...of much debate. At one extreme are those who argue that Americans have the best healthcare system in the world, pointing to the freely available medical technology and state-of-the-art facilities that have become so symbolic of our system. At the other extreme are those who accuse our system of being fragmented and inefficient, pointing to the fact that the U.S. spends more on health care than any other country in the world, yet still suffers from a substantial rate of uninsured, uneven quality, and administrative waste (Sultz, 2013). A review of U.S. healthcare expenses by the Institute of Medicine revealed that thirty cents of every dollar spent on medical care is wasted, adding up to $750 billion annually (http://www.iom.edu, 2012). The Institute of Medicine report identifies six major areas of medical waste: unnecessary services; inefficient delivery of care; excess administrative costs; inflated prices; prevention failures; and fraud (http://www.iom.edu, 2012). Americans spend twice as much on health care per capita than any other country in the world. In fact, according to a series of studies by the consulting firm McKinsey & Co, the US spends more on health care than the next ten biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain, and Australia (http://www.mckinsey.com, 2008) Introduction Most industrialized nations have single payer systems. Many argue that such a system would eliminate the convoluted paperwork...
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...services that includes automation services, analytics and transaction intensive processing. Segments include Public Sector, Healthcare and Commercial Industries. Its portfolio includes multi-industry service offerings in a range of markets, such as customer care, payments services, transportation and healthcare. The Public Sector segment provides government-centered business process services and subject matter experts to the U.S. federal, state, local, and foreign governments. It is organized into two primary businesses: (1) Federal, State & Local Government and (2) Transportation. The Company provides revenue generating transportation services to government clients throughout...
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...Single-Payer Healthcare Reform in the United States Not long ago, Tina Bachtel, a beautiful thirty-five-year-old women from Ohio walked into a local healthcare clinic seeking treatment. Tina was pregnant and having health issues. She had visited the clinic prior to that day while uninsured which resulted in her having a large unpaid balance. Bachtel was denied treatment. She was told she could only be granted service if she paid one hundred dollars per visit. Tina Bachtel did not have the money to pay upfront. Shortly after leaving the hospital, Tina Bachtel and her baby died (Krugman). Healthcare nightmares like these are not uncommon in the United States. Reform of the American healthcare system is crucial for a healthier and more financially...
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...continues to spend significantly more on health care than any country in the world; however, even though with this statistic the United States has a lot of uninsured and does not have the healthiest citizens. The lack of universal healthcare coverage in the United States has been a forefront issue. With the overwhelming amount of uninsured Americans and the past unsuccessful efforts of health care reform, the possibility of universal health care seemed to be very unlikely. The new healthcare reform bill that was recently passed under Obama’s administration anticipates covering 30 more million of the uninsured (Riegelman, 2010). However, this bill does not offer universal healthcare. While excellent medical care is available in the United States, the rising cost and the U.S. health care delivery system present many challenges for the consumer and lawmakers. This paper addresses four dimensions that are pivotal to the successes and failures of the system: cost, efficiency, quality. The cost of the U.S. health care system is higher than any country in the world. Its efficiency is also under heavy scrutiny. If it were not an emergency most physicians would require insurance verification. Therefore, patients would be delayed of treatment. Moreover, The healthcare system in the U.S. should be redesigned in terms of prevention rather than treatment when people are already sick. Insurance should not go higher for people that have pre-existing conditions or with more health risks. Prevention...
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...While managed care can be beneficial for most parties, it can also be a nightmare for a healthcare provider. The idea behind managed care is that the managed care network is in charge of the rates and the networks in which the recipient of the insurance policy can receive care (Medline Plus, 2014). This can sometimes mean that healthcare is not the full focus and that the care system is more of a business which can lead to complications for the provider (Welch, n.d). Managed care is a multi-faceted and complicated system. At its very barest and basic definition it is “a healthcare plan or system that seeks to control medical coast by contracting with a network of providers” (Dictionary, 2015). This means that the network providers control...
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...Full draft The United States spends 17.6 percent of its Gross Domestic Product (GDP) on healthcare each year (Kane, 2012), this amounts to 17.6 cents of every U.S. dollar. The Organization for Economic Co-operation and Development (OECD) is an economic group comprised of 34 member nations including the United States. The OECD average is between 6 and 8 percent GDP spent on healthcare. Among OECD nations the U.S. scores below average in almost all areas of healthcare, despite spending 2 ½ times more of its economy on the health industry.There are many reasons for this and just as many proposed solutions. I will address three potential solutions here. These are price variations for services, bureaucratic waste, and prescription oversite. Price variation is a substantial part of why healthcare costs so much in the United States. Prices for the same procedure vary by hospital, region, provider and insurer. For the first example, we will look at the cost of a lower joint replacement. According to a Washington Post article (Kliff and Keating, Ye2013r) the price in Virginia varies from $25,000 to $117,000. While in Texas, two hospitals that are 5 miles apart range from $42,632 to $160,832. The second example comes from two hospitals in New York City, which have a price variation of 321% for treating complicated cases of asthma and bronchitis. The difference is $34,310 compared to $8,159. (Kliff and Keating, Ye2013r) Other countries have developed a set fee schedule to address...
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...LINCOLN COUNTY HOSPITAL HAWKEYE (Telemedicine program) Overall idea: We plan to propose that the hospital continue its quality initiatives and advertise to patients via low-cost options. We think the hospital could market telemedicine to in-home users, cardiac patients and a range of inpatients (expanding services offered to inpatients). Our assessment differs from others in that negotiating with payers (where possible) is also a consideration. 1. Background/Situation Assessment SWOT Analysis Strength: Strong partners (providence sacred heart) Physician alignment Competition is less First telemed program there 24 hours (ER, helipad) Low cost Funding from local club organizations Advanced technology (detailed monitoring) Weakness: Limited resources Community is small Unknown community reaction to new technology Single service line (cardio, one machine) Accurate assessment of internal buy-in? Threats: Competition can be there (other telemed program Valley or Deaconess or other national chains/organizations) Patient can lack confidence, as it’s new Policy critical access status Poor outcomes Opportunities: With ACA, re-admissions can decrease, patient satisfaction can increase Reducing costs, shared savings programs with 3rd party insurers Expand service lines/ inpatient Increase in revenue and reimbursements InTouch Reduces cost for patient Improving community good-will Increased appeal for Physician recruitment Federal...
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...The Parity of Healthcare Model is actually made up of two separate models that where put together. One of them is the Managed Care Quaternion, which was developed by Coppola in 2003. This model is actually become very popular and has gained much support. So much so some state agencies are using it to make decisions with, and try to identify future needs. This is even a more powerful tool when it is used in tandem with the Iron Triangle, which was created by Kissick in the 1990’s. Kissick recognized that there are three important factors when trying to make health care related decisions, which are cost, quality, and access. The main idea here is that if you change the angle of one it will also affect the other two constructs. For example, if a hospital spends a lot of money buying new diagnostic equipment and training people/hiring people to run that equipment this will increase the cost of health care. This increase in cost will limit who could gain access to health care at your facility. The flip side of this coin is if you want to stay accessible to most people you will have to keep cost down which may mean your quality might not be as good as it could be. This might mean not buying the new version of some kind of diagnostic equipment that you may already have (Ledlow & Coppola, 2001, p. 288). When these two models (Managed Care Quaternion & Iron Triangle) are put together it creates what is known as the Parity of Healthcare. If we look at it from the point of...
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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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...opinion? The current focus on continuous improvement with a concentrated effort to bring daily engagement into the organization’s specialty care areas is a right focus. In my opinion, PAMF when it’s focusing on care area especially it’s a not-for-profit healthcare organization, its support the providers and patients in their efforts to get to better care. Lean leaders within the organization partners with departments improving innovation and value in healthcare. That quality alliance steering committee, a multi-stakeholder group of employees, insurers, providers,...
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...EMPOWERING THE NEW HEALTHCARE ECOSYSTEM 2 EMPOWERING THE NEW HEALTHCARE ECOSYSTEM Today, the healthcare industry finds itself on the threshold of a new era in which key stakeholders, empowered by technology, are breaking down barriers and redefining what’s possible in medical care. Find out how IT is shaping this new healthcare ecosystem. A NEW ERA Never before has the healthcare industry offered so much hope amid so much uncertainty. In the last decade, we have seen the unlocking of the human genome, which has put personalized and predictive medicine within reach for the first time in history. Advances in biomedicine and pharmaceuticals are achieving unprecedented success against formerly intractable diseases. And the next generation of information technology is sparking innovation across the healthcare value chain. Yet we are also living in a time of great economic and social upheaval, with healthcare businesses and organizations contending with extraordinary new financial, demographic, and regulatory pressures. A challenging global economy continues to strain the bottom lines of providers, payers, and pharmaceutical companies - not to mention the businesses and taxpayers who ultimately foot the bill. What’s more, the economics of healthcare are set to become even tougher in the years ahead as aging populations in industrial countries place new demands on both private and public healthcare systems. Tighter finances and thinning margins have made cost cutting and operational...
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...The U.S. health care system is the subject of much differentiating debates. On one side we have those who argue that Americans have the “best health care system in the world”, pointing to our freely available medical technology and state-of-the-art facilities that have become so highly symbolic of its system. On the hand we have those who criticize the American system as being fragmented and inefficient, pointing to the fact that America spends more on health care than any other country in the world yet still suffers from massive un-insurance, uneven quality, and administrative waste. Understanding the debate between these two diametrically opposed viewpoints requires a basic understanding of the structure of the U.S. health care system. This paper will explain the organization and financing of the system, as well as explain the U.S. health care system in a greater perspective. For most people, the frightening prospect of being unemployed, losing health insurance coverage, having inadequate insurance benefits, or living in a rural community without a physician raises one vital access-related question: Will I be able to get the care I need if I become seriously ill? Because of health care's special status, society has an ethical obligation to ensure that all people have access to an adequate level of health care including access to new technologies as well as existing ones, without facing excessive burdens in obtaining such care. Society's recognition and implementation of...
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...Name : Shabana Ambreen Assignment # 1-- The Marketing Process Instructor-- HAROLD GRIFFIN Course-- Essentials of Healthcare Marketing Date-- 01/24/11 The present environments for healthcare organizations contain many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer outlook, increased competition, and strengthen governmental pressure. Meeting these challenges will require healthcare organizations to go through fundamental changes and to continuously inquire about new behavior to produce future value. Marketing can not only be seen as a selling process, when it involves introducing value and creating well-built relationships among customers. Management also delivers a strong role in each critical business decision making sure it is made with full knowledge of the impact it will have on their consumers. In addition, Marketing is a development within a company relying on a strong foundation within a staff regardless of association or position. A company must push on an uphill climb towards profits, satisfaction and success. Orthopedics is a branch of medical science that deals with disorders and deformities of the spine and joints . For healthcare professionals who do not have experience in the business world, promoting orthopedics might seems like a daunting task. However, there are a variety of strategies you can use to market and promote your orthopedics practice. That means taking careful steps to ensure...
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...HCS 514 University of Phoenix Decision Making Case Study Today’s healthcare organizations have the difficult task of maintaining adequate operations in the economic climate we live in. Budget cuts have hit all organizations in corporate America as well as the healthcare industry. Staying afloat in these economic times requires the implementation of difficult decisions, often including reduction of services. This has never been more prevalent than in the health care industry. Healthcare organizations are being hit hard. Hospitals and outpatient clinics are operating with budget deficits. Many organizations are now required to cut or eliminate clinical services in order to remain operational. Determining which clinical services should be cut requires managerial staff to make the difficult decision. Managers require tools that enable them to best make that difficult decision to best address the health care needs of the community served. The New York State Medicaid program is the largest single payer of healthcare in the state of NY to the tune of about $47 billion dollars (“Advocates,” 2008). New York has the nation’s highest total and per-patient Medicaid spending and must link spending to healthcare priorities. The number of uninsured patients has steadily increased over the past few years. Funding losses and projected increased operating expenses have left many healthcare organizations with budget shortfalls. In New York State alone various facilities...
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...Healthcare reform and policy establishment has been driven by politics since modern medicine began to make a rise in our western culture. In 1935, President Franklin Roosevelt was the first to attempt to integrate a national health care program within social security. President Harry Truman proposed a multi payer insurance fund while in office but also was unsuccessful. Multiple presidents have attempted to succeed at providing healthcare reform and finally succeeded in 2010 with the Affordable Care Act. Each political party has their own agenda that they use to guide the policies they support. Unfortunately, many health care providers are not aware of the policy challenges that our profession faces daily and the impact our government has on healthcare policies. Policy making is driven by committees within our federal and state government where bills that have been presented are reviewed. Each party typically will push for new policies that benefit their political party often voting for bills in the legislature that gain the most popular vote. The passing of policies through our legislature impacts healthcare in various ways. For example take the Bill presented by Illinois congresswomen on safe patient-staff ratio. If this bill is passed and becomes policy, hospital systems will be forced to revamp patient census requirements, when there is only one study available showing improved quality of care. . It is crucial that evidence based practice be incorporated with policy making...
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