for extracting a higher quality of care at reasonable cost by establishing clear health outcomes measures as a purchasing standard.

Despite the massive resources it consumes, the American health care system remains under stress. While we are global leaders in technical accomplishments in medicine, the quality of health outcomes we achieve per dollar invested is far from optimal. Neither market nor regulatory reforms have addressed this failure of our system.

In the wake of the failed 1994 federal reform effort the system is changing without legislation through market forces. There is no evidence, however, that these changes are reducing costs, increasing quality, or covering the uninsured.

This book details how Dr. Kindig's plan could work and the stages of implementation. It concludes with an examination of the price of inertia in facing this long-standing problem.

This work will appeal to senior policymakers in the private and public sector, including legislators and staff, officials of corporations, and professional organizations. In addition, faculty and students in schools of medicine, nursing, public health, and business, as well as health services researchers and a sophisticated lay audience will find it interesting.

David A. Kindig is Professor of Preventive Medicine, University of Wisconsin- Madison School of Medicine.

Praise / Awards

  • "...a major contribution to our understanding of the forces driving the health care system and the need to create the incentives for a healthier America in the 21st century."
    --Philip R. Lee, M.D., former Assistant Secretary for Health, Department of Health and Human Services
  • ". . . the book sets out a challenge for integrating the health care system with our new concepts on population health. The ideas proposed by the author lack detail at this stage, but they at least set a framework for future debate and the evolution of new strategies about a subject that is of fundamental importance to all societies."
    --Health Affairs
  • "The book definitely will stimulate discussion and debate about purchasing population health among health policy decision makers. In addition to being a valuable resource for health policymakers and management, this book easily could be used as a source for courses in health economics and health care policy. The chapters are well written, and accessible to a broad audience. With both private and public sector decision makers emphasizing health care cost containment, this book fills an important need."
  • "Purchasing Population Health is a must read for any medical director seriously interested specifically in managed care and health care delivery in general. . . . [It] ties into an attractive package a blueprint for overall change in America's patchwork healthcare system."
    --Norbert Goldfeld, M.D., Journal of Ambulatory Care Management
  • ". . . Kindig has done an excellent job of adapting a population health framework, developed within the context of a Canadian--or European--perception of health as a public responsibility, for application within the very different American health care system and ideological culture. This book is a very creative attempt to take an academic model and mould it into a practical tool for use by American managers who, it would appear, are currently in some need of new ideas. At the same time it should serve the useful function of providing an influential audience with a very accessible summary reminder of the limits of medicine and the multiple social determinants of health."
    --Robert Evand and Aleck Ostry, University of British Columbia, Journal of Health Politics, Policy and Law, October 1999
  • "David Kindig reminds us of the importance of population health and how little we know of the health effects of modern medicine, in the tradition of Sigismund Peller, Thomas McKeown, and A. L. Cochrane. . . . It is difficult not to support integrated population health strategy and systems needed for implementation, for it is only by systematic change, I believe, can we have any long-lasting positive effect on population health with limited resources. David Kindig has placed before us a serious challenge, one that we ignore at our peril and our pocketbooks."
    --Journal of the American Medical Association
  • "David Kindig lays out a comprehensive scheme that would establish incentives to direct health spending in ways that improve the health of the population. He has written a book that reflects a deep understanding of the health care system. For students and non-experts, the book will be a provocative, engaging, and informative way to pursue a line of clear analytic thinking that argues for a radical health policy prescription. Kindig introduces both illustrative data and his concepts in a way that the reader can appreciate their intrinsic power."
    --Public Health Reports
  • ". . . an important contribution to [the] discussion."
    --Oliver Schoeffski, University of Hanover (Germany), Social Science & Medicine, 1999
  • "This book provides a valuable prescription for the future. Kindig argues simply and persuasively that we won't really improve our health care until we measure the society-wide outcomes of medical interventions and couple our ample medical financing to those institutions and systems that deliver the best results. While this seems sensible enough, Kindig demonstrates that current incentives reward institutions for what they do rather than what they accomplish. His thesis is intriguing and written in a language for the non-economist."
    --Fitzhugh Mullan, Washington Post Book World

Product Details

  • 6 x 9.
  • 216pp.
  • 48 drawings.
Available for sale worldwide

  • Hardcover
  • 1997
  • Available
  • 978-0-472-10893-0

Add to Cart
  • $65.00 U.S.