Ethics Of Rural Health Care

The health care system must change to improve our nation’s health and takes strong steps to address the unsustainable growth of health care costs in America. We still have a long way to go before our health system become effective. We still have population that do not have insurance, have difficulties accessing their health care, or their needs are not met within the healthcare system. It is an investment in prevention and wellness and increasing access to primary care physician.

According to the U.S Department of Health and Human Services, the Affordable care Act from President Obama gives consumers more options and benefits when seeking coverage from insurance company. It offers lowering cost as well as gets more access to high quality of care. This law creates Patient’s Bill of Rights that is very effective to protect consumers from any abuses or fraud from insurance company. Some preventive services are available to many Americans especially Medicare recipients at no cost. Not just that, they also receive a special offer of 50 percent discount for any well-known drugs in the market place under Medicare named “donut hole.” The Affordable Care Act helps other organizations and programs to convince healthcare providers

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.

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.

Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the

Health care has evolved and is continuously evolving. The management of care now involves different clinicians to better assess, diagnose and cure a patient. The clinicians evolved from a general practitioner to a team now comprised of Physician’s Assistant, Nurse, License Practical Nurse and Specialists. These health care professionals now compose a team of health care providers that are essential in a patient’s over all health care. The team-based approach is a delivery system that provides a patient an all-encompassing health care delivery system. “ By practicing in a team-based care model, physicians and other

Lack of physician’s involvement, lack of research studies, and complexity of teams are the most prominent challenges for primary care reform.

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.

On an average, primary physician groups may see about four or five patients within an hour, probably about one patient every fifteen minutes. Because of increase productivity and cost restraints and pressures, this number could increase dramatically. This trend, unfortunately, will be matching the burden of physicians declining incomes and job market. A lessor number of physicians earn what physicians earned many years ago. Primary health has been affected more as compared to services rendered. Additionally, the shift to a bundled fee for performance from the fee for service reimbursement system for force solo practicing physicians and small group practices into forming or partnering into

The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.

Recently, my primary care clinic implemented a strategic initiative to increase patient accessibility to health care provider appointments. The managers within my clinic restructured our clinicians and nurses into health care teams called Patient-Centered Medical Homes (PCMH). PCMH involves realigning staff into teams around the primary care managers (PCMs) who have a support team helping them provide comprehensive, coordinated healthcare for patients (Army PCMH implementation manual, 2013). The PCMs are the physicians, nurse practitioners (NPs), and physician assistants (PAs) within our clinic. Each team has one PCM and three support staff (RN, LPN, CNA or medic) helping them provide care to their empanelment of patients (Army

The most fundamental reason for high costs and low quality plaguing the US Healthcare system is the fact that there is a lack of collaboration and shared patient information between the different healthcare providers. This lack of collaboration results for multiple reasons. For example, Primary Care Physicians (PCPs) are faced with drastic increase in overhead costs. Because of the increase in overhead costs coupled with the current system of insurance reimbursement, PCPs are forced to see more and more patients per day which in turn results in less time for each patient. Moreover, there are multiple rules and regulations forced upon them by the insurance companies and to fulfil those requirements, extensive amount of time is consumed which

One of the core competencies of public health is partnership and collaboration, and over the years, the need for collaborative partnerships between primary care and public health has grown substantially. Studies have shown that collaborative partnerships between primary care and public health working together towards a common goal, is essential for improving health quality (Valaitis, 2012).

Primary care, or day to day care, is expected to rise significantly over the next five years because of the increase in population as well as the aging of an already staggering population. Also having some to do with the increase in health care is the expansion in health insurance. If the fundamentals of primary care remain as they are, there is expected to be a shortage of 20,400 primary care physicians by the year 2020. If non-physician practitioners are integrated into the system, such as in patient-centered medical homes, the stress that will be on the health care system will be somewhat alleviated. In a study done by the US department of health and human services, national averages in areas where primary care physicians is well above average their numbers will remain above average, while areas where the number of primary care physicians is well below average will be severely struggling. Aging population and population growth accounts for 81 percent of the change, while the remainder is taken into account because of the implementation of the Affordable Care Act. To help with the increase in health care services needed, primary care nurse practitioners is expected to increase roughly 30 percent, and if primary care nurse practitioners would be integrated into the primary care health setting it could help alleviate up to 6,400 jobs by 2020. The institute of medicine reported that primary care physician shortages are based on the traditional health care delivery model,

little access to medicine and doctors. Most examples will be based off our state, Hawai’i. The