Case Study : Healthcare And Associates

The healthcare industry consists of many strengths and weaknesses during the improvement of patient safety, efficient operations, reduction of medical errors, and ensuring that they provide timely access to all patient information. This will have to still comply with all legal guidelines as they control costs and protect patient privacy. The adoption of advanced information technology is a popular strategy being used in the healthcare industry because it allows their weaknesses to be progressively diminished as they gain and use the opportunities necessary as an analytical tool. This would allow their capabilities to be further developed with the new technologies and processes used as they unify the adoption of IT standards. In order to stay competitive within the healthcare industry, then there must be specific actions and measures that must be taken to ensure a positive outcome. This includes external opportunities to increase the capability of the IT infrastructure in a national environment as the growth of industry standards are met in order to decrease the pressured threats of legal compliance through patient trust and the high cost of IT. The growing recognition of strategic leadership often leads to both improved financial stability and contact accessibility of the system. Some challenges that may occur within the healthcare system may cause issues in a hospital setting because of the centralized society of an organization. This is because of the different visions and

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

The fact that there are broad spectrums of services available within the Kaiser Permanente network makes it easier to coordinate patient care. For example the Northern California site has implemented programs that focus on five “imperatives of personal care”, which are: patients have to have a primary care doctor, they need to be able to see that physician, patients that call have a short telephone wait, patients should receive timely appointments and have a great care experience (Commonwealth fund June 2009). Care management definitely plays a crucial role in health care. When the patients needs are met and quality care is received the result is patient satisfaction and potentially cost saving for the organization. Patients not only have to deal with health issues, many experience challenges within their environment and certain limitations depending on socioeconomic status. Therefore , coordination of patient care is key to the success of any health care delivery system.

Healthcare is often driven by consumers and insurance companies; there is strong pushes for insurance companies to start paying better through Patient Care Medical Homes (PCMH) or Accountable Care Organizations (ACO) rather than paying at a per-visit basis (Hamlin, 2015). With PCMH or ACOs payment is made on a continuum of care, encouraging the provider to be involved in all aspects affecting health of the patient (Derksen, & Whelan,

In the past few years the American health care system has changed in many ways. First there was the passage of the Affordable Care Act, which is a law that is giving Americans the opportunity to obtain health care. Under this new law, in 2011, the Department of Health and Human Services decided to create Accountable Care Organizations (ACO) to help doctors, hospitals and other providers better coordinate care (AthenaHealth.com). The first idea of an Accountable Care Organization was brought up in 2006 by Elliot Fisher, MD, and now there are over 400 in the United States (Healthcatalyst.com). An ACO’s primary job is to improve health care delivery, performance, and payment. This is done through physicians and

While faced with competitive markets and globalization, companies are always looking for ways to improve their overall cost and pricing structure. It is becoming increasingly more difficult to maintain quality levels of service while providing good and services at rates where companies can remain profitable.

​Kaiser Health News recently published an article on a new trend in healthcare. This trend introduces the Accountable Care Organization (ACO). The Centers for Medicare and Medicaid services defines it as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients” (“Accountable Care Organization,” 2015). According to the Affordable Care Act (ACA), the goal of the ACO is to be able to share health cost-savings with providers who are able to save money by eliminating unnecessary procedures and reduce health costs while increasing quality of care. ACOs make health professionals become more accountable in maintaining good-quality, coordinated healthcare for a patient through a value-based system that is evaluated through a number of criteria and benchmarks (Ronai, 2011).

One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.

Coordinated care is reminiscent of a Health Maintenance Organization (HMO); however, the difference between the two is that an ACO does not have a gatekeeper like HMOs thus patients are free to see whichever provider or specialist accepts his or her insurance. Another key difference between ACOs and traditional hospital and physician payment programs is how they are paid. As mentioned above, healthcare systems are rewarded for coordinated quality care that is not duplicated; essentially, the program rewards health systems for keeping patients out of the hospital. In an ACO, hospitals are fined for readmissions and rewarded for reducing costs and population health. Although that sounds great from a patient’s perspective, it is a huge culture and financial change in the business of healthcare. In a descriptive study performed by Epstein et al., they found, “…no differences in baseline quality between hospitals that participated in an ACO and those that did not…found only modest differences in baseline

Seems like American Health Alliance is doing a great job coordinating their care to manage chronic conditions. When care is more organized with coordination with providers in delivering quality care, the medical outcome is usually successful with good patient experience. This encourages the patient to seek additional care when needed and to follow their treatment plan with a goal of achieving a healthier lifestyle.

The Affordable Care Act was a major healthcare reform centered on providing affordable health insurance coverage to all Americans regardless of their socioeconomic background or prior medical conditions. Under the Affordable Care Act, community health centers have been expanded to play an increasingly significant role in meeting the needs of the many newly insured individuals (Proser, Bysshe, Weaver, & Yee, 2015). Community health centers follow a unique model of care delivery that uses multiple primary healthcare team members, including PAs to increase capacity, reduce barriers to care, and improve patient outcomes while attempting to reduce the costs of care (Proser et al., 2015).

The current health care sector is too costly and too fragmented with a lot of variation in care even with established evidence based guidelines. Providers lack the tools, support and information they need to offer the coordinated health management that can reduce cost and improve outcomes. Primary Care Physicians are constrained in their abilities to perform any proactive care that involves avoiding Hospital or ER visits, and influencing healthy lifestyles.

Managing the growth of allied health care sector in the United State. Healthcare delivery system changings are most effectual when they are cohesive and ensure real answerability from providers to patient to improve outcomes. With the expected increase in allied health staff in the healthcare organizations, the first need will be to ensure that the care provided to patients is not impacted in anyway. Hiring new allied health staff allows organization to provide to provide adequate care for patients, but it also increases the cost to provide care. This means that recovering the financial costs of care and minimizing the cost of care takes a higher priority. Evidence proposes that multiple methods to delivery system changes may be necessary bend the cost curve and improve care quality. For example, the efficiency of a single disease administration program may be limited for patients who have multiple chronic conditions and who require coordinated care from many

The Affordable Care Act 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. The Patient Protection and Affordable Care Act (PPACA) is a multi-faceted reform of the nation 's health care system. The Wow Hospital Association is working with members, stakeholders and lawmakers to facilitate implementation of the law. Wow Hospitals will experience as a result of the ACA. Common themes in all of these reforms are accountability, efficiency, and quality. Furthermore, these plans provide new opportunities for WH to invest in upstream interventions– working to make policy, systems and environment improvements that will impact the communities in which we serve.

One significant challenge to business success in this rapidly changing global economy is that many business are focused on efficiency and economic of scales. Just like the example provided by Michael H. Hugo on Chapter 1, many companies are focused on lowering operating cost as much as possible. This is causing for executives not leave any room for unpredicted changes limiting the company’s ability to respond to customer’s changing needs.