TY - CHAP M1 - Book, Section TI - The Future of Dermatopathology A1 - T. Desman, Garrett A1 - Veremis, Brandon A1 - Donovan, Michael A1 - Cordon-Cardo, Carlos A2 - Barnhill, Raymond L. A2 - Crowson, A. Neil A2 - Magro, Cynthia M. A2 - Piepkorn, Michael W. A2 - Kutzner, Heinz A2 - Desman, Garrett T. PY - 2020 T2 - Barnhill's Dermatopathology, 4e AB - In the United States, medicine has largely been practiced on a fee-for-service basis, focusing on the treatment of ill patients with a long chain of reversible and irreversible pathological events (“sick care”) rather than the promotion of health care initiatives that prevent disease (“health care”). The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease of infirmity.”1 The Institute for Healthcare Improvement has proposed a triple aim for future health care models: 1) improving the health of populations, 2) improving the patient experience of care, and 3) reducing the cost per capita for health care.2 In 2012, the Agency for Healthcare Research and Quality found that the top 1% of chronically ill patients of the U.S. population accounted for 28% of the total health care expenditures and that the top 5% accounted for more than half.1 The Center for Disease Control defines “population health” as an “interdisciplinary, customizable approach that allows health departments to connect practice to policy for change to happen locally. This approach utilizes non-traditional partnerships among different sectors of the community—public health, industry, academia, health care, local government entities, etc.— to achieve positive health outcomes.”3 Fundamentally, population health is centered on value-based care. Whether funded by bundled payments, capitation, or other risk-sharing arrangements, these new models of care will enable physicians to provide the health care services that meet the “triple aims.” This shift away from fee-for-service “sick care” will dramatically place increased responsibility on providers to demonstrate cost effectiveness in their practice of medicine. According to the NIH, “precision medicine” is defined as “an emerging approach for disease treatment and prevention that considers individual variability in genes, environment, and lifestyle for each person.”4 SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/03/29 UR - dermatology.mhmedical.com/content.aspx?aid=1178398126 ER -