Reverse Integrated Care

With any form of integrated physician model both parties have much to gain, patient acquisition, quality of care, and resources are some examples that both parties could see as incentives to work together. Treatment is being shifted from volume of care to quality of care since the incorporation of the affordable care act set

(Mann, 2014, p.2) These strategies include: broadening access to primary care services; focus on individuals who frequently utilize the emergency department (super-utilizers); and targeting the needs of individuals with behavioral health problems. (Mann, 2014, pp 2-4) Many resources and processes have been implemented in order to help decrease inappropriate emergency department visits. This paper is going to demonstrate some resources and processes that are in place to help individuals obtain health care at the appropriate health care setting.

Vertically integrated health care system that I have chosen is the Veterans Administration (VA) it's accountable for a large patient population for military veterans. As stated, The Veterans Health Administration is America’s largest integrated health care system with over 1,700 sites of care, serving 8.76 million Veterans each year (VA.GOV). The services that's provided to veterans is health care, rehabilitation, employment, education, home loan guaranties, and life insurance coverage. VA control costs by buying in bulk and control costs by engaging in a deep, single-source relationship with each patient. The Assistant Secretary for Management oversees all resource requirements, development and implementation of agency performance measures,

Patients in the United States are receiving an elevated level of care that places their needs at the core of each health care visit. As the US adopts the new, patient-centered medical home model (PCMH), the health care system transforms into a community-focused on holistic wellbeing. While making use of existing resources, the addition of technology that enables timely file sharing between practitioners and outreach programs, decreases duplicated processes and creates sustainable improvements to system efficiency (Cliff, 2012). Standardization of data formats and billing practices enables health care providers and insurance companies to make informed decisions that maximize profits (Harbrecht & Latts, 2012), or excess revenues over expenses in nonprofit HCOs. The PCMH establishes an effective, trustful, and

The article by Vogel, Kanzler, Aikens and Goodie (2016) summarizes and critically evaluates current scientific knowledge about integrated primary care. In their paper they present a call to action in two critical areas: improved clinical/operational/financial research and extensive policy change. They believe that increasing integrated primary care research in quality will allow clinical work to gain a great understanding of which models and approaches work best. According to Vogel at al (2016) integrated behavioral health care is the future of all good primary health

It is essential to train primary care clinicians and behavioral care clinicians in assessing the needs of patients. According to “Preparing the Workforce for Behavioral Health and Primary Care Integration” few organizations hire clinicians that contain the capacity to work with primary care clinics (Hall, Cohen, & Miller 2015). A reason is that working as a team and sharing a patient in order to deliver the highest care is difficult. For example, a behavioral health clinician working in a primary care clinic must be able to provide a brief diagnosis to a primary care patient as oppose to a extensive consultation. Aside a primary care clinician must be capable to analyze a patient behavioral health and how to address the topic.

Co-occurring disorders are described as a person having the presence of two or more disorders at one time. Estimates suggests that up to 7 million people in the United States have a combination of at least one co-occurring mental health and substance related disorder in any given year (US Department of Human Services, 2003). Research shows that a person’s mental health condition should not be overlooked when treating for substance abuse (Green, Noordsy, Brunette, & O'Keefe, 2008). Integrated treatment as an organizing concept began in the 1980s when it was observed that clients with co-occurring disorders were highly unlikely to receive treatments for both mental health and substance use problems under the existing circumstances

In my opinion, I feel that every person should be given the best medical care available and the opportunity to live a long life expectancy. As an assistant, I must make sure that the hospital follows the proper ethical guidelines and ensure that the client is aware of her choices and what is available to her as well as her rights. I will also make sure that the patient knows what the health home offers her as an elderly woman who lives alone and is in need of some assistance. Health homes in today’s society have begun to take hold in several states via the integrated care delivery models. This has been occurring in the U.S. who continues to search for modern ways to control the costs of health care. Some states have progressively become labs

An integrated care pathway is a structured multidisciplinary synopsis of anticipated care, placed within a set timeline, to aid a patient with a specific condition or set of symptoms to move progressively through a clinical experience to positive outcomes, It is one of the main tools used to manage the quality in healthcare concerning the standardisation of care processes and therefore promotes organised and efficient patient care based on evidence based practice. (British Medical Journal, 1998). In this essay I aim to justify a patient pathway of care with reference to national and local agendas. I will analyse the assessment strategies utilised in the pathway from a bio-psycho-social perspective with reference to contemporary evidence and provide examples from clinical practice where assessment of the patient of the pathway impacts upon the care planning process.

Integration of care is possible and important because it will help the population especially the aging population. This integration of care will involve a lot of reconstruction, time, effort and some sacrifices. However, providing health care in US is a problem because the mode of delivery and the gap between health and social care, which is why integration of care is necessary.

These efforts include early intervention, appropriate treatment, use of medications, and suicide prevention. The AAFP being in great support of integrated health care continue to struggle with the rates of reimbursements and continues to advocate for proper payment structures to enable them to support and implement the integrated process into their own private practices. The Affordable Care Act specified that Medicaid payments for primary care services would be at Medicare levels for primary care physicians in 2013 and 2014. Since then this provision has expired and instead of implementing new payment proposals the Center for Medicare and Medicaid services reverted to rates that proved to be lower than those most state Medicaid payors. (Blackwelder,

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.

Integrated care can focus on a variety of different aspects in the medical profession. This study examines how to better approach patients needs and reduce fragmenation services. By implementing a collaborative care model for all ages , there is a opportunity for intergrated delivery system in a primary care setting. The study includes a new case where the model can incorporate a collabortation with some medical insruances to reduce expenditures while preserving or enhancing the quality of care. In efforts to see how to improve care through different platfoms, such as telephonically.This can help support treatments and expedite referrals. The goal would be to administer a universal screening, identify an connect with team, montitor and improve

Though the need for integrated health care continues to rise not all doctors are willing to consider the change. Critics have proposed that integrative medicine is “driven largely by market forces, as well as public fascination and demand for alternative treatments.” (Kam, 2009, para. 9) Tom Delbanco, M.D., a Harvard Medical School professor and physician at Beth Israel Deaconess Medical Center advises that in a national survey conducted amongst hospitals “implementing integrative care shows the most common barriers include physician resistance to change accounting for up to 54% of those surveyed, budget constraints (65%) and lack of evidence based research (39%).” (Kam, 2009, para. 10)

Toothbrushing is a part of the Implementation phase of the process of care. The seven factors I will assess with Jay regarding his oral hygiene are: current self-care behaviours, type of toothbrush used, frequency and duration of toothbrushing, toothbrush replacement practices, level of satisfaction with tools and technique, personal values and preferences. These seven factors will make sure all areas of his oral self-care are discussed and recommendations will be made out of this discussion. There is a connection between overall health and oral health in an individual. Jay currently is a healthy individual and he exercises regularly. If he does not improve his oral health it will begin to affect his overall health. Jay admits to brushing his teeth but does not use any other intraoral aids. Jay needs to be informed about the importance and purpose of tongue cleaning. Cleaning the tongue will decrease the amount of bacteria in the mouth and improve the overall cleanliness of the oral cavity. It is important for him to clean his teeth, tongue, gingiva and mucosa because microorganisms in the oral cavity are found everywhere. A tongue cleaning aid should be introduced to Jay but with his busy life style and lack of oral self-care motivation he may neglect to use it. He should be showed how to use his tooth brush as a tongue cleaner because that may be easier for him to use. According to Darby and Walsh (2015) to use his tooth brush as a tongue cleaner he will apply the