In interviews with Health Affairs, government ministers in Germany and the Netherlands talk up market-oriented refinements to their universal health insurance systems for the future. But the news from Europe isn’t all happy: an unsettling survey in the United Kingdom finds that some physicians believe that the market will unravel the government-owned and -operated National […]

The Medicare Modernization Act (MMA) has succeeded in providing seniors with more “choice” among Medicare Advantage (MA) private health insurance plans. However, particularly in rural areas, much of the increased choice stems from a proliferation of private fee-for-service (PFFS) plans, which mimic traditional Medicare’s fee-for-service structure but receive reimbursements that exceed spending in the traditional […]

The spread of convenience clinics—or “McClinics”—has been debated across the health care blogosphere in recent weeks, stemming in part from Wal-Mart’s announcement that it plans to open hundreds in coming years. Yesterday, the subject was the question of the day on the Wall Street Journal’s health blog (sparked by a Journal op-ed by Grace-Marie Turner, president […]

Old hands in Washington are getting a here-we-go-again feeling about health care these days. Candidates and polls are pushing reform toward the top of the nation’s agenda. Many states are on the march. Realism occasionally rears its head in the right places: Controlling cost growth seems to be recognized increasingly as a priority of the […]

We want to thank those who contributed to a lively debate about our book, Redefining Health Care. James Robinson sums up our argument succinctly: “Porter and Teisberg appropriately emphasize the central role of the organization and delivery of care, putting it ahead of insurance, consumer choice, employer purchasing, and government regulation. Of course, payment, choice, […]

Is pay-for-performance really such a new thing? After all, “aligning incentives” was the ubiquitous mantra of the ‘90s. It applied to capitation and integrated care in the managed care era. But times change. It’s a fee-for-service world again, and aligning incentives means something different now -– although it’s still assumed that how we pay for […]

Michael Porter and Elizabeth Olmsted Teisberg are experts in strategy and innovation, but, for better or for worse, they are relative newcomers to the health care arena. As a result, the language they use in Redefining Health Care often differs from the terms used by health policy analysts, even when their diagnoses and prescriptions are […]

Michael Porter and Elizabeth Olmsted Teisberg’s overall vision for health care delivery is an archipelago of free-standing Integrated Practice Units (IPUs), each focused on the total cycle of care for a medical condition. This contrasts to the view of competition among integrated delivery systems (IDSs) [2-week free access] that organize or arrange comprehensive health services […]

In their recently published manifesto, Redefining Health Care (2006), Michael E. Porter and Elizabeth Olmsted Teisberg — hereafter simply PT — offer a utopian vision of a health system that might occur to anyone possessed of a modicum of common sense but not too familiar with the real world of health care.

Redefining Health Care is a tour de force, a magisterial analysis, and a long-overdue application to the health sector of core principles of business strategy. It’s also a bit of “Goldilocks and the Three Bears.” Porter and Teisberg don’t like capitation, vertical integration, integrated physician-hospital organization, multispecialty group practice, or any of the other epiphenomena […]