Analysis of Massachusetts’ Health Care System
Merna Chung
Massachusetts is located in the northeastern section of the United States with a land area of 7 ,838 sq. miles. It is nicknamed the Bay State. The total population of Massachusetts is
6,016,425. Massachusetts has a white majority with the protection of the rights of minorities. There is no single body responsible for making and enforcing health care policy. The majority of the population is White 5,405,374 ( 89.8 % ) ; Blacks 300,130 ( 5.0 % ) ; Hispanic 287,549
( 4.8 % ) ; Asian 143,392 ( 2.4 % ) ; and the American Indian 12,241 ( 0.2 % ). The median age is 33.4 years. 22.5 % is under 18 and 13.6 % is over 65 years.
The major industries are Health Care , tourism, education , farming , and fishing making this state more rural than urban. It is not economically depressed because tourism has become an important factor in the economy.
Health care is a major industry in Massachusetts. It has seen a rapid growth in managed care organizations in recent years. These organizations strive to deliver high quality health care in a cost – effective manner by using our health care premiums to contract with doctors and hospitals. Two – thirds to three quarters of Massachusetts residents receive their health care through managed care organizations.
There are many health care systems and managed care organizations in Massachusetts. To name a few - Caregroup Health Care System ; Northeast Health Systems ; Partners Health Care Systems , Inc. Aetna Health Care ; Cigna Health Care of Massachusetts ; ConnectiCare of Massachusetts ; Fallon Community Health Plan ; Harvard Pilgrim Health Care , Inc. ; Health New England , Inc.
In general the population of Massachusetts is very healthy considering that there are so many health care organizations. Massachusetts General Hospital was founded in 1811 and is the third oldest general hospital in the United States and the oldest and largest in New England. This medical center has 820 beds and offers highly sophisticated diagnostic and therapeutic care in every specialty and subspecialty of medicine and surgery. Massachusetts General Hospital
Admits approximately 35,000 in patients each year and handles more than 1 million visits in its outpatient programs at the main campus and at its four health centers. Annually the emergency department at the main campus handle about 80,000 visits.
Therefore, CMC is experiencing an ALOS of 9.2 days with the statewide average being 6.4 days. Expenses per patient day are highest at CMC with an exception of 2 larger university medical centers. There is currently a Governing Board of 27 members and a Parenting Corporation of 19 members. Both boards lack diverse environment.
What is managed care? According to the Oxford English Dictionary, managed care is “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.” Managed care is a variety of techniques designed to reduce the cost of providing health benefits and advance the quality of care. In the United States alone, there are various managed care programs, that are ranged from more restrictive to less restrictive. As stated in the National Institutes of Health, the future of managed care is uncertain. It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed
There has been a shortage of physicians, lack of inpatient beds, problems with ambulatory services, as well as not having proper methods of dealing with patient overflow, all in the past 10 years (Cummings & francescutti, 2006, p.101). The area of concern that have been worse...
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
Health Maintenance Organizations, or HMO’s, are a very important part of the American health care system. Also referred to as managed care programs, HMO's are combinations of doctors and insurance companies that are formed into one organization. This organization provides treatment to its members at fixed costs and decides on what treatment, if any, will be given based on the patient's or doctor's current health plan. Sometimes, no treatment is given at all. HMO's main concerns are to control costs and supposedly provide the best possible treatment to their patients. But it seems to the naked eye that instead their main goal is to get more people enrolled so that they can maintain or raise current premiums paid by consumers using their service. For HMO's, profit comes first- not patients' lives.
The University of California – San Francisco Medical Center is one the best hospitals in the country. In 2010 the hospital was the seventh best hospital out of 100’s of others. How does a hospital reach this level of success? A hospital such as UCSF they have to be willing and able to find better and new ways to approach the care for their patients. Superb patient care is only one of the reasons why UCSF is one of the best. The innovative research and the extensive education in the Science of Health at their medical school are more reasons. UCSF Medical Center has been known to specialize in many of areas of medicine but there are areas they are most popular for. They also have many strategic plans that are already being putting in affect to better their hospital reputation and for the coming years.
Hospital costs in context:A transparent view of the cost of care [Excutive summary]. (2010). Retrieved from Massachusetts Hospital Association: https://www.mhalink.org/AM/Template.cfm?Section=Home&ContentID=11241&Template=/CM/ContentDisplay.cfm
Niles, N. J. (2011). Basics of the U.S. health care system. Sudbury, MA: Jones and Bartlett.
While most countries around the world have some form of universal national health care system, the United States, one of the wealthiest countries in the world, does not. There are much more benefits to the U.S. adopting a dorm of national health care system than to keep its current system, which has proved to be unnecessarily expensive, complicated, and overall inefficient.
The Hispanic diversity of the United States has been well documented in immigration. and population numbers for many years. In 1994, there were 26.4 million Hispanics. Americans living in the Continental United States. In 2005 that number had ballooned to over 35 million.
It is debt-free and has highest overall occupancy rate among the city’s six general hospitals
What Seems To Be The Problem? A discussion of the current problems in the U.S. healthcare system.
With the United Nations listing health care as natural born right and the escalating cost of health care America has reached a debatable crisis. Even if you do have insurance it's a finical strain on most families.
Shi, L., & Singh, D. (2012). Delivering health care in America: a system approach. Burlington, MA: Jones & Bartlett Learning, LLC.
American society is becoming increasingly culturally diverse. The 2010 Census indicates that the racial and ethnic makeup of the American population has increased dramatically throughout the years. The U.S. Bureau of the Census predicts that the United States will continue to undergo the following population changes over the next half century: Hispanics will represent 24.5% of the population (16.35% in 2010), African Americans will represent 13.6% of U.S. population (12.6% in 2010), Asian and Pacific Islanders will increase to 8.2% of U.S. population (4.8% in 2010), American Indians will represent 0.9% of U.S. population (0.9% in 2010), and Whites will represent 52.8% of the U.S. population (72.4% in 2010).