Case Study: Ambulatory Care Delivery System

A surgical facility in which ambulatory surgical cases are performed and which is licensed as an ambulatory surgery facility, separate and apart from any other facility license. (The ambulatory surgery facility may be physically connected to another licensed facility, such as a hospital, but is corporately and administratively distinct.)

Decrease in funding is another economic challenge in health care. The amount of finances coming from various sources not just the

In this assignment, we are asked to act as a chief operating officer of a hospital tasked with opening a new ambulatory care center in my city. We will specify a perspective of choice which are either professional autonomy, social contract, or free market. Describe at least two (2) advantages and two (2) disadvantages of your chosen perspective. Provide at least two (2) examples of the perspective in action to support your response. Additionally, analyze three (3) key components sources of law related to the effects that each source could potentially have on your healthcare organization’s new initiative.

Moving forward with the social problems issue chosen for this course, I have found two reliable resources that are underway of working out the United States health care system, seeing as how there are so many concerns and issues that patients, physicians, families, and insurance programs are facing. The current structure of the health care system has been sustained and used for years simply because it rests on its own set of reinforcing elements. These elements include: “…organization by specialty with independent private-practice physicians; measurement of “quality” defined as process compliance; cost accounting driven not by costs but by charges; fee-for-service payments by specialty with rampant cross-subsidies; delivery systems with duplicative service lines and little integration; fragmentation of patient populations such that most providers do not have critical masses of patients with a given medical condition; soloed IT systems around medical specialties,” (Mayberry, et al., 2006).

Given that we are talking about medicine, it makes sense to begin by asking: are there sound medical or scientific reasons for the current fragmentation of U.S. health care. The fact that other nations have far more integrated health care systems and hospitals dominated by salaried doctors, and achieve similar or better health results at lower cost, belies any claim that medicine or science inherently requires U.S. levels of disintegration. This same fact seems inconsistent with the claim that the sociology of the medical profession inherently requires such fragmentation. Further, Institute of Medicine studies of the U.S. system have condemned fragmentation because it leads to more medical errors, meaning that, if anything, sound medicine and science cuts in the opposite direction and is being overwhelmed by other causes. This much may seem obvious, but it has an important implication. If medical or scientific reasons are not driving current health care fragmentation, it is unlikely that fragmentation is going to be cured by studies that show how it leads to medical errors, by analyses demonstrating medically optimal team methods, or by new information technologies that help hospitals and physicians coordinate better. Those may help at the margins, but to really tackle fragmentation we are going to have to address the underlying structural cause that has been driving U.S. health care to levels of disintegration that are medically

Access to health care is a significant problem. There are many stakeholders involved in the health care system and this paper will outline how the problems with health care access affect them. In general, the major stakeholders of the health care system are the patients, the physicians, nurses, other staff, management, shareholders, politicians and regulators. The families of patients, insurance companies, suppliers, medical schools and others are all key stakeholders worthy of consideration as well. The problem with access to health care is that health care access is uneven, so that many people have no access.

The five factors that are highly influenced to the rapid growth of ambulatory services. In order to reach the initial purpose to reduce the health care service cost, government and private sectors have been initiating many actions on the ambulatory services. Therefore, the ambulatory care has been moved quickly to the freestanding and independently owned facilities because of those factors.

Shi and Singh (2015) noted increase competition in hospitals from an expanded scope of outpatient services such as home health agencies, ambulatory care, urgent care, and outpatient surgery.

Within ambulatory clinics, there are three levels of service that are preformed based on the type of diagnosis and treatment recommendations. Level one ambulatory service is considered an option to inpatient care with both patient and service parts that corresponds with the point of intensity. The role of this level is to offer alleviation from acute symptom reducing mechanisms such as less severe residential constituents such as the family treatment home for children. Level two ambulatory services are set apart by effective treatment; regularly with a rehab or transitional process that is built-in to the care plan. This process is complete in a staff-supported setting that expands past the care setting into the important sections of the patient’s district

I chose to report in the area of general medical and surgical hospital, although it provides explanation on cost and revenue it fails to mention them in detail. The article stated that for the past decade hospitals have decreased in numbers, as well as in patient hospital beds. However, reading the article under organization and structure it reveals cost and revenue. For instances in the late 2000’s, the largest source of income for hospitals came from Medicare and Medicaid services, of 2.24 trillion, in governmental funds they provided 1.04 million or 46.2 percent. Medicaid accounted for 19.2 percent and Medicare, 14.7 percent. Private insurances paid 34.6 percent which would be over 775 billion, finally out-of-pocket expenses accounted for 12 percent, which was equivalent to 268.9 billion. The remaining 7.2 percent came from other sources of revenue.

Dialysis clinics like DaVita and Fresenius, being the two largest for-profit corporations are fighting against a proposed Senate Bill No.349 (SB 349, 2017) that would necessitate dialysis clinics in California to have a mandated minimum staffing requirement. Furthermore, SB 349 (2017), as authored by Senator Ricardo Lara, would also require that dialysis clinics to provide patients with forty-five (45) minute transition time, and frequent inspection be done yearly instead of every five to six years (SB 349, 2017). With this regulation in place, patients will be provided with a higher level of care. The mandated staffing ratios would also help promote patient safety. Furthermore, with greater than 66,000 dialysis patients in

Pennsylvania is a large state that consists of 67 counties. These counties vary in size, demographics, terrain, setting, population, and employment opportunities. These factors generate challenges in providing consistent healthcare across the state. Further complicating the matter is the fact that Pennsylvania has the third largest number of rural counties in the United States. The following proposal will review the current status of the health care system in Pennsylvania and identify areas in which it can be improved.

I enjoyed reading the thread about the cause for fragmentation in US Health care system and the concept of reform for whole. However, the fragmentation in health care system is by administration for participating in health care coverage for health insurance is the hierarchy of socioeconomic for those who have and they have not.

Health care system in the U.S is a very complex system that undergoes significant evolutions as part of

Building and leasing costs. This is an important factor for most companies to minimize overall cost to offer lower prices to customers and also optimize profits but for hospitals this is of little relevance because good qualities building in good locations don’t come cheap.