Health affairs
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Payment reforms clearly are an important change agent in our efforts to improve the health care delivery system. For broader health care delivery reform to take root and work, however, payment reform cannot be imposed in a vacuum. To maximize the chances of success and minimize the possibility of unintended consequences, the appropriate culture and structure of our health care institutions first must be in place.
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Building privacy and security protections into health information technology systems will bolster trust in such systems and promote their adoption. The privacy issue, too long seen as a barrier to electronic health information exchange, can be resolved through a comprehensive framework that implements core privacy principles, adopts trusted network design characteristics, and establishes oversight and accountability mechanisms. The public policy challenges of implementing this framework in a complex and evolving environment will require improvements to existing law, new rules for entities outside the traditional health care sector, a more nuanced approach to the role of consent, and stronger enforcement mechanisms.
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Start-up companies in the biotechnology and medical device sectors are important sources of health care innovation. This paper describes the role of venture capital in supporting these companies and charts the growth in venture capital financial support. ⋯ Entries and exits in one sector also appear to influence entry in the other. These findings have important implications for developing innovative technologies and ensuring competitive markets in the life sciences.
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Chronic conditions are not just a problem for industrialized countries; they also affect more than a billion people in low- and middle-income countries. This Perspective shows how some middle-income countries are beginning to respond to the growing cost and prevalence of noncommunicable chronic diseases (NCDs). The primary message here, however, is that low-income countries will need substantial international assistance to confront the growing cost and burden of disease associated with NCDs. Evidence from middle-income countries suggests that there are low-cost, cost-effective ways to prevent and treat NCDs in low-income countries.
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We discuss the challenge of managing innovation in and access to health care interventions in an evidence-based, cost-effective way, and we describe a decision-making framework (using U. S. and U. ⋯ We argue that providing reimbursement for what could be a cost-effective technology "only in the context of research" will be appropriate if the costs of delaying implementation are offset by the value of "keeping one's options open" by waiting for more information. We conclude that there is a need for better integration of health care decision-making processes with research policies.