...Delivery Systems 8/25 • Public health is preventative health services, services intended to preserve and enhance health, water supply, FDA, restaurant sanitation, assessing the environment in a general sense, education • Restorative health: direct intervention in the body, medicines, procedures, injections, “touching” • Interventions and restorative health are more costly, some studies show if people exercise we can reduce need for restorative health • Migrating from medical model to public health is difficult, clinical intervention associated with restorative health • Preventive: whole is greater than sum of the parts • PA’s and NP’s to extend primary care, about improving access and slowing cost curve increase • States are the primary vehicles for licensure for healthcare personnel, states need to expand the scope of practice • Managed care: managed cost, in 1980s there was financial disincentives for referring to specialists • Public health very small effort of maintaining health • Institution: doctors, payors, hospitals, insurance, technology, pharmaceuticals, taxpayers, professionals, communications, • free market vs. gov. control: history founded on individual rights and liberties, we are a society and there are needs greater than any of us as individuals, works for other countries that don’t have a culture of individualism • Most hospitals are not for profit, for-profit chains are low percentage, VA, military, state hospitals aimed at behavioral health •...
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...Evolution of the Healthcare Delivery System in Hospitals The healthcare system has gone though many changes in its long history. . The American health care system has not only made drastic changes within the last 2 centuries but also continues to change and evolve. It is very important that those who have access to healthcare today understand the history of the U.S. healthcare delivery system, how it operates today, and what problems continues to be issues today. We are all consumers of health care. In this paper, I will discuss the origins of the first hospital, and how it has influenced out healthcare system today. Origins of Hospital Healthcare The evolution of hospitals in the Western world has been...
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...Integrated Delivery Systems What conditions need to be in place for an integrated delivery system to work properly and achieve the financial benefits possible from such a system? Integrated healthcare systems offer an array of healthcare services as a chain; in fact integrated delivery systems are forms of joint ventures. For such a system to work properly, its primary focus should be making sure it meets the local population’s general health needs. An integrated healthcare system should be able to match the services required and must have the capacity to take care of the population’s requirements and the care offered must be coordinated and integrated across the continuum. It should have a management information system good enough to link its patients, the providers and payers across the whole system. An integrated healthcare system should be able use financial incentives and the organization’s structures to support day to day running, physicians in the network and other caregivers so as to meet the goals of the organization. Care provided must be continuously improved and the integrate network should be willing to work with others in the region to make sure that the community’s health objectives are fulfilled in continuum of care. Cost effective measures that still fulfill good patient care must be used because one of the main objectives of the integrated care system is providing care in the lowest cost setting, Gapenski 2012 (p.15). The success of integrated health...
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...Running Head: CHANGING HEALTH CARE DELIVERY Changing Health Care Delivery Phylicia Knox MHA 628: Managed Care & Contractual Services Instructor: Martha Jennings Date Submitted: February 2, 2015 Abstract Changing health care is important, because many Americans are being faced with many issues in regards to health care and its delivery. The changes that will be made will provide a clear, concise overview of the main features of the current medical care delivery system. The current healthcare world zooms in mainly on illnesses and injury. It is clearly time for a different approach to healthcare in this country. If a change would happen it would build a healthcare system that will concentrate on promoting good health and disease control and managing more difficult disease. Currently there is a large sum of money in the healthcare system, but reorganizing the order it is spent out, will improve the quality of care while lowering the cost. It is a must that a change comes, but if not the United States will continue to spend more and more money on health care. Americans assume that change may have not been predicted because of cost. Overall, there are many barriers to success, but it can be done. Managed Healthcare Quality According to (Washington, DC: August 2010)the current the patient health care needs are not being met, the reasons are because of several issues that need to be resolved such as poor connection and communication between the providers, mismatch...
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...How Does Cost Affect the HealthCare Delivery System? An In-Depth Look at the Health Care Delivery System and Cost. | | Princess L. Brigham | 11/23/2010 | HSA 6414: Social Dimensions and Issues in Health Care | ABSTRACT How does cost affect the health care delivery system? This research focuses on the cost of the health care delivery system and how it affects today’s society. High costs, gap-ridden coverage, and sporadic quality are the health care problems that most concern Americans. Yet most of the policy discussion is focused on the issue of coverage. Health care is expensive because of the pervasive entitlement attitude held by literally everyone in the system: patients, providers, suppliers, insurers. Government insurance (Medicare, Medicaid, veterans, Department of Defense) covers 87 million; tax breaks subsidize 176 million in employer coverage; insurers and other third-party payers take care of the bills for 85 percent of Americans. There is little awareness of the full cost or value of medical treatment on the part of consumers or providers, and little opportunity for individuals to choose their own coverage or make informed decisions with their doctors about treatment. Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster than the overall economy or personal incomes...
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...head: COST AND QUALITY ANALYSIS Healthcare cost and quality Grand Canyon University July 24th, 2012 Ethics, Policy, and Finance in the Health Care System Sally L. Clark A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare. Differences in HealthCare Cost and Quality Working in the healthcare system, you often wonder if the nation works on quality of care or do they work more on cost of healthcare. Quality of care is an important role in achieving the best healthcare. Cost of healthcare is based on incentives that support the effectiveness while curving the spending growth (MacReady, 2012). Reform needs to be provided a baseline in evaluating healthcare delivery systems for a broader success of payments and delivery models with payment providers (2012, p.2). Sometimes higher cost effects quality of care. Some decisions need to be made that may affect the “clinical and fiscal health of the nation” (2012 p.1). Differentiating Roles and Major Activities Public and Private agencies plays an important role on how healthcare is delivered. The Commonwealth Fund is a private...
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...8 Introduction: The healthcare industry is evolving both nationally and globally, and as a result, the challenges facing health care services delivery organizations are also increasing. Health care professionals are the decision-makers and also the ones closely associated with the day-to-day decision making processes affecting the delivery of health care services and goods to patients. The economic evaluation of the health care services delivery systems has proven to play an important role in the different types of health care decision-making. For example, formulary decisions, reimbursement decisions, high health cost decisions, and e-prescribing. This makes it a point of interest to assess the influence of economic evaluations on health care decision-making both at the macro, me so, and micro levels. Even though the impact of economic evaluation studies on health care decision making has been limited, there is an increasing requirement for the cost-effectiveness of the health care intervention to be considered when formulating and implementing guidelines for clinical practices. What is encouraging at this moment is the fact that health care decision-makers do recognize the usefulness and necessity of published economic evaluations that rightly inform the public about their decision making processes (Van Velden/Severens/Novak, 2006). Delivering value in health care therefore, will continue to be a challenge to health care services delivery organizations both in the...
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...clearly states the facts that currently affect the healthcare system in the U.S. and proposes solutions that are at our reach as individuals, as a community and as a country. We are a country that sets the tone for almost everything that is popular in the world and something as necessary to our livelihood as healthcare is, we certainly are not on top of how to set that tone in that aspect that should be as popular as the air we breathe. We have the ability to change the game as it is suggested in the movie, and persuade the behavior changes necessary for all Americans to make in order to control the management of diseases culture that we are currently in and turn it into a more preventive culture. The amount of money spent every year in the U.S. on healthcare is a number that is almost three times of what other industrialized countries spend per capita, and yet, our life expectancy is at number fifty in the world. Clearly, our outcomes are not commensurate with the money that is being spent. Preventive medicine is the model that we need to follow and we currently follow the disease management way of healthcare. 30% of the money spent per year is spent in vain, for, it does not improve the health of those treated. As suggested in the movie, we need to have more Primary Care Physicians that have the opportunity to educate, treat, prevent and follow up without the burden of productivity that is driving the healthcare system to be managed as a business rather than a social service...
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...ABC Organization Size: Small Healthcare Organization with less than 100 beds MISSION "ABC endeavours to provide comprehensive, quality healthcare in a convenient, compassionate and cost effective manner." VISION ABC is consistently at the forefront of evolving national healthcare reform. Our organization provides an innovative and integrated healthcare delivery system. We remain ever cognizant of our patients' needs and desires for high quality affordable healthcare. VALUES Compassion: We provide an environment that is caring and conducive to healing the whole person physically, emotionally and spiritually. We respect the individual needs, desires and rights of our patients. Quality: We believe in continuous quality of care and performance improvement as the foundation for preserving and enhancing healthcare delivery. Effective communication and education of our patients, physicians, staff and the community we serve are essential elements of this process. Comprehensive: We are committed to an integrated healthcare delivery system that encompasses the entire spectrum of healthcare delivery. This continuum of care encompasses all aspects of an individual's healthcare. Cost-effectiveness: We offer high quality healthcare that is accessible and affordable. CURRENT INFORMATION SYSTEM CONFIGURATION The hospital’s IT system is developed by the in house IT department and has been customized over the time. The OR Management System has a drawback of integration. The...
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...VISION FOR THE FUTURE OF NURSING 10 Human Genome Project completed the initial mapping and sequencing of a composite set of human genes in 2003” (p. 392). This is an area of nursing practice that nurses will question their own morals and ethics. With technology on the rise, there will be new ethical dilemmas and nurses will be more active in exploring ethical aspects of patient care. Nurses’ ethical perspective will be respected by other professionals and as a result, nurses in larger numbers will sit and serve on ethics committees as ethics consultants. As new roles become the norm, nurses need to be trained in these specific areas to have the knowledge how to care for these patients. Nursing care will become more important in the future as the nation’s demographic changes. Nurses must be culturally competent and recognize that cultural sensitivity begins with health care providers. The rise of community base health care is seen throughout the United States and nurses will be needed to fulfill these roles in the community base setting such as school nursing, hospice, clinics, HMOs, and other health care settings (Chitty & Black, 2010). Conclusion As different trend in nursing become more popular in the future professional nurses must keep up with the new trends and practice evidence-based nursing. Professional nurses must be aware of and incorporate in their daily practice nursing theories to care for their patients. Finally, with new trends and roles available to nurses, most...
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...The U.S. health care system comprises of different groups of entities. These different entities are insurance companies, different types of providers, physicians, hospitals, and patients. The main purpose of the U.S. health care system has always been to provide the best care possible to all citizens at an affordable low cost. For the past decades, the U.S. healthcare system has not being effective in terms of delivery, finance, management, and sustainability because it only reached out to part of its citizens. Majority of the population had limited access to care due to the spiraling cost involved. After researching through the healthcare system that has been in existence for decades, I see that the problem that affected delivery, management and sustainability of our healthcare system was finance “overwhelming cost from all angles”. Medical debt has no limit to any individual, it can be devastating and trigger other severe consequences. Even though a substantial number of people may have insurance through their employers, an unanticipated illness, accident, or even pregnancy can accrue unexpected expenses which could lead more people into severely devastating problems such as losing their homes, and bankruptcy. The rising cost of healthcare has dearly affected individual citizens and the government into a huge national deficit. Mostly, individuals who lived on limited income have trouble affording their co-pay as well as the exceedingly high levels of health plan cost sharing...
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...Bodies……………………………………………………………………………...4 Literature review………………….…………………………………………………………….....4 Challenges that are experienced in achieving and maintaining accreditation…………………..…5 The role of the URAC as an Accreditation Body………………………………………………....5 How the URAC accredits healthcare institutions….........................................................................6 Quality assessment and control solutions in accreditation ……………………………………......8 Implementation of quality improvement and accreditation solutions…………………………......9 Justification…………………………………….…………………………………………………10 Summary and conclusion……………………….…...……………………………………………10 References ………………………………………………………………………………………..11 Achieving and Maintaining Accreditation in Managed Care Managed healthcare organizations and professionals encounter numerous challenges on a yearly basis in the course of offering services, whereas the state, stakeholders, and clients (patients) expect to be reassured that bodies that render managed healthcare services are well equipped to meet their demands. Accreditation is, therefore, a detailed evaluation process through which an independent professional body or authority assesses another organization’s systems, structures, and procedures to certify that it satisfies the set industry criteria and standards (Bialek, Duffy & Moran, 2009). The evaluation and accreditation processes that are conducted by bodies such as URAC help in maintaining the quality of care in organizations...
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...FOR IMPROVING HEALTHCARE DELIVERY AND ORGANIZATION PERFORMANCE The present report is focused on identifying strategies for defining, measuring, and improving performance of the healthcare delivery system in any organization. The scope of the report is kept limited to the frontline health service delivery system like hospitals and clinics which directly interacts with patients. The main objective of the report is to identify important determinants of organizational performance in healthcare and to present examples of solutions which can improve its functioning and performance. Identifying present performance: Before formatting future strategy for any organization, it is important to evaluate its present performance. It is important for any organization to deliver healthcare of high quality, high efficiency, easy accessibility, and easy utility; to be considered as a high performance organization. Additionally, the high performance organization must be open to enable learning and to have well planned strategies to access support from different parts of the society to attain sustainability. Thus section discusses the six main outcomes required by high performance organization which are quality, efficiency, utilization, access, learning, and sustainability. 1. Quality: Research on the clinical quality of the healthcare is as old as the healthcare delivery system itself. The researchers identify clinical quality as safe and medically appropriate healthcare. Furthermore,...
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...Healthcare delivery in India - effects of Public policy, IT and Insurance Bhavik Kaul 1 Gaurav Dalvi 2 Great Lakes Institute of Management, Chennai October 2012 Abstract The global healthcare industry has greatly transformed itself into a professional service system, wherein each stakeholder has to justify its performance. In the increasingly globalized market, private healthcare providers have started dominating the supply side. Healthcare sector in India needs to be reoriented globally towards excellent service promotions and healthcare be made available at lower cost. With this view we plan to study the impact of various factors on the quality of healthcare delivery in India over the next decade. This research will attempt to verify the impact of the mentioned crucial factors on the Healthcare delivery in India through an empirical research and provide some assessment of the deficit in access to health services through structured integrated way called the Gaps Model of Service Quality which will take into account significant gaps identified & suggest methods to close the gaps. These suggestions will be used to make recommendations towards a 10 year incremental National Health Plan. 1. Theory & Hypothesis The 3 areas that we intend to include into our study of the healthcare landscape are – 1) Public Policy 2) Insurance 3) Healthcare Information Technology Systems (HIT) a. Hypothesis 1: Favorable National Health policies will have a positive impact...
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...advice on the national level that addresses issues of medical care, education, and research. Through research, collected data, and nurse-led solutions, the IOM created an informative report in 2010 called The Future of Nursing: Leading Change, Advancing Health, which provides specific recommendations on the improvement of the nursing workforce and the healthcare delivery system. The report is directed towards various entities; individual policy makers, national state and government leaders, licensing bodies, educational institutions and consumer advocates, are just to name a few. Three particular recommendations, transforming education, transforming practice and transforming leadership, will be further discussed to display how each transformation will impact changes in the nursing profession and the health care delivery system. Transforming Education The first recommendation to be discussed that will impact change in the nursing profession and the health care delivery system is the transformation of education. The IOM report states that “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (IOM, 2010, p. 163). Several educational pathways have become available for nurses to smoothly transition from the Associate Degree in Nursing (ADN) to the Bachelor of Science in Nursing (BSN) degree. The IOM report explains how many hospitals are making arrangements with colleges and universities in...
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