Week five Power Point Presentation
University of Phoenix
Delivery of Health Care in the United States
HCS 235
January 30, 2013
Week five Power Point Presentation
Health Care in the United States is a vast industry that has many different types of people involved in the delivery of care. There are stakeholders that affect the daily operations of health care and they are not necessarily in a hospital setting. The Agency for Healthcare Research and Quality, AHRQ, defines a “stakeholder” as persons or groups who have a vested interest in the clinical decision and the evidence that supports that decision ("Effective health care," 2011, p. 1). These stakeholders are making decisions that impact costs, procedures, and the future of
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Documentation of referrals sent outside of the systems is necessary to track what needs are not met and what physicians are not staying within the referral network. Clinics range from primary care to specialists treating various ailments and injuries. Keeping patient referrals within the system creates continued revenue. Home health care is also a service provided within a health care system. Home health is a wonderful option for patients who are not able to leave the house but need nursing care, physical therapy, and assistance with activities of daily living such as eating, bathing, meal preparation, and some house cleaning. Health care systems have created their own home health care agencies to help with the continuity of care and the ease for case management to setup a patient within their own system are great benefits on both sides of the spectrum.
Health care Providers Health care providers deliver the care needed by the health care consumer. Services range from preventative services to surgical services, chiropractic to cancer treatments. Physicians, surgeons, nurses, medical assistants, radiology technicians, and home health providers are a few different positions within health care professions that deliver services to health care consumers.
Health care consumers Health care consumers are the people that are in need of the services provided in health care. This range covers patients with chronic needs and constant access to health care
Historically, many interventions or processes implemented to promote and improve health care and quality were directed by professionals with a lack of input from the local populations . In recent years however, stakeholder engagement has become the core remit to guidance and many national strategies for improving healthcare systems (e.g. Department of Health) . Community stakeholder engagement is broadly defined as
A health care provider is any individual, institution, or agency that provides health services to health care consumers otherwise known as patients (http://medical-dictionary.thefreedictionary.com/Health+care+service+provider). Health care providers are vital because they are trained to provide health services to patients which help treat illnesses, diseases, broken bones, or any injuries or health issues in which they are trained to treat.
Those who utilize the Medicaid system range from low income families to the over 65 age group. Within this population is also those who are disabled due to physical or mental problems. This is among the sickliest of our American population. A paper based on a study in Oregon stated that “Medicaid significantly increased the probability of being diagnosed with diabetes, and being on diabetes medication as well as high blood pressure and high cholesterol.”(Baicker et al., 2013, p. 1715). Much of this is due to the struggle that the Medicaid beneficiary has
Home health care is taking care of an individual medically at their residence. Usually, there is a home health aide that comes to the house that provides the medical care for the patient.
When a patient scheduled an appointment, they arrived, and now you are waiting to be seen by the doctor for over 15 minutes. Or when you have the appointment, and you have waited in the lobby for about 20 minutes pass your appointment time to be seen by the doctor, you’re called inside the patient room, and from there you are still asked to wait on the doctor for over 15 minutes.
In Tennessee alone, we are once again facing an obstacle under the umbrella of healthcare coverage. In 2017, 3 regions in the state of Tennessee will lose coverage from BlueCross BlueShield of Tennessee (BlueCross BlueShield of Tennessee, 2016). It will leave 100,000 individuals looking for coverage through other marketplace plan providers. BlueCross BlueShield of Tennessee stated that they had to pull out of Obamacare in these three regions due to profit losses over the last 3 years (BCBST, 2016). It may seem simple enough to others that these individuals just go get another plan from someone else. We must first consider affordability. Will Cigna and Humana offer plans that are similar to the BlueCross BlueShield of Tennessee plans? Will consumers have nearly the same or the same benefits as before? There are many different changes that may occur by simply changing insurance plans. The consumers may not be able to have the same providers. They may not have the same medication coverage as before. The deductible could change and make the policy invaluable to the individual based on their needs. Obtaining coverage has been an ongoing uphill battle for some. Our state and federal legislators all share different views on healthcare issues. The Healthcare Reform Act of 2010 brought
A stakeholder are people or groups that have an investment in the patient evidence based healthcare decisions (Agency for Healthcare Research and quality, 2015). In this case, already listed is the patient and the physician but Medicaid is a stakeholder as well. The stake for Medicaid is being the insurer this tells the patient where he can and cannot get treatment. It also set the type of treatment is covered. According to AHRQ, the local clinic is also a stakeholder. The facility has made the decision on what kind of insurance to utilize which was not Medicaid cause the patient to be denied access to care. The healthcare industry is a also listed as a stakeholder especially in reference to manfacture for treatment. The manufacture is the expert when it comes to how to administer treatment and how to operate the device they made. Policy makers also have a stake in the patient healthcare utilization . In this instance the lawmakers had to set policy who was eligible for Medicaid.These few factors have impacted the patient tremendously.
Identify roles of various stakeholders in the health care industry.Week Two Read Me First EBOOK COLLECTION: Read Ch. 2 of The U.S. Health System: Origins and Functions. EBOOK COLLECTION: Read Ch. 2 of The United States Health Care System: Combining Business, Health, and Delivery.
Key information as well as a step-by step process to develop and analyze a policy was provided within the LearnScape module one activity. Jones & Bartlett Learning (2014) identified these steps as gathering data, identifying stakeholders, key factors, and writing the policy. Although, gathering data seemed self-explanatory, I wasn’t exactly sure what a stakeholder was until I completed this assignment. A stakeholder is any group, organization or individual that will be directly affected by the policy (Jones & Bartlett Learning, 2014). It is within my scope of practice as a future healthcare provider to identify the need for policy change or development. This assignment has taught me that any breakdown in the policy development process can lead to cost wastefulness and prolongation of changes that need to occur to provide a safer, more effective patient care atmosphere.
First of all, both scenarios represent emotionally charged situations that impact many stakeholders both internally (employees, patients, providers and board members) and externally (payers, community, government entities, community leaders). There is no doubt that the knowledge I have gained over the course of this program allowed me to have a broader understanding of the implications for each of these stakeholders. Furthermore, not only having knowledge of the perspectives of these various stakeholders but also the tools to critically assess the situation and formulate a plan is also a byproduct of my studies. Additionally, this work highlights the complex and fragmented nature of the US health system and the challenges in working on a solution to almost any problem tackled by healthcare leaders today. Thankfully, the program has given me the confidence to undertake these
Health Services is provided for individuals who they serve. They offer dental service, therapeutic service, genetic testing, nursing service and
In contrast, Eden and Ackerman (1998) take on a utilitarian approach to stakeholder analysis, with the aim of identifying stakeholders who be persuaded and support actively the strategy and intent of the organization that is prioritizing them. The stakeholders in the institution play a major role as they hold varying degrees of power and interest in the institution. In order to be successful with a proposed project, it is important to identify the stakeholders and to understand their attitudes concerning their expectation and acceptance of the project. Routinely, while the procedures are in progress in the operating rooms, updated information is exchanged among health care providers and family members via nurse liaisons. With the installation of new technology, the access to updated information can be accomplished in a faster, timely, and professional manner. Some of the benefits include the need for less staff members that can be economical to the institution and increased patients and relatives' satisfaction.
Countervailing power is the too-simple concept that describes how powerful actors with privileged access to decision-making processes. Countervailing power conjures images of organizations of patients facing down health maintenance organizations. They appear as interest groups, public interest litigators, social movements, or perhaps crosscutting networks of professionals and officials. Four sources of countervailing power lie in government regulation, managed care systems, doctor-patient relationship changes, and health care business corporations.
The other type of home health care agency offers help with household duties and non-medical personal care. This could include preparing meals, bathing, dressing or moving around the house. Depending on the state, these agencies may or may not be licensed. This type of home health care allows a person with special needs to stay in their home. It is for individual's who are getting older, are chronically ill, recovering from surgery or disabled. The best place to receive ongoing care may be in the comfort of your own home.
Proceeding admission to home health care, the nurse establishes services including nursing care, physical and occupational therapy, home health aide, social work, and other medical assistances. The goals of home health care services are to help individuals to improve their function and live with greater independence, to promote the client’s optimal level of comfort, and to assist the patient to remain at home, avoiding hospitalization or admission to long-term care institutions.