Cover image for Purchasing population health : paying for results
Purchasing population health : paying for results
Kindig, David A.
Personal Author:
Publication Information:
Ann Arbor : University of Michigan Press, [1997]

Physical Description:
xiii, 194 pages : illustrations ; 25 cm
Format :


Call Number
Material Type
Home Location
Item Holds
RA395.A3 K52 1997 Adult Non-Fiction Central Closed Stacks

On Order



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

Reviews 1

Choice Review

The current measure of effectiveness in the US health care system is how much money is saved or how much profit has been earned for investors. Kindig challenges this misplaced thinking with the propositions contained in this iconoclastic book: payment for health and medical care should be based on an insurance plan's performance tied to a specific measure related to population health outcomes. The author suggests that the attention should shift from what services have been provided to what are the outcomes of those services in relation to population longevity and quality of life. Kindig, a physician with broad health-care system experience, presents a discerning analysis of our past and current systems of health care and health-care payment, explaining why they are ineffective. He then proposes his ideas regarding linking payment to health outcomes. He recognizes that health is not solely the absence of disease or the result of medical care, and he works to integrate other systems (e.g., education) into the plan. The book is not just theory: in the final chapters, he presents a specific plan for effecting the framework. In addition, he does not shy away from the ethical challenges posed by the plan. His ideas are clearly presented and easy to understand, even for the nonhealth professional or economist. Highly recommended. General readers; undergraduates through professionals. M. A. Thompson Saint Joseph College