Healthcare Providers and Products Essay

Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations

Primary care: primary care is the kind of a health services that is designed to provide care over time to a individual when it is first needed, this type of care in the sense that only rare or unusual cases of ill health are referred to a facility that is more equipped to handle critical to severe life threatening illness.

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.

emerge as a professional entity until the beginning of the 20th century, with the progress in biomedical science. Since then, the

Traditionally, it is custom that patients to travel to the provider. Although it is possible to create an establishment for patients to visit providers, Mullin & Stenger (2013), advise patients choose home care in which the provider travels to them. According to Buchan, Couper, Tangcharoensathien, Thepannya, Jaskiewicz, Perfilieva, & Dolea (2013), the World Health Organization provides favorable recommendations to procure health care professionals into the rural environment. These recommendations include providing further education opportunities, improved living conditions, career development programs, incentives such as public recognition, and a safe and supportive work environment. Another essential recommendation is to implement jobs for multiple scopes of practices and varieties of health care workers. It is important that health care providers have the support of a multidisciplinary work staff to implement safe and efficient

Health professionals are responsible for providing services that improve the health and well-being of the community.

Health care systems are organizations that are formed to meet the overall health needs of the population. Health care is regarded as one of the leading cause in promoting not only physical and mental health but the well-being of the population. Legislation is implemented requiring government to offer services to all members of its society. The role of health services and the organizations that provide aid is to focus on the health of an individual and to uphold their human rights. According to WHO (2013), a “well-functioning health care system requires a robust financing mechanism, a well-trained and adequately-paid workforce, reliable information on which to base decisions and policies, and well maintained facilities and logistics to deliver quality medicines and technologies (World Health Organization; 2013).

Westmount Nursing Inc. is a for profit chain with seven different nursing homes. It has a grown from a small few bed facility to a facility with 4 different divisions that made to help make seniors more independent. The Westmount Nursing Homes were in search for a chief executive officer and president, which was filled by Shirley Carpenter. After Shirley Carpenter came on to the company, many changes were made and implemented. Some implementations were successfully, but she was also challenged with many problems with the Union Federation of Nurses and the Board of directors regarding wages and total quality management implementation. My recommendation would be for Shirley to stop the implementation of total quality management and focus on

1. Prepare a brief situational analysis of LMF for Dr. Townsend, identifying at least 3 internal issues and 3 external issue/competitive issues that are affecting LMF.

Understanding the classification of healthcare services in terms of acute and long term care enable us to plan for services, to describe institutions, and to allocate funding and reimbursement. In the United States, healthcare services provided by health care providers (such as doctors and hospitals) are paid for by the following including, private insurance, Government insurance programs, people themselves (personal, out-of-pocket funds). Additionally, the government directly provides some health care in government hospitals and clinics staffed by government employees. Examples are the Veteran’s Health Administration and the Indian Health Service.

Health care is a system to deliver care to consumers as a whole. Evaluating and reporting on health care quality is very significant; it provides users and employers the ability to make knowledgeable elections and choose the greatest accessible care (NCQA.org, 2016). There are different levels of care, if you will, of health care. The first s primary health care, which is simply delivering basic treatment and or vaccinations as well as small

Mr. Howell, the director of radiology for Pacific Healthcare has passed away. He was in charge of the supplier section of X ray film. Mr. Howell would not authorize the use of any X ray film other than Kodak. Barney Rubble is the corporate director of supply management for Pacific. He is in charge of buying supplies for all of the Pacific Healthcare Subsidiaries. Mr. Rubble will be Mr. Howells replacement. He now has the opportunity to authorize the use of any X ray film other than Kodak. An investigation was complete in

• Consider issues and identify ways to meet the needs of Pacific Healthcare and their patients at a lower cost without compromising the quality of the industry standard of a company like Kodak.

I agreed with you on the fact that insurance coverage as a determinant of health care service coverage. However, the use of hospitalists has changed health care delivery processes. Pham, Grossman, Cohen, and Bodenheimer, (2008) suggested that utilizing hospitalist model in patient care proffer prospective benefits to both providers and the patients. Hospitalists assist to decrease the length of stay at the hospital, lower hospital cost, increase patient satisfaction, and enhanced quality of care (Pham, Grossman, Cohen, Bodenheimer, 2008).

The provider selected for this assignment is Aetna. Aetna Insurance Company organized an annuity fund to sell life insurance in 1850. “In 1853, the Annuity department separates from Aetna Insurance and is incorporated as Aetna Life Insurance Company. The company 's first president is Eliphalet A. Bulkeley. The "Aetna" name is retained to take advantage of the good reputation of the original Aetna. The name was inspired by an 11,000-foot volcano on the eastern shores of Sicily, Mt. Etna, which was the most active volcano in Europe (Aetna, n.d)”.