Healthcare Cohesion And Health Care

The pay-for-performance program will take health care from basic health care delivery to high-quality health care delivery. The way that this is going to affect the patient "customer" is because they are going to have an overall better experience with more attention to their overall health. The patient will also see benefits because there are incentives for patients when they live a healthy lifestyle. One of the incentives that the patient will see is in cost savings in the immediate future. Pay-for-performance is positive for all stakeholders involved within the program because it delivers on the main goal which is to increase the quality of care to patients while reducing the costs.

“An Integrated Physician Model is the result of a series of partnership between hospitals and physician develop overtime” (Harrison, 2016). Primarily, it is a joint venture that has become many joint ventures. In addition, all of this joint ventures are connected through congruent goals, and that is to provide different level of care to all the patients. Integrated physician model also organizing themselves to improve the cost and quality by operating under a clinical guideline. This could include acute care hospital, home care, nursing homes, affiliated medical group, primary care clinics, employed physician and any independent medical groups.

According to Harrison (2016), “an integrated physician model is the result of a series of partnerships between hospitals and physicians developed over time.” The plan behind this model is to enhance joint efforts with medical specialists and associations. There are four strategies that need to be implemented for successful integration: “1) understand the forces affecting physicians; design strategic offerings to meet the needs of local physicians, 2) understand the hospital or health system’s specific capabilities and infrastructure in the context of the communities served, 3) ground physician-integration efforts on a well-defined strategic financial plan with sufficient resources and performance targets, and 4) ensure strong physician participation, leadership and governance.” (Cullen, S. J., Lambert III, M. J., & Pizzo, J. J. (2012)

This model will be widely used in the future and it is something that we want to make available to the patients who participate in our health care system. It has been shown that this health care model will benefit the patient and save money for the health care system. Financially, this system has been shown to be beneficial to the insurance company, the hospital, and the patient. Medicare has led the movement towards change in how we service our patients, and with the new ACA opening up to more individuals, Medicaid is leading the way towards a total comprehensive service model with efforts included such as transportation to and from appointments,

According to AHRQ (2008) care coordination is an associated concept that represents the transition among two particular care settings. It encompasses the collaboration of providers and health plan administrators through a variation of care settings to ensure optimal patient care (p. 6). Therefore, respectable care outcomes are in need of admirable coordinated communication among providers. The lack in connectivity between providers in the health care system has risen to the national consciousness. According to Wolfe (2001), the Institute of Medicine (IOM) report emphasizes that health care quality suffers because of the lack in effective treatments and insufficient health care delivery systems that fail to exploit these treatments. Disjointed

Clinically integrated programs enable hospitals, physician networks and other providers to collectively negotiate with managed care companies and health plans to improve the quality and efficiency of healthcare. However, this type of arrangement has issues that need to be carefully considered when deciding how incentives are structured, and how rewards and penalties are distributed. To date, relatively few organizations have pursued formal clinical integration or ACO status as a physician alignment strategy, due to the significant infrastructure and care delivery requirements of formal programs. Many health care entities are simply not equipped to pursue such FTC-compliant programs at this time. To date, relatively few organizations have pursued formal clinical integration or ACO status as a physician alignment strategy, due to the significant infrastructure and care delivery requirements of formal programs.

“Attention should be given to assessing the impact of new methods of organizing the delivery of health care services, adoption of electronic information systems, and health reform provisions that will test and reward health care organizations that are accountable for achieving better outcomes, higher quality, and lower costs” (Davis, 2012). Only collaboration between payers and physicians, with a focus on improving the health outcomes of patients will bend the projected cost curve set forth.

Brailer (2005) acknowledges that a sizeable number of citizens receive treatment from multiple providers at a time. Interoperability is a gateway for many business ventures in healthcare to accommodate for patients being admitted in multiple provider organizations. All healthcare professionals, especially managers, must communicate effectively. A good example of interoperability is transformation of electronic medical records, or recruiting physician specialists to operate on a specific procedure (Hellberg & Gronlund, 2013).

I guess the article in the link was more focused on the need to enable patient care coordination across different conditions or settings when it delved into clinical integration programs. Integrating clinical care is not as easy as it seems because it covers a variety of issues that are needed to be changed or improved upon to be considered a success like changes in provider culture, payment methods and incentives, and even federal laws (AHA.org, 2015). And I agree with the notion that combining data to produce a complete picture of what treatment and recovery looks like is essential to deliver research value for a patient and his care.

The integrated-physician-model is described as an innovative model of organization and collaboration of medical doctors which grants tasks and interprets roles differently for primary medical services within the hospital. This model aims to improve participation between competing medical groups within the same hospital and between competing hospitals. By establishing this improvement, the integrated-physician-model creates merit for doctors, hospitals,and also patients.”To achieve a hospital-physician integration strategy that is sustainable for both parties, hospitals and health systems must lay the needed groundwork of knowledge, capabilities, infrastructure, resources, performance targets and physician

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.

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

To form and operate integrated health care delivery systems successfully requires a great deal of commitment, leadership, and business savvy and can pose major challenges to even the most experienced health care executives. Health care providers integrate for many reasons. From the insurance and liability perspective, risk financing for these entities has also been integrated.

The formal definition of a physician, as described by the Bureau of Labor Statistics, is individuals who “… diagnose and treat injuries or illnesses” (2015). Doctors are caretakers of their fellow humans. The road to becoming a doctor is intense,

People see hospitals as a place where one goes for healing and medical care, but hospitals are businesses that healthcare administrators have the responsibility of maintaining. Healthcare administrators’ responsibilities include many aspects related to patient care. Some of those aspects are social and public policy and the technical management of healthcare delivery in hospitals. Unfortunately, healthcare administrators are faced with many challenges as well. One of the growing challenges that healthcare administrators are facing is the shortage of healthcare professionals.