...Healthcare Utilization Paper Option A Tracie Y. Smith HCS/235 August 03, 2015 Mrs. Darnecia Garner Healthcare Utilization Paper The very mention of healthcare can send some people’s blood pressure up the charts. The debate over healthcare and who deserves what has been a constant ongoing issue since the early 1900s. There are some people who think medical care should be for the people who can afford to pay for it, and others think medical care should be a right to everyone. This paper will address five questions and provide the writers opinion on the matter. A recent healthcare legislation reform that has expanded access to care for individuals who otherwise could not afford it is, The Affordable Care Act. The passage of this act by the Obama administration during the early stages of his presidency puts consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights gives the American people the stability and flexibility they need to make informed choices about their health” (US Department of Health and Human Services, 2015) . This act allows individuals to gain access to insurance through a marketplace or government subsidies; therefore creating access to services such as checkups, well woman exams, and health prevention for heart disease, and diabetes that many people were not getting because of costs. One way access may inhibited would be locating a physician who will accept...
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...reform is needed now Almost twenty percent of all Americans lack any form of healthcare insurance. Many more are underinsured. Consequently, a great number of Americans receive little or no healthcare at all. Many, but not all, of these people are women and children. Some are destitute, but most are not. Quite a few of these uninsured are actually working families who cannot afford coverage, yet, earn too much to be eligible for Medi-Cal, the state's healthcare provider. In a great society, such as ours, it is a pity that we cannot provide what should be a basic human right, to all of our citizens, equally. The level or quality of healthcare should be an inalienable right of all people, not a privilege of the few. Money should not be allowed to dictate that some should live in good health while others suffer in humiliation and anger. The lack of universal healthcare is one of the greatest social inequities of our society. A single payer healthcare system would go a long way toward leveling the playing field for all. A single payer system is one in which a single entity, such as Medi-Cal, procures, provides and or pays for all healthcare needs. Providing uniform and universal healthcare for all, regardless of race or stature, can only improve our entire civilization. The common good is served best by serving all. However, profits dictate the rules in U.S. healthcare today. So long as healthcare thrives only as a function of profit, a single payer system will never come...
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...Health Care Utilization Kelly A Faust HCS/235 July 21, 2015 Dr Lisa Church Health care in the United States is teetering on the edge; it will either turn into universal health care or become too expensive for the majority of Americans. Recent health care reform has been developed to lower the cost of health care and make it more widely available. However, health care in the United State may start trending towards becoming a universal system. There are many arguments to both sides of health care reform and universal health care. The Affordable Care Act is one of the most recent and controversial of the health care reform acts. The Affordable Care Act was created to lower the costs of health care for patients, providers, and the United States government. The Affordable Care Act is estimated to “reduce the federal budget deficit by more than $100 billion over the first decade and by more than $1 trillion between 2020 and 2030” (Orszag & Emanuel, 2010, para. 3). On top of saving the government money the Affordable Care Act also expands the access to health care. Starting in 2014 patients cannot be decline health insurance coverage due to a pre-existing condition. This will allow patients who have been without health insurance for at least six months to get insurance no matter their income (The United States Department of Health and Human Services, n.d.). Allow all patients to get health insurance will help lower the cost of premiums for those who already have insurance...
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...Health Care Utilization in the United States HCS/235-Health Care Delivery in the United States University of Phoenix January 29, 2013 Over the past decade, government operated and privately owned health care organizations have made improvements identifying patient disabilities, discovering alternative treatments at the patient’s discretion, identifying the cause of diseases, and discovering lifesaving cures. The current United States health care delivery system has undergone enormous changes throughout the years. People the United States utilize health care services for many reasons: to prevent disease, to prevent future illnesses, to eliminate pain, and promote a healthier lifestyle to patients. The Patient Protection and Affordable Act will cover over 95 percent of the nation (House Committee, 2010). These new laws and provisions are provided much needed health care to the more rural areas of the country. There are new measures to stop overpayments in Medicare by 14 percent (House Committee, 2010). The bill provides people with information about their doctor and future medical staff. Also, there will be stricter provisions against medical fraud, private insurance claims, and abuse in Medicare. The Patient Protection and Affordable Care Act will provide great low cost health insurance care to millions of American nationwide. The congressional Budget Office (CBO) predicted that this bill alone will reduce the national deficit by $138 billion dollars over the...
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...Production Options at Prime Safety Ltd. Case Study Analysis About Prime Safety Ltd.: PSL is a manufacturer of corporate and industrial clothing in Karachi, Pakistan. The characteristics of operations of the company are – • Wide variety of clothes • A majority of customers have order size below 500 • The manufacturing process involves similar operations but varying work content Issue in the Case: To improve flexibility and operational efficiency, PSL has plans to implement modular manufacturing in sewing department. The issue in the case is to analyze the impact of this shift on the operational efficiency, employee coordination and customer service of the organization and recommend a suitable course of action. Cloth manufacturing process: The structure of the manufacturing process is - Parts -> Pre-assembly -> Final Assembly Process flow diagram: Existing process in sewing department: Assembly line or Chain Flow The main characteristics of this process are - • Bundled routing of material • Each operator performs same operation on all parts. This leads to worker specialization in a particular task assigned to him. • Modified bundle system is used for short order quantities Problems with existing process: Switching time for a different style is very high, about 6 to 8 hrs. This leads to underutilization of the existing machinery as well as other problems like lack of flow and rhythm in the work done by the operators. Why did...
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...In manufacturing, facility layout consists of configuring the plant site with lines, buildings, major facilities, work areas, aisles, and other pertinent features such as department boundaries. While facility layout for services may be similar to that for manufacturing, it also may be somewhat differents is the case with offices, retailers, and warehouses. Because of its relative permanence, facility layout probably is one of the most crucial elements affecting efficiency. An efficient layout can reduce unnecessary material handling, help to keep costs low, and maintain product flow through the facility. Firms in the upper left-hand corner of the product-process matrix have a process structure known as a jumbled flow or a disconnected or intermittent line flow. Upper-left firms generally have a process layout. Firms in the lower right-hand corner of the product-process matrix can have a line or continuous flow. Firms in the lower-right part of the matrix generally have a product layout. Other types of layouts include fixed-position, combination, cellular, and certain types of service layouts. PROCESS LAYOUT Process layouts are found primarily in job shops, or firms that produce customized, low-volume products that may require different processing requirements and sequences of operations. Process layouts are facility configurations in which operations of a similar nature or function are grouped together. As such, they occasionally are referred to as functional layouts. Their...
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...as mass production. 1) _____________ 2) A(n) ________ is an activity at which a firm excels as a world-class leader. 2) _____________ 3) The ________ is a collection of independent firms that use information technology to coordinate their value chains to collectively produce a product or service for a market. 3) _____________ 4) ________ refers to the existence of laws that permit individuals to recover damages done to them by other actors, systems, or organizations. 4) _____________ 5) The ________ model prohibits an organization from collecting any personal information unless the individual specifically takes action to approve information collection and use. 5) _____________ 6) ________ can boost server utilization rates to 70 percent or higher. 6) _____________ 7) A(n) ________ activity is a part of the organization's infrastructure, human resources, technology, and procurement that makes the delivery of the firm's products or services possible. 7) _____________ 8) ________ is permission given with knowledge of all the facts needed to make a rational decision. 8) _____________ 9) ________ computing is an industry-wide effort to develop systems that can configure, optimize, tune, heal, and protect themselves from outside intruders and self-destruction. 9) _____________ 10) A(n) ________ company uses networks to link people, assets, and ideas, enabling it to work with other companies to create products and services without...
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...The Business Context The call centre of the Eastern Medical Faculty Foundation, hereafter referred to as EMFF, provides a competitive advantage to the Internal Medicine Department of the Chicago School of Medicine through the delivery of efficient and high quality service to patients. Treating patients generates revenue the Internal Medicine Department and contributes to investments in research in the highly competitive healthcare sector. Unfortunately, declining customer satisfaction, as evidenced in a growing number of customer complaints, suggests the quality of service is deteriorating and threatens the very competitive advantage of the EMFF. Problem Description Laura Jones, supervisor of the call centre, seeks to remedy operational deficiencies. Laura suspects the call centre suffers from insufficient capacity and/or scheduling problems. The call centre faces high employee turnover, which is consistent with the industry norm. As a result most customer care representatives (CCRs) have limited experience. Only two CCRs have over two years experience while the remaining seven have worked at the centre for less than one year. While new CCRs are given standard training they lack incentives linked to key performance indicators. Compounding the problem is the increasing number of duties assigned to CCRs, including; scheduling patients, translating, handling queries, providing advice on first aid, and to performing administrative duties. Time spent on translation and...
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...BenihanaOperations Management Education Review 1: 5-28. © 2005 NeilsonJournals Publishing. Benihana: A New Look at an Old Classic Ricardo Ernst and Glen M. Schmidt Georgetown University Abstract. This short case heavily references the “old classic” HBS case on Benihana, and is intended to be used in conjunction with a simulation that helps students gain insight into how Benihana achieved its profitability. The simulation helps bring out many key operational issues, such as how variability in demand and in processing can negatively impact profitability. The case analysis goes on to show how Benihana reduces variability, and illustrates concepts such as the product-process spectrum, the impact of a bottleneck, and the advantage of simultaneous product and process engineering. Keywords: process analysis, simulation, variability, queueing. 1. Introductory Note Benihana might be thought of as an “old classic” in Operations Management. The original Harvard Business School (HBS) version was published in 1972, but the Harvard case continues to be a best seller. This short case heavily references the HBS case, number 9-673-057 (rev. Dec. 14, 1998), however what has been added to enhance the case experience is a simulation that can be used to gain insight into how the operation achieves its profitability, as compared to other restaurants. There is a set of web sites associated with this case note, intended for both students and instructors, at http://www.msb.edu/faculty/schmidtg/...
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...The overall goal in today’s healthcare is to obtain better care and lower the cost of receiving healthcare. As the healthcare system is comprised of employers, physicians, healthcare professionals, consumer and patient advocacy groups, patients quality organizations, health plans, hospitals and unions, they all must join together to establish an effective and efficient system. The PCMH’s do just this as they improve health outcomes, heighten the patient and provider experience of care. Also they reduce expensive, unnecessary hospital and emergency department utilization. On the opposing side, the healthcare systems that focus more on volume rather than value are constantly facing inefficiencies, having inconsistent health outcomes, and unstable financials. For these reasons there has been growing support for the PCMH across the vast majority of the United States. One of the most influencial benefits of the PCMH is the patient and family engagement. The PCMH’s initiatives are conveying the expectation for authentic patient and family engagements. This type of engagement happens at a few different levels within its system. As a patient one of the most important engagements is at the clinical encounter. This is where the patient and family engage in the care, the planning, and most importantly the decision-making. One of the hardest and most difficult process’ in your health is making decisions. PCMH’s give the patient and family a sense of trust and comfort. Engagements also occur...
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...Executive Summary With the evolution of the Pharmaceutical industry in the US and the current decline of the blockbuster products of Eli Lilly which were coming to an end of their life cycle, the company is in the process of developing three new products that plan to launch in 1996. A great number of factors such as decrease of the industry growth rate, steady decline of innovation, increasing competition from competitors, generic drug substitutes, government regulations and an ever increasing cost in manufacturing, R&D and quality protocols and processes have made the decision to launch new products into the market place a necessity and created a topic of debate within the management and leadership of the company. In response to these conditions, the management has established a company-wide initiative and goals to accomplish in the launching of their three new upcoming products. These goals were set up keeping in mind that the company wanted to bring new innovative products to their customers faster, cheaper and serving the needs of their customers. 1. Reduce manufacturing costs by 25%. 2. Reduce product development lead time by 50% as compared to the current lead time of 8 to 12 years. 3. Never Stock out – meet projected manufacturing demands. The dilemma facing this company and the upcoming challenge has given rise to a difficult decision by Steve Muller, Manager of Strategic Facilities and Planning at Eli Lily and Company. The decision was to decide on the type...
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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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...health care and economics are connected in the sense of sharing the same terms such as resources, quality, and cost. The objective of this paper is to analyze how the terms of cost, quality and resources are similar and yet dissimilar in healthcare and economics. Resource The term resource is defined as the product, asset, or other service with limited availability utilized to generate commodities and services that convene to human requirements and desires (Gretzen, 2007). As a result of these resources can be restricted, many economists, decision makers, and health care providers are forced to find ways to efficiently allocate resources within their organization in order to maximize cost effectiveness. Economic resources are also found to have a substantial and considerable effect on the utilization of medical care (Chung, 2006). Healthcare services are provided to consumers by the utilization of resources such as personnel or work force, equipment, funds, and facilities. Consequently, economics and health care utilize different types of resources to produce services in order to meet people’s healthcare needs. As mentioned before there are many similarities in both in health care and economics when organizations deal with resource utilization (Gretzen, 2007). An example of this would be when...
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...performance to meet multiple internal and external needs and demands. Internally they measure current performance that identifies the strengths and weaknesses of the current process giving insight of areas that needs improvement. When measuring the external performance objectives you are assessing healthcare provider accountability, decision-making, public reporting, organizational evaluation and supporting national improvement goals and activities. The framework for measurement is support by leadership commitment, staff understanding and participation, partnership with key stakeholders, performance improvement oversight, use of a performance improvement method, development of performance improvement protocol, the identification and response to performance improvement resources, recognition and acknowledgement of performance improvement efforts and continuous assessment of improvement efforts. Control charts and comparison charts are tools used to track performance measurement data. Control charts mange process stability and control, it is a graph with a central line used to study how process changes over time within an organizations norms, they are able to tell a healthcare organization whether the changes they made towards quality improvement was effective. Comparison chart analysis evaluates the organizations performance against the standard norm of several organizations. Chapter 8 The profiling of physicians is to...
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...Introduction In Health care, quality and utilization management have been forced into the spotlight by an insatiable demand for technologically advancing services, a legal system that compels physician to order unnecessary services, and the costs that are soaring higher than ever. The inconsistent use, overuse, misuse or even under used healthcare services has created inefficiencies and value concerns that demand oversight to ensure the best care is received while utilizing resources in the most efficient manner. "The knowledgeable health reporter for the Boston Globe, Betsy Lehman, died from an overdose during chemotherapy. Willie King had the wrong leg amputated. Ben Kolb was eight years old when he died during "minor" surgery due to a drug mix-up."[i] The Institute of Medicine Committee on Quality of Health Care in America identified strategies for quality improvement through two historic reports: To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century[ii]. The IOM published the "To Err is Human" study which showed that these horrible examples (commonly referred to as "Never Events") were only the tip of the iceberg. The study found that adverse events occurred in 2.9 to 3.7 percent of every hospitalization and that over half of all adverse events had resulted from medical errors that could have been prevented. To apply these numbers across American's nearly 34 million hospital admissions in 1997...
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