The following is the proposed business model for Providence Health System (PHS) to successfully introduce an ACO in Metropolis City and the surrounding communities.
Directional Strategy: Mission/Vision/Values
Mission:
The Providence Health System’s (PHS) mission is to provide high quality medical care with a focus on improving both the health of the population and of our communities. Our objective is to not only manage our communities’ health care needs but to facilitate strength through continued health management.
Vision:
At PHS we envision the future of healthcare as the embodiment of teamwork. The physician patient relationship is redefined from that of occasional encounters to one encompassing trustworthy lifetime management across the continuum of care. It is our purpose to touch our communities by implementing sustainable improvements in the form of well coordinated, cost-efficient and transparent care models. We are dedicated in our resolve to deliver excellent care along the spectrum of prevention to long-term demands. What does this mean for you?
• For Patients: To improve the health and quality of health care delivered to all ACO patients. PHS will listen to our patients and caregivers and will address all needs associated with their personal health care journey.
• For Physicians: Our physicians and providers will be provided with the tools required to dispense high quality care and the resources to promote continued health maintenance, defining each individual’s path.
• Workforce: To promote educational and training resources to build tomorrows leaders and healthcare personnel. We will create opportunities for existing health care providers to develop and achieve greater success.
• Community Resources: To build ...
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...ment that incentivizes avoidance of poor choices rather than treating mismanaged cases. Providers will enjoy incentive pay for well-managed patient caseloads, reaping the benefit of endorsing healthy outcomes. Providers will enjoy coaching patients through newly established products, setting up goals and building patient accountability as incentives to reach and maintain healthy goals. Increased use of general practioners will be supported by improved coordination of care. Uniformity among the network will facilitate greater ease and use among the various clinics, hospitals, and providers allowing for better outcome tracking, documentation processes and tracking.
In summary, the stakeholders will all benefit from a unique collaborative experience. The PHS ACO will embrace the model of family by becoming an extension of each family within the community they serve.
The PCMH model promotes doctor-patient interaction and the personalized management of each patient by their primary care provider. The reimbursement system in particular sets this model apart from others. Physicians are reimbursed for the time spent with the patient in the clinic as well as for coordinating the patients’ health care team and communicating with the patient out of clinic. This means that, “doctors can be paid to send their patients a letter, or a link to a computer web site or a text message”.1 This will not only generate stronger patient-doctor bonds but also enable the patients to be more active in their health care plan. The model offers patients easier access to their health care team by providing more opportunities of communication outside the clinic in which they can receive medical counsel in a timely manner. This is made possible by the reimbursement system and its ability to compensate for out of clinic communications. The PCMH model therefore provides a preventive stance on medicine and ensures that the patient receives quality care on a regular
● Manage daily operations of busy, high volume medical practice with multiple locations and establish and implement administrative policies
In Medicare's traditional fee-for-service payment system, doctors and hospitals generally are paid for each test and procedure. This drives up costs by rewarding providers for doing more, even when it’s not needed. ACOs continue to utilize fee for service by creating incentives to be more efficient by offering bonuses when providers keep ...
...lthcare system is slowly shifting from volume to value based care for quality purposes. By allowing physicians to receive payments on value over volume, patients receive quality of care and overall healthcare costs are lowered. The patients’ healthcare experience will be measured in terms of quality instead of how many appointments a physician has. Also, Medicare and Medicaid reimbursements are prompting hospitals, physicians and other healthcare organizations to make the value shifts. In response to the evolving healthcare cost, ways to reduce health care cost will be examined. When we lead towards a patient centered system organized around what patients need, everyone has better outcomes. The patient is involved in their healthcare choices and more driven in the health care arena. A value based approach can help significantly in achieving patient-centered care.
If I was to become the CEO of a large health care organization, I would investigate and analyze all the information to determine what needs to be improved within the organization in order to make the best decision for the company. There are three major elements of quality: structure, process, and outcome”(Burns, Bradley, & Weiner, 2011, pg 251). One way to improve the quality of care in my organization is to be passionate and excited about the engagement of consumers. The patients need to be able to have access to the right information to educate themselves about their health care decisions. If they are active working with the physicians it can reduce emergency hospital visits and improve treatment and quality of life that is associated with different chronic diseases (Aulbach, 2015). As for my staff, I would ensure that they have all the equipment as well as the
The fourth key point is payment models. In order to make sure quality health care is given across the board you have to follow the money. In this section it talks about an idea of restructuring the payment scheme. Using bundled payments “offer the potential for promoting equity by redirecting resources to health care values...
The healthcare world has simply grown too large, too quickly and, as a result, has forgotten the reason behind which it stands: the patient. Continuity of care is in dire need of repair and without effective communication and coordination of care, the problem will not be corrected.
The national pay for value based system development has positive and negative aspects. System implementation will require multiple entity participation. Hospitals, physicians, outpatient centers, and clinics all will be responsible for collaboration in developing an integrated communication system which will present additional expense on the front end. Government mandates will be required; from implementation dates to specified circumstances in which assistive funding may be available. Multi provider ...
.... Each day your will leave a lasting impression on the people you interact with. By providing care and communicating with your patients, you will foster not only trust but also you will heal not only your patients’ bodies but their minds too. The sense of gratification felt from such service is unparalleled.
I want to make a difference in the quality of patient care when and where I can. Although I do not work directly with patients, I do realize the impact I as a health information professional have on the patients and the care they receive.
Support your professional and personal growth, so you can thrive in the ever-changing health care environment.
reimbursement determinations. As a result, the camaraderie among physicians has developed into a more aggressive approach to impede competition (Shi & Singh, 2012). Little information is shared with patients in regards to procedures or disease control. The subjects are forced to rely on the internet for enlightenment on the scope of their illnesses (Shi & Singh, 2012). Furthermore, the U.S. health care system fails to provide adequate knowledge on billing strategies for operations and other medical practices. The cost in a free system is based on supply and demand and is known in advance of hospital admission (Shi & Singh, 2012). The need for new technology is another characteristic that is of interest when considering the health care system. Technology is often v...
My overall vision is to develop and promote information technology solutions to better improve health outcomes, patient safety, and prevention of medical errors in underserved countries. In closing, Health informatics and Health Information Management is an exciting program that is designed to provide me with a suite of resources to help me develop essential leadership, teamwork, and healthcare management skills that will help me to become successful leader in healthcare
What will US healthcare look like in 2050? According to Getzen (2013), trends in better health will lead to greater need for long-term care and chronic care for the aging population while correspondingly trending toward less acute illnesses (p. 438). Personalized prognostic healthcare will lead to healthier longer lives (Lawrence, 2010). Physicians will become leaders of teams within healthcare organizations rather than the independent practitioners we are familiar with today (Getzen, 2013, p. 438). Thus, the concept of the primary care physician will become a thing of the past (Lawrence, 2010).
As a future healthcare leader, I will start by collecting data on the health of the community that my organization serves. I will develop a five-step program to contribute to public health efforts within my organization. My five-step program towards public health will involve monitoring, diagnosing and investigating, informing and educating, partnering, and researching. I will monitor the health indicators of my community and be aware of health needs and disparities. I will seek to identify hazards through research and analysis and diagnose root causes. Once root causes are recognized, improvement is possible. It is