Role of transparency in managing outcome successes: Causes and end use/least cost as decision guides

Russell Jaffe (Health Studies Collegium, Sterling, Virginia, USA)
Robert A. Nash (Nash Medical Center, Virginia Beach, Virginia, USA)
Richard Ash (Ash Center for Comprehensive Medicine, New York, New York, USA)
Norm Schwartz (Integrative Medical Clinic, Milwaukee, Wisconsin, USA)
Robert Corish (Integrative Clinic, Fort Lauderdale, Florida, USA)
Tammy Born (Born Medical Clinic, Grand Rapids, Michigan, USA)
James P. Carter (Complementary and Integrative Medical Services, LLC, Mandeville, Louisiana, USA)
Harold Lazarus (Frank G. Zarb School of Business, Hofstra University, Hempstead, New York, USA and ASIMP Working Group on Healthcare Transparency)

Journal of Management Development

ISSN: 0262-1711

Publication date: 24 October 2008



Healthcare is both the largest (17 + percent) and the most rapidly growing (three plus times the consumer product index (measure of inflation) and half a percent of gross domestic product each year) segment of the US economy. The purpose of this paper is to focus on outcome successes that illustrate application of a previously reported health equation. The health equation allows an organized and more transparent assessment of healthcare outcomes.


The approach includes “end use/least cost” techniques that identifies healthful care as a big unmet need (BUN) and equally attractive business opportunity in identifying health promotion that improves outcome at lower net costs.


Opportunity exists to reduce costs while also reducing adverse events, healthcare morbidity and morality. Transparency is essential to find what works more effectively to yield desired outcomes. Metrics and measures, particularly more precise tools to assess true outcome in promoting health or managing ill health, are given priority as they allow quantified and, often econometric, outcome opportunities in the midst of current uncertainties.

Practical implications

This paper is for consumers and businesses, managers and administrators, professionals and allied health professionals. The successes described herein illustrate fundamental opportunities driving change and innovation within healthcare and in our society.


Attention is called to opportunity areas that can fund out of savings the transition from the authors' current “sickness care” system to a healthful care, proactive prevention approach to delivering care. Novel application of transparency and end use/least cost can help guide choices to achieve healthier outcomes.



Jaffe, R., Nash, R.A., Ash, R., Schwartz, N., Corish, R., Born, T., Carter, J.P. and Lazarus, H. (2008), "Role of transparency in managing outcome successes: Causes and end use/least cost as decision guides", Journal of Management Development, Vol. 27 No. 10, pp. 1086-1114.

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