Health Care Delivery System: A Case Study

The seminar that I am leading is the integrated and managed health care systems. One the lessons I’ve learned from watching the documentary “The Good News on American Medicine” is that as doctors we can make a difference in the way we deliver health. That is an important message with all the uncertainty that lie around. That is easier said than done, however. What separate Grand Junction and Seattle and other town mentioned in the video was that the doctors worked collaboratively to ensure low-cost quality care. To accomplish that it means that we must make sacrifices, time and/or monetary, to achieve the same goal.

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.

Roemer’s model of a health care delivery system shows the different necessary elements for a system to be successful. As health needs are the input; the system needs resources, organization of programs, economic support mechanisms, and delivery of services to provide the health needs output (Roemer, p 33). Able 2 is an organization that provides services to people with disabilities. They have many resources, but perhaps not enough to meet the health needs of every consumer. They have well organized programs, have economic support, and can deliver services completely and holistically to produce health as the output of the client. The most important implication that was found in analyzing Able 2 was the need for increased resources as they are not able to meet the needs for every client in need of its services. Ultimately though, Able 2 is an excellent organization that provides an array of services for those people with disabilities.

The primary care practice is essential to improve the care of our population, our current system is fragmented, but it does show potential for improvement. The Agency for Healthcare Research and Quality has listed some areas that will help improve our system. One is “the need for external infrastructure to help primary care practices develop quality improvement” this is done with support to the quality capacity (Agency For Healthcare Research and Quality, 2015). Quality care will include the coordination of care within the system, as well as understanding what needs the patient will have

In the past, managed care in the United States took the form of voluntary programs. Such programs date from about 1850, when managed care was provided chiefly by cooperative mutual benefit and fraternal beneficiary associations. Limited coverage by commercial companies was also introduced during that period, and subsequently many plans were established by industries and labor unions.

The health care delivery system of the United States is unique compared to the other developed countries. The health care system of United States relies on the development and implementation of new health care technology. The use of new technology in the field of health care will help to provide services with increased quality and efficacy (Shi & Singh, 2015). The external forces affecting the provision of health care delivery also has an inevitable role in the functioning of the system. The affordable care act (ACA) or “Obama Care” was signed into law by president Barack Obama on March 23, 2010 with the goal to give more Americans access to affordable, quality health insurance, and to reduce the growth in the U.S. health care spending (Ober & Craven, 2010).

The United States health care system is currently facing a projected shortage of up to 94,700 physicians by 2025, a number which has been exacerbated by policies within the Patient Protection and Affordable Care Act. Current policies established or proposed to address this issue have been either insufficient in scope or lacked necessary funding for successful implementation. In order to assure quality and adequate access to health care for all individuals, new policies are desperately needed to both increase the physician population in the future and provide solutions until the need can be met. Recommendations to address this issue include increasing the team-based care structure within primary care, reducing the current limitations on non-physician practitioners, and increasing the number of residency positions offered through graduate medical education.

Healthcare is a hot topic for all Americans and everyone has their own views on how the healthcare system should run. This includes the public and the politicians. Today we are going to address issues in the United States healthcare system including access to care for both physical and financial reasons, how payment for care runs the industry, and quality of care in the aspects of internal factors including: public insurance plans, and private insurance, as well as the external factor of the economy.

According to Madicaid.gov (2016), “Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.”

There are many methods in which providers are reimbursed for services. Some of these methods are:

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.

Step 1) A current issuse in my core prgram which is surgical technologist, is health insurrance coverage in the operating room. This is actually becoming more of an issue among people. Hospitals are constantly getting patients without health insurrance. When this happens it is always difficult to figure out the next move because it's not like the hospital can turn the patient away, but, at the same time it is difficult for the patients to want to undergo the operation for fear of the cost and the debt they will be in.

Great observation and suggestions. It is true that HIS cannot survive and become a viable means of healthcare delivery without the full support and acceptance for the physicians. I think the first step to implementing HIS is to develop and implement an effective communication plan to enable experts on the subject to educate and conscientize the various stakeholders about the importance and benefits of HIS. Leaders should not only communicate well with these primary users but, must be good listeners too. They should create a platform where physicians, nurses, and other relevant HIS users would voice out their concerns or reservations, such costs associated with HIS and how it disrupts their tasks so that both sides can brainstorm and come out

In this paper there will be a brief discussion of three forces that have affected the development of the U.S healthcare system. It will observe whether or not these forces will continue to have an effect on the U.S healthcare system over the next decade. This paper will also include an additional force, which may be lead to believe to have an impact on the health care system of the nation. And lastly this paper will evaluate the importance of technology in healthcare.

The other type of patient care delivery system is the primary nursing. In primary nursing, registered nurses provide direct care for the patient and their family (Finkelman, 2016). The primary nurses must be expert about the patient’s conditions and must be autonomous. In the short article called The Bridge of Primary Nursing, Rebecca Billing conveyed how primary nursing is based upon liability, responsibility, and leadership. Billing is currently taking care of a teenager who has a bone cancer that was diagnosed in October 2010, and throughout his therapy, Billing had the opportunity to know him well. She affirmed how primary nurses have the authority and skilled in knowing their patient’s emotional and physical needs. In this scenario, the