...HCS/552 November 5, 2012 Introduction Complex health care delivery systems in the USA Describing health care delivery structure at MGH Comparing health care delivery system with SGAH Factoring licensing and regulatory requirements Quality affecting pricing Health Care Delivery Structure of MGH Decentralized model Hybrid organizational model Service‐based health care delivery structure Predominantly utilitarian authority structure Health Care Systems of the Competitor SGAH represents the hierarchical organization Centralized organizational model Mutual beneficiaries system Predominantly normative authority structure SGAH positions itself as a specialty hospital Licensing and Regulatory Effects The Center for Disease Control and Prevention (CDC) Health insurance portability and accountability act (HIPAA) Occupation safety and health administration (OSHA) Health services cost review commission (HSCRC) Licensing and Regulatory Effects Licensing and Regulatory Effects (Continued) Health Information Technology for Economic and Clinical Health Act (HITECH) Certificate‐of‐need (CON) Prospective payment system (PPS) Balanced budget act (BBA) Regulations Affecting Health Care Patient protection and affordable care act (PPACA) Recovery Audit Contractor (RAC) program Observation admit status Mandatory electronic health records Pricing and Competition Trends Hospitals positioning and differentiation...
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...public health and health care delivery systems, we first have to have an understanding of what each of these terms mean. Public health is defined as the "science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community effort.."1 On the other hand, The Institute of Medicine in its report, The Future of Public Health in the 21st Century describes health care delivery systems as "various organizations and individuals working collectively,"2 and include clinicians, insurance plans, health care facilities and independent and corporate health care providers. In the United States, public health and health care delivery systems complement each other in several ways. One of the major way in which they complement each other is through their focus on prevention services to the communities. For instance, governmental agencies may implement programs to help improve the health of members of the communities ,such as the Woman Infant and Children (WIC) program that helps with nutrition education and provision for low income mothers and their children up to the age of five. Here we can see how public health is in place since there is the promotion of health and disease prevention among the target population. The health care delivery systems include the WIC...
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...polio and mumps. Back then, health care providers focused more on vaccines and isolation as ways of controlling the diseases. Today, people are more worried about lifestyle and age related diseases. In the very way, the delivery of health care services has also changed. Disease trends, therefore, influence the delivery of health care services. One will ask what determines disease trends. Factors like globalization and industrialization are major determinants of disease trends. Globalization has increased the degree at which people from different parts of the world interact. People keep travelling from one country to another, and along the way, they are likely to acquire or spread diseases that they otherwise, would not contract had they remained in their home countries. Industrialization, on its end, has increased the need to have a modernized society. Modernization comes with an increased demand for manufactured goods, and services, and very busy lives. People are not eating healthy foods as they did in the past. Due to the busy schedules, many people do not have the time to exercise their bodies. Poor eating habits and insufficient exercise have led to lifestyle-related diseases and complications such as obesity, and diabetes. These diseases are now a major concern for health care services providers. Disease trends and population demographics determine the delivery of health care services. Age, a demographic factor, increases the need for health care services. This explains why...
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...Introduction to the U.S. Health Care Delivery System Introduction to the U.S. Health Care Delivery System Information Aubrey Gaines June 22, 2011 Health Care Delivery Systems BHS 450 Trident University International Dr. Leequan Ray Managed Health Care is debated on a number of aspects; nature and origin of managed care, the notion of the death of managed care and the current state of managed care in the U.S. health care system. Anyone in America, who’s used healthcare insurance through their employer, experienced managed care at some point. What is managed care and how does it affect us? The Health Maintenance Organization (HMO) ACT of 1973 required employers with more than 25 employees to offer federally certified HMO options along with indemnity insurance upon request. With the HMO ACT of 1973, employers needed them more than ever. HMOs had to instantly find a way to provide quality care at the lowest possible cost to the employer, so they engineered techniques that became known as managed care. Managed care is loosely defined as a mixture of techniques intended to reduce the cost of providing health benefits in order to improve the quality of care for a predetermined population. The intent is to decrease unnecessary cost through a multitude of mechanisms which include offering economic incentives for physicians and patients to select less costly forms of care, reviewing the medical necessity of specific services, increasing...
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...The health care delivery system in Utah is set up much the same as many other states, from the opportunity for the community to participate in Medicaid or Medicare programs, to all sort of resources, from information on local health departments, campaigns and awareness programs, to allowing for easy access to the licensing bureau to ensure the safety and comfort of assisted living centers and nursing homes. According to health.utah.gov, growth rates in Utah for Medicaid have far exceeded the annual revenue for the last two decades. Health care costs are continuing to soar, while many people are suffering without insurance or proper care when they are in need of it most. The State of Utah has contracts with many health care organizations in which it can arrange quality care and continually improve on ways to manage health care costs, cover medical procedures, and allow opportunities for the community to be aware of how and when to utilize the benefits that they are provided, whether it be through state or government agencies, or employer’s plans. The State of Utah wants to reduce health care costs, which it can help maintain by providing out-of-network payment limitations when dealing with Medicaid, and with their budget management strategy the state makes supplemental payments to its teaching hospital. The State is also strategizing on making each Medicaid client responsible and accountable for their portion of the system, as well as replacing limits on the copayment amounts...
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...MDOC health care implications and best practices: A case was presented, where a 21year old man had died being strapped naked to a concrete table for four days. Considering this, a federal judge from Correctional Medical services (CMS) has ordered Michigan DOC to implement reforms in its prison mental health care programs in order to prevent many deaths of several mentally ill patients (Marcia Clemmitt 2007). According to (National Commission on Correctional Health Care, 2008) a report was prepared on Michigan DOC Health Care System. The survey interview was conducted to determine the strengths and weaknesses of the current health care delivery system in MDOC. They interviewed various staff of MDOC; administrators, health care providers, Central...
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...1. Explain how the medical model drives up costs in the health care delivery system? The current health care plan just treat the symptoms of diseases and is less focused on completely eliminating the problems. As the reading states this drives up the want for the best technologies and this drives up the cost of the newest and greatest technology. This technology can include new ways to make medicine, diagnose or find problems, The increase in newest and greatest also increases the overall cost and has to be made up someone were. So this cost is put on where the money is coming in. Generally this will be cost to patients. You also have to consider the ACA law which has ruined the insurance game. By raising the cost to cover the overload...
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...TUI University Blanca I. Rivera ENG101 English Composition I 11/17/09 To: Independence Business Owners From: Blanca I. Rivera Subject: Starting a Nightclub business Creating a desirable nightclub in the right location can prove to be both lucrative and satisfying. Although there are inherent risks and short life spans associated with such a business venture, a well thought out plan followed by proper execution will make the difference between a successful business and one that is not so successful. Keeping in mind the important elements that a startup nightclub must take into account, it will be possible to strategically market a nightclub that appeals to the right crowd. It begins with having a nightclub that provides entertainment, either in the form of dance floors and/or live artists such as DJs. Equally important is the ambience that our hypothetical nightclub will have. Designing the right ambiance begins with knowing the kind of people we would like to attract to our nightclub. Given a limited budget, it may be best to market to younger crowds as the startup costs will be less than marketing to a higher income crowd. Finally, finding a great location for the nightclub will require significant research into demographics and potential threats from competitors. Ideally our nightclub will be located in a central place with a high flow of traffic and a safe distance from other...
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...Health care today is becoming more complex with the aging population, multiple comorbidities, and rising health care costs. There are many issues that health care providers face while caring for patients on a daily basis. The two health care problems that will be discussed are hospital acquired infections and how it affects patient outcomes as well as antibiotic resistance related to overuse and misuse. This paper will discuss those two health care problems and how they affect health care delivery as well as costs, access to care, quality of care, and nursing qualities that influence evidence-based practice. Problems That Affect Health Care Delivery and Health Care Policies Hospital acquired infections The first health care problem to be discussed...
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... September 22, 2013 The impacts of healthcare delivery systems biggest issues are the aging and obesity. We need to understand how these can impact our lives and what we can do to address them now before they become a bigger issue in the future. Many of the Americans from the baby boomer era are becoming retired and will add to the future endeavors of the working class with many of our government programs being affected. The second contributor is obesity. Since this can go in hand with the aging these are the main reasons we need to look at our delivery systems. Aging The median age of the world's population is increasing because of a decline in fertility and a 20-year increase in the average life span during the second half of the 20th century. These factors, combined with elevated fertility in many countries during the 2 decades after World War II (i.e., the "Baby Boom"), will result in increased numbers of persons aged >65 years during 2010--2030. Worldwide, the average life span is expected to extend another 10 years by 2050. The growing number of older adults increases demands on the public health system and on medical and social services. Chronic diseases, which affect older adults disproportionately, contribute to disability, diminish quality of life, and increased health- and long-term--care costs. Increased life expectancy reflects, in part, the success of public health interventions, but public health programs must now respond to the challenges created by...
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...American Health Care Delivery System IP5 Angela Stewart American Health Care Delivery System America’s emergency rooms see this type of critical events as a daily occurrence. Often you will find that people will go to the emergency department for care because the ER cannot refuse to care for that come to be seen. If we look into the Emergency Medical Treatment and Active Labor Act any person seeking care must receive assessment and immediate care for their ailment. Often the issue is financial, if a patient is seen at a doctor’s office co-pay or full payment is required at the time of service. With many Americans that do not carry medical insurance their ability to attend to the issue prior to it becoming an emergency is not something they can afford. At this time it is estimated that 77% of Americans are living from pay check to pay check (What percentage of Americans Live paycheck to paycheck? 2012). Without having access to a general physician to control this issue the child will end up being admitted to the hospital (Transferring patients, 2008). The Emergency department has become the safety net that catches those that fall through the cracks. If seen in the ER the individual will get the best possible care for the issue they came in for. In this case the child would be kept in the ER until they were able to clear her lungs and free her of the tightness and inability to take a deep breath. At that time the attending doctor will give a prescription for her immediate...
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...Health Care Organization and Delivery System Health Care Organization and Delivery System HCS/531 November 09, 2011 In the current era of technology, health care system continues to research on improvising the various ways on delivering outstanding health services to its people. In health care industry, majority of the developed countries are run by national insurance generated by enforced general taxes. Unlike in United States healthcare insurances are run by partly private and government institution ensuring individuals based on certain eligibility. Although the distinct system in the United States protrudes as one of the best health care providers around the globe, some individuals considered it as unmanageable catastrophic scheme. Additional information regarding United States health care system, the implications of its belief and values, and some models of health care delivery used in America are presented below. The health care delivery system of United States is a complicated organization involving education and research, medical suppliers, private, and government insurers, health care providers, payers, and the government. It composed an approximate number of 10 million in employment from doctors, nurses, dentists, pharmacists, administrators, caregivers, and more. The system also involves several institutions such as hospitals, nursing homes, mental health facilities, and clinical sites serving millions of people yearly...
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...Team-Based Health Care Delivery Maria Reodique Grand Canyon University: HCA-515-0101 June 16, 2015 Introduction Health care has evolved and is continuously evolving. The management of care now involves different clinicians to better assess, diagnose and cure a patient. The clinicians evolved from a general practitioner to a team now comprised of Physician’s Assistant, Nurse, License Practical Nurse and Specialists. These health care professionals now compose a team of health care providers that are essential in a patient’s over all health care. The team-based approach is a delivery system that provides a patient an all-encompassing health care delivery system. “ By practicing in a team-based care model, physicians and other clinicians can care for more patients, better manage those with high-risk and high-cost needs, and improve overall quality of care and satisfaction for all involved” (Zawora, O’Leary & Bonat, 2015). Case Description A female 36-year old patient underwent an annual physical exam. The primary care physician ordered full blood panel. The result showed elevated levels of LDL and ALT (alanine aminotransferase). The gastroenterologist confirms that the patient has chronic Hepatitis B. The levels are not high enough but still needs to be watched carefully. The patient is already suffering from high blood pressure and is over weight. The patient migrated from an underdeveloped nation that includes in its diet high sodium content and fatty foods. Patient...
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...Multidisciplinary Teams In Health Care Martinez, Juan Grand Canyon University: UNV 515 December 16, 2015 Multidisciplinary Teams In Health Care Hospitals are integrating a variation of team-based health care delivery concepts for staff working in intensive care units, emergency rooms, and operating rooms. Team-based health care delivery often referred to as multidisciplinary teams, improve communication between different levels of healthcare workers. According to Epstein (2014), multidisciplinary teams are responsible for improvements in patient outcomes, improved patient and employee satisfaction, and most importantly a decrease in adverse events (AE). Case Description Peter, a 24 year-old male involved in a traffic collision has suffered internal bleeding due to liver trauma and is in need of a surgery and a blood transfusion. Past medical history includes asthma, diabetes, and a significant drinking problem that started at a very young age. It is important to note that the patient is a Jehovah’s Witness and his mother raised him without a father figure. Health Care Delivery Team The multidisciplinary team delivering care to the patient include: the paramedics that arrived at the scene of the accident, extracted the patient from the car, and transported the patient to the emergency department, the registered respiratory therapist that assisted in intubating the patient and was appointed to make sure the patient had ample respirations...
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...Characteristics of the U.S. Health Care Delivery System Introduction The U.S. health care delivery system can be best characterized as a loosely coordinated network of components that are interconnected. As noted by Shi and Singh (2008, p.4), “the system is a kaleidoscope of financing, insurance, delivery, and payment mechanisms that remain unstandardized but loosely connected”. The system is a combination of both government run programs (Medicare, Medicaid, Schip) private carriers such as HMO’S and other volunteer services such as the American Heart Association, American Lung Association, and a host of other organizations. The purpose of this assignment is to describe two defining characteristics (financing and delivery) of the U.S. health care delivery system and to further analyze and describe their implications on the system. Financing of Health Services As asserted by Shi and Singh (2008, p. 6), financing is an important prerequisite to obtain health insurance or to pay for health services. In the private sector, the financing of health care services for individuals is typically derived from their employers who often pay partially for such insurance in the form of fringe benefits. Employees are also given an opportunity to add other members of their families to this type of employer based insurance. As noted by Barton (2010, p.177), private insurance is estimated to cover about 67 percent of the nonelderly population and accounts for 54% of the revenues...
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