The Health Care Value Chain: Producers, Purchasers, and Providers

Book Description

Written by Lawton R. Burns and a panel of expert contributors, from the prestigious Wharton School, The Health Care Value Chain analyzes the key developments and future trends in the United States' health care supply chain. Based on a groundbreaking research initiative underwritten by the industry/university consortium— the Center for Health Management Research— this important book offers an in-depth examination of how the health care supply chain helps create value and competitive advantage.
The Health Care Value Chain offers a thorough examination of the trading relationships among the manufacturers of health care products, the distributors, the group purchasing organizations, and the hospital customers and end users of those products. And the authors show how health care professionals and manufacturers can work together to form beneficial strategic alliances.

Customer Reviews:

Comprehensive baseline analysis of US healthcare.......2007-06-03

This book is an excelent synopsis of the healthcare delivery system. I bought it in order to have a better systematic understanding from a sales and marketing standpoint. I have been able to apply what I learned to achieving seven-figre increases in sales by better understanding the competitive environment and getting better ideas of where the benefits were in my product offering. There's a lot that has changed in the years since this was published (2002), and for that reason, it's not a "5" any more. However, the fundamentals are pretty much the same and this is an excellent foundation, with depth.

The Health Care Value Chain: Producers, Purchasers, and Providers.......2007-03-13

Seemed a bit out of date. Easy to read.

How to Create Win-Win-Win Partnerships in Health Care.......2006-04-03

Burns and several of his Wharton School colleagues collaborated on this book as well as a subsequently published book, The Business of Healthcare Innovation, which I also highly recommend. In the later work's Introduction when explaining the value chain perspective, Burns observes that it "analyzes the entire sequence from raw materials (input) market to final customer (output) market. The sequence is labeled a `value chain' because each link in the chain adds value to its inputs. Each link seeks to maximize its contributions to the total product's value added, thereby capturing as much profit as it can. This may involve focusing on only those links which add the greatest value (and let other firms focus on links that add less value), or encompassing as many links as possible in order to maximize the total profit captured (and leave as little as possible for other firms to divide up)."

This is a key point because whatever decision is made, there can be -- and almost always are -- significant consequences insofar as gross volume, net income, and market share are concerned. In this earlier published volume, Burns and his Wharton School collaborators focus on a large segment of the health care industry which, until now, has not received the attention it deserves. They rigorously examine "the trading relationships between [and among] the producers (manufacturers) of health care products, the purchasers of these products (group purchasing organizations, wholesalers/distributors), and the health care providers (hospital customers) that are the end users of those products -- hence the title of this book."

This is by no means an "easy read" but, as does The Business of Healthcare Innovation, it generously rewards those who absorb and digest the material, then carefully consider appropriate ways by which to apply what they have learned. Obviously, the relevance of the material will ultimately be determined by its practical value to each reader but it may be helpful if I suggest some of the questions to which Burns and his Wharton School collaborators respond.

1. What does the health care value chain consist of and how does it work?

2. What are the major pathways and stumbling blocks to improved value chain operations?

3. Which are the most effective strategies used by manufacturers in pharmaceuticals, medical devices, and medical-surgical product areas?

4. Which are the most effective strategies used by group purchasing organizations and wholesaler/distributors?

5. What do the health care value chain and the "extended enterprise" found in the auto industry share in common? So what?

It is important to keep in mind that this book was published in 2002. There have been several significant developments within the health care industry since then, several of which Burns and his Wharton School collaborators examine in The Business of Healthcare Innovation (published in August, 2005). I take this opportunity to recommend, also, Steven J. Spear's article, "Fixing Health Care from the Inside, Today" which appeared in the September 2005 issue of Harvard Business Review.

For whom will this book be most valuable? In my opinion, there are two separate groups. The first consists of teachers and students associated with undergraduate, graduate, and post-graduate programs such as those offered by the Wharton Center for Health Management and Economics. The second group would include senior-level executives of organizations which are (a) producers of health care products, (b) purchasers of these products, or (c) health care providers that are the end users of these products. I presume to observe that decision-makers in any one of these three categories would be well-advised to understand its inter-relationships with the other two.

In the concluding chapter of this book, Burns and John R. Kimberly suggest that in order to avoid the failure of prior organizational innovation (e.g. integrated health care), "the revamped health care value chain must find parties willing to pay for it." Given the nature and extent of the investment required, it seems imperative that all of those involved share the costs as well as the benefits of organizational innovation. According to Burns and his Wharton associates, there is no acceptable alternative.

Comprehensive Analysis.......2006-01-20

The author can be forgiven for writing a book that reads a little more like a formal academic paper, given his illustrious credentials. However, it is a surprisingly comfortable read given the complexity of the industry (if you could call it one industry) and the material covered. His analysis is as comprehensive as it is thought provoking. He does an excellent job of portraying the myriad of complex relationships between various evermore technologically sophisticated players within the health value chain. I would have preferred more coverage and discussion of specific company/organizational profiles. But, his artful and deft handling of the complex subject matter presented in a way that gives the reader many "aha" moments makes this book a must-read for anyone serious about the business of healthcare.

Excellent Industry Overview.......2005-07-03

For anyone working in the manufacturing or distribution industry within pharmaceutical, diagnostic or medical device companies, this book offers an excellent oversight. Its very helpful for anyone doing business analyst work in a technology department who is new to the industry, but wants to come up to speed rapidly. I recommend it for everyone in my department.

Its rare that a good overview of an industry value chain is available and so accessible to help someone understand how an industry operates.

Average customer rating:

THE Family Business Guide!

Scrub-a-Dub cleans up

A thoughtful look at the family business

well worth your time

Sustaining the Family Business
Marshall B. Paisner
Manufacturer: Basic Books
ProductGroup: Book
Binding: Paperback

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Perpetuating The Family Business : 50 Lessons Learned from Long Lasting, Successful Families in Business

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Strategic Planning for the Family Business: Parallel Planning to Unite the Family and Business

Keeping The Family Business Healthy: How to Plan for Continuing Growth, Profitability and Family Leadership (Jossey Bass Business and Management Series)

ASIN: 0738203203

Book Description

A practical guide to successful management-today and tomorrow-of the family business, from one of its most innovative and outspoken proponents

From the local dry cleaner to the nation's largest breweries, family businesses make up 90 percent of the 15 million businesses in the United States. Yet only one-third make it to the second generation, and 10 percent to the third, as owners-tempted by lucrative offers-cash in to ensure the financial security of their children. In Sustaining the Family Business, Marshall Paisner celebrates the unique qualities of the family business and offers a comprehensive resource for successfully managing the enterprise across generations. Drawing from his own extensive experience, new primary research, and examples of family businesses in a wide range of industries, Paisner offers practical recommendations for handling conflict, establishing professional management structures, setting long-term goals, making the most of outside directors, preparing heirs to take the reins, proactively developing tax and estate strategies, and knowing when selling makes sense.

Customer Reviews:

THE Family Business Guide!.......2006-03-28

Paisner fully succeeds in addressing the various critical issues challenging family businesses. A superb work that delves into multiple scenarios--from leadership and control situations to managing for future generations to run the business. Paisner at all times leads the reader to the conclusion that the family business is far more than just a job or even a piggy bank for future generations but rather a means to an end stressing the growth and development of both the future heirs as well as the communities in which the business operates. "Sustaining the Family Business" takes into account numerous societal, family, and financial considerations and pulls from numerous sources (several full pages of citations attest to this fact.) A must-have, must-read for family businesses and their heirs, a resource that needs to be discussed and internalized as more and more family businesses seem to disappear into big-business corporate amalgamations. Fantastic, 5 Stars!

Scrub-a-Dub cleans up.......2002-07-26

Articulate and literate. The author has some valuable insights.
If your business is worth many millions, check out his column versus pyramid idea of ownership succession. Or if you're ready to pass your company, of any size, along to the next generation, the options are discussed here.

A thoughtful look at the family business.......1999-09-21

These days, it seems harder than ever to predict the future of the family business. Killer companies, rollouts and sweet buyout offers have dampened the enthusiasm of many first-generation business owners for passing their businesses on to their sons and daughters.

Indeed, when presented a "too good to be true" offer from a potential buyer, patriarchs and matriarchs are inclined to say "Why not?" They can take the cash, make sure that their retirement years will be comfortable, and have some money left over to pass on to the kids.

A compelling argument, but it's not what family businesses are about, says Marshall Paisner, founder and now chairman of the ScrubaDub Auto Wash Centers, a chain of 10 car washes in metropolitan Boston. Paisner believes that family businesses exist to sustain families financially and spiritually. Yes, they must be innovative, customer-focused and, ultimately, profitable. And yes, sometimes selling out is the best option. But Paisner believes that it's the best option far less often than people think.

Paisner launched ScrubaDub in 1965. Through innovation, a participative management style, fun and a slavish devotion to the customer, the company has grown steadily since then. No doubt much of that growth is due to Paisner's enthusiasm about customer service. He's even managed to make car washes fun, offering coupons and red-carpet service for regular customers. (See the company's website at www.scrubadub.com for information on the Car Care Club, gift ideas and the Scrubadub Difference.)

He sees the family business as a gift, not a burden. Indeed, this is the fundamental thesis of his book. But getting kids to see the business as a privilege instead of a right doesn't happen overnight. It starts at the dinner table, when the kids are young.

"In too many families, parents send signals to their children that running a family business is a stressful and unfulfilling endeavor," says Paisner. "Wishing to spare their children unnecessary worry about problems they can't understand, parents unwittingly turn their children against the business by banishing business talk from the dinner table, closing off opportunities to share both disappointments and triumphs."

Paisner himself prepared his kids for a ScrubaDub future by having them to work in the car wash during summers, then encouraging them to work outside the business after graduation before joining the company. Once the kids were involved in the business, he instituted a participative style of management that allowed all family members to gradually take on responsibilities and learn how to deal with conflict.

He drew up a "family plan" to articulate the family's overall intentions for the business. Owners can use such plans to articulate their conception of the business "as a trust for which each generation acts as a temporary guardian, preserving it to pass on to later generations," he believes.

Paisner firmly believes that most of the reasons people give for selling are based on "inadequate information, poor planning, or what I consider to be an insufficient appreciation for the benefits of keeping a family business in the family."

Still, he does allow that sometimes - though not often - selling the family business is indeed the best option. Perhaps the best reason, he believes, is when the business is about to get knocked off by new technology.

If it comes down to a sale, owners shouldn't make a move without enlisting the aid of a smart investment banker to help them value their business and elicit the best offers possible. Then, once the sale is made, every provision should be made to distribute the money equitably. Distinguishes family business culture from general business culture, because it makes clear that the business exists, essentially, for extrabusiness reasons. It doesn't exist solely to make money and to be successful, like most business; it exists to take care of a family."

Maybe there's more to life than the golf course after all.

well worth your time.......1999-05-23

The dreary statistics are familiar to all of us who work with family businesses: family businesses make up 90% of the 15 million operations in the United States. Only one-third make it to the second generation. And only 10% make to the third.

Given such depressing numbers, isn't it only logical that owners can easily be convinced by industry consolidators to turn their ownership into cash?

Marshall Paisner takes strong objection to this view.

Accountants can only consider market value when making pricing decisions. Family business owners need to take market value into account, but they also need to consider family values. In the long run, family value is more important. The goal of a family business is to live a desired lifestyle and give the next generation the opportunity to do the same thing.

And if you don't like Paisner's "soft" view of business, he argues that the return on a successful family business is almost always greater than the after-tax return of an estate produced by the sale of such a business.

Much of what Paisner says has been said elsewhere. This book is worth reading because Paisner is the Chairman of Scrub-A-Dub Auto Wash Centers, Inc., one of the world's largest car-wash chains. Founded in 1965, he has successful transitioned the business to his two sons. And we can personally attest that Scrub-A-Dub is one of the best consumer products marketing companies we have ever seen! And we have seen many.

SUSTAINING THE FAMILY BUSINESS is a "How I Did It" book plus an integration of published research plus an integration with other family businesses around the country.

Topics include: Creating a Family Culture, Managing Family Conflict, Developing Tax Strategies, Developing Estate Strategies, When Selling Makes Sense, Navigating a Successful Sale.

For those of who serve on Boards of family businesses, Paisner speaks positively about the use of true outsiders to serve on his Board of Advisors, how he selected them, and how he compensated them.

He has a section on what actions to take when spouses' perceive that their mates are being unfairly treated. Such perceptions can poison both the business atmosphere and the family atmosphere. Paisner has a cogent prescription for what those steps ought to be.

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A story - not a simple business book

Neither Passionate Nor Informative

Excellent read for any business

Sound advice for all businesses

an invaluable book on building and transition

Portraits of Success: 9 Keys to Sustaining Value in Any Business
James Olan Hutcheson
Manufacturer: Dearborn Trade
ProductGroup: Book
Binding: Paperback

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ASIN: 0793152593

Book Description

Learn from the insider-outsider expert who knows how to build businesses that last!

More than three-quarters of all U.S. businesses are closely held, and worldwide the percentage is even higher. Yet closely held businesses are fragile-more than two-thirds fail to survive the founder's involvement.

Portraits of Success offers solutions to the most common problems faced by closely held firms as they strive to create value that can and will be sustained by future generations of management. For the first time ever, business expert and consultant James Olan Hutcheson, the grandson of Olan Mills Portrait Studios patriarch, Olan Mills, shares with readers how closely held firms can prosper well into the future. In practical and inspiring terms, he presents proven management tools in tandem with illustrative examples from his clients' companies and his own family's business. Readers will learn how to:

• Give the next generation of leaders room to grow.

• Incorporate outsiders into the inner management circle as the business matures.

• Keep clear chains of command as future leaders are being groomed and promoted.

• Create a culture rich with business traditions, rituals, and myths.

• Build shared beliefs among the business's founders and its future management.

In closely held businesses, personal relationships are of paramount importance. Hutcheson's practical, prescriptive information from his experience as a consultant, and his revealing, personal anecdotes from working at all levels of the family business provide readers with a uniquely satisfying look at how to build lasting value within their own firms.

Customer Reviews:

A story - not a simple business book.......2006-05-09

A great book to read especially if you are interested in building a great company.

I've done the leadership thing at Toastmasters. I've attended the 12-class Dale Carnegie Course. I've read a lot of books on leadership, and I've counseled clients at SCORE.org counseling sessions on leadership. What I've garnered from all of this on the subject of starting a business and doing it as a leader is described in this book.

If you are leading a company - are you interested in just creating short term profits, or are you looking to the long term? When you hire people are you promoting them because you have become their friend, or because they have earned it? Are you leading or just managing? Do you have passion, or are you just putting in your time? These and other topics are addressed in this book. Get it and read it. You'll be glad you did.

Neither Passionate Nor Informative.......2003-02-25

"Portraits of Success: 9 Keys to Sustaining Value in Any Business" by James Olan Hutcheson is just another "how to succeed at business" book. I wish its value was more than that, but it isn't. It is neither passionate nor any more informative than its competitors.

In the business books I have read recently, I found this one lacks the authority and substance I found in others. William Pollard's "Soul of the Firm" has the authority, as he took ServiceMaster to a new level. "Values of the Game" by Bill Bradley was worth the read because of Bradley's unique metaphorical look at life. "Leadership" by Rudolph Giuliani has power because of what Giuliani has gone through. "Portraits," however, has a flaccid tone to it. I felt as if it was researched information regurgitated into book form. I felt like I was reading the kind of book which gets sold after a corporate sales seminar.

The book, as seen in the subtitle, can be boiled down to nine major points. In each, Hutcheson retells stories of business success and failures, from security company founder Richard Wackenhut to Yankees owner George Steinbrenner.

Action items accompany each chapter, and herein lay the book's greatest value. Hutcheson provides a topic sentence to lead the mini-lesson, but weakly completes the thesis in the following paragraphs.

The redundancy of subject matter mixed with a bland presentation has me suggesting to you to look elsewhere. It was not edited tightly enough to build the necessary tension and excitement. Overall, "Portraits of Success: 9 Keys to Sustaining Value in Any Business" lacks the poignancy I have come to expect from professional advancement books.

Anthony Trendl
editor, HungarianBookstore.com

Excellent read for any business.......2002-11-20

I was skeptical at first that this was a book by someone born with a silver spoon just looking to sell a book. But after reading through the thoughts and stories included, it's evident that Hutcheson has been on the front line throughout his career and the information included can be a benefit to any business owner and manager, particularly one looking to grow and transition ownership while facing the rough roads that will come with it.

Sound advice for all businesses.......2002-11-16

As the world changes, a business must change or decline and die. Some do so even if their business climate has not changed at all. These businesses self-destruct due to internal incompetence or conflicts that blur their focus on what it is their business should do. James Olan Hutcheson is the grandson of the founder of Olan Mills, the world's largest photography company. After starting in the company as a telemarketer, he rose to a position of responsibility and then resigned to pursue a career as a business consultant. Therefore, while he draws heavily from the history of Olan Mills, he also uses examples from several other businesses.
His advice is sound, logical and yet not simple. Ideas such as having proteges (including relatives), work their way up through a company rather than having the reins of power simply handed to them without training is a sound yet often ignored management principle. Another bit of sound advice that is often ignored is the toleration of honest, well meaning and factually based dissent. An examination of business, political and religious history shows quite clearly that when dissent is crushed an organization loses its' health and eventually dies, sometimes rather abruptly. As greater details of the latest corporate fiasco's come to light, it is clear that those who dissented were hounded, and sometimes it continues even after they were proven correct. This is an absurd business practice, as denying the truth only makes it worse when the end finally comes.
The nine keys listed in this book will not make your business a success. Only the making of a valuable product and executing a sound business plan can do that. What it can do is increase the odds that you will do both by showing you how others have done it.

an invaluable book on building and transition.......2002-10-29

James Olan Hutcheson has written a book that should prove invaluable to owners of small businesses and other nonhierarchical organizations. Portraits of Success: 9 Keys to Sustaining Value in Any Business is a book that deserves--and will hopefully get--a large readership.

Drawing on what he has seen in his own family business' transition to second generation leadership, as well as what he has witnessed as a consultant on such transitions, Hutcheson gives the reader much to think about. As he makes each point in his "9 Keys" he illustrates it with a real-life example.

Many of the keys are basic but easy to overlook and (after having overlooked them) sometimes tricky to introduce in a static leadership environment. Yet Hutcheson is a faithful guide through the peaks and valleys.

Having suffered through encounters with ineffective organizations (my daughter's school) and reveled in being a part of an effective, on-purpose organization (my Church), I cannot stress enough how important it is for people in leadership positions to be intentional in what they do and have the ability to be life-long learners. Learning about leadership and listening to those who "have been there," like Mr. Hutcheson, is a big part of this. Nothing less is in the balance than the difference between a life of drudgery and one of joy and freedom.

My only critique of this book is one that springs from my Christianity. I feel that the missing tenth (and possibly most important key) is Spiritual giftedness. When people serve in an area they not only enjoy, but also are gifted by God to serve in, explosive results are to be had. Also, as part of the Kingdom, "Business Traditions, Myths, and Shared Beliefs" melt away in the face of the kind of common purpose given by the Great Commission and the whole history of salvation.

Bearing this in mind and also recognizing that Mr. Hutcheson's audience probably have not all partaken of the Kingdom as of yet, I have to say that this book does a darn good job as a whole. It is less of a compilation of other sources than are most other leadership books. I found it refreshing to be able to distinguish an actual authorial voice in a work such as this. Too many leadership books read like a cross between a presentation and an instruction manual.

Book Description

This digital document is an article from Youth Studies Australia, published by Australian Clearing House for Youth Studies on March 1, 2003. The length of the article is 324 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.

Citation Details
Title: Creating the future: welcoming, sustaining, enterprising. (Reports).
Author: Sue Headley
Publication: Youth Studies Australia (Refereed)
Date: March 1, 2003
Publisher: Australian Clearing House for Youth Studies
Volume: 22 Issue: 1 Page: 55(2)

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Don't Leave It to the Children: Starting, Building and Sustaining a Family Business

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Don't Leave It to the Children: Starting, Building and Sustaining a Family Business
Alan Crosbie
Manufacturer: Mercier Press
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Binding: Paperback

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ASIN: 1860231152

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How to reproduce human and social capital in the new economy
Knowledge communities: means and ends for society's future
Finally an academic book that makes sense for your life

Sustaining the New Economy
Martin Carnoy
Manufacturer: Harvard University Press
ProductGroup: Book
Binding: Hardcover

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ASIN: 067400373X

Book Description

This book explores the growing tension between the requirements of employers for a flexible work force and the ability of parents and communities to nurture their children and provide for their health, welfare, and education. Global competition and the spread of information technology are forcing businesses to engage in rapid, worldwide production changes, customized marketing, and just-in-time delivery. They are reorganizing work around decentralized management, work differentiation, and short-term and part-time employment. Increasingly, workers must be able to move across firms and even across types of work, as jobs get redefined. But there is a stiff price being paid for this labor market flexibility. It separates workers from the social institutions--family, long-term jobs, and stable communities--that sustained economic expansions in the past and supported the growth and development of the next generation. This is exacerbated by the continuing movement of women into paid work, which puts a greater strain on the family's ability to care for and rear children. Unless government fosters the development of new, integrative institutions to support the new world of work, the author argues, the conditions required for long-term economic growth and social stability will be threatened. He concludes by laying out a framework for creating such institutions.

Customer Reviews:

How to reproduce human and social capital in the new economy.......2002-05-30

Martin Carnoy did a great job to organize his own field works and general trends into a seamless fabric. The broad features of new economy is captured by a deft hand with timely insertion of lively facts. Whenever I meet materials on this kind of subject, I cannot but be assured that social sciences are not science but a derivative of literature. They tend to be super-optimistic or ultra-pessimistic. But equipped with well founded conception, Carnoy takes a realistic stance. He shows what should be called social sciences
The author raises the question: How to sustain current economic expansion? On the face of cut-throat global competition, the workplace could not but be transformed to attain flexibility. With it, firms compete in the new environment. But flexibility indicates disaggregating workers from the social institutions that reproduce human capital and social capital. The author calls for public intervention to establish reintegrating institutions for two reasons:
1. Traditional nuclear family and local community have been stressed with mounting pressures from labor market. Those institutions have been the very place where human capital and social capital are reproduced. Human capital and social capital are indispensable to sustain the economic growth. New economy is more vulnerable to such undermining the very infra, society, where the economy is embedded.
2. What is the most distinct in the new economy is knowledge. Knowledge, or human capital, should be reproduced. Now it¡¯s relegated to the individual¡¯s hand. This has devastating effects on social integration. Without some measures, the access to knowledge, skills, and information divide workforce into the dual labor market where winner and loser reproduce themselves for good.

Knowledge communities: means and ends for society's future.......2001-02-20

Carnoy's analysis of labor data, along with astute personal insights, are his tools for describing a changing world of work, family, and community. He examines tchnology-based workplace changes, as well as trends concerning globalization and the impact of women's role in the labor force and changing family structures. The "cloth" of Carnoy's vision is woven from many emerging trends which affect the way we define community. He concludes that societies might benefit from a shift in power from mega-nationals to innovative local governments, requiring active commitment on the part of citizens, a a redirection from job-centeredness to knowledge-centeredness.

Finally an academic book that makes sense for your life.......2000-11-05

This book explains the current transformation of employment and work, and the consequences for families and communities. It shows, with an impressive documentation, that flexibility is the norm. The new economy is productive because workers move around and change jobs and activities. But this flexibility may be socially unsustainable, unless we strengthen the family, the community, and the schools. What I really like about this book is that it is a great piece of academic research, yet it is a down to earth, policy oriented book that could help us and our politicians to make the new economy socially sustainable. Required reading for economic and social sciences in colleges. And easy, interesting reading for everybody wanting to understand our new world. Manuel Castells, Berkeley, California.

Withdrawal of life-sustaining therapy after sudden, unexpected life-threatening illness or injury: interactions between patients' families, healthcare ... from: American Journal of Critical Care

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Withdrawal of life-sustaining therapy after sudden, unexpected life-threatening illness or injury: interactions between patients' families, healthcare ... from: American Journal of Critical Care
Debra Lynn-McHale Wiegand
Manufacturer: Thomson Gale
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Binding: Digital

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