Professional integration and the type selected for many healthcare organizations will determine their success when they begin implementation of the Patient Protection and Affordable Care Act (PPACA). Cuellara & Gertlerb (2006) list the five most common arrangements in use: Independent Physicians Associations (IPAs), Open Physician–Hospital Organizations (OPHOs), Closed Physician–Hospital Organizations (CPHOs), Management Service Organizations (MSOs), and Fully Integrated Organizations (FIOs). Each of these five types of professional integration has proven successful however there have been many failures, which ultimately led to a degraded access and quality of health care in those communities.
It would be an awesome day in history if the healthcare industry could mimic restaurant chains business practice of combining quality control, cost control, and innovation. Even though it’s a great gesture from a patient’s perspective, there is no way that healthcare could even come close to such models of restaurant business practices. Why is that? Well, a restaurant is more predictable than any health care sector. First, restaurants are able to plan and coordinate their business practice to meet the needs of their customers. Secondly, they can control inventory and certify quality meals at an affordable price. Additionally, they can predict how many customers will
The Integrated health care is an approach of interdisciplinary of collaboration and communication among health professionals. The characteristic is unique because of the sharing information which in the team members and related to patient care to establishment of treatment whether biological, psychological, and social needs. The interdisciplinary health care team includes a diverse and variety group of members (e.g., specialist, nurses, psychologists, social workers, and physical therapists), depending on the needs of the patient for the best treatment to the patient care.
The chronic care model calls for an organizational change in the way individuals with illnesses are cared for, and the involvement of nurses, social workers and patients themselves. The challenge is moving in an effective way of improving quality from research carried out predominantly in health maintenance organizations to the mainstream of health care practice (Wielawski, 2006). Wagner’s explanation is to substitute the customary physician-centric office structure with one that supports clinical teamwork in association with the patient. The notion spreads outside the health care organization to collaborative associations in the community. Wagner et al. (2001) termed this approach the “chronic care model.” With this model, physicians, nurses, case managers, dieticians, and patient educators
The Center for Medicare and Medicaid Services has a link to Partnership for Patients, it has explanations of the health care models for the future. Many are functioning now, and having great reductions in hospital readmission rates. “The Independence at Home Demonstration will award incentive payments to healthcare providers who succeed in reducing Medicare expenditures and meet designated quality measures.
Over the past decade, one of the clear trends in healthcare delivery systems in the United States is the evolution of large group practices. Clinicians are increasingly joining large group models, a larger number are becoming personnel of hospital owned and centered practices, and many are forming multi-specialty teams. There are fewer single and small practices, fewer medical doctor owned practices, and fewer self-reg...
In recent times, healthcare organization across the nation are facing unprecedented challenges as they strive to improve the overall quality of care provided to their patient’s population, while improving their organization’s financial performance. Furthermore, uncertainty of new reimbursement models, diminishing reimbursement, and complicated compliance regulations are playing the role of a catalyst for streamlining the Chargemaster process in majority of healthcare organizations.
The demands on health care providers to provide the best quality care for patients is increasing. With added responsibilities and demands on our health care workers, it is hard not become overwhelmed and forget the reason and purpose of our profession. However, there is a way where all professionals can meet and come together for a common cause, which is the patient. A new approach in patient care is coming of age. This approach allows all health care professionals to collaborate and explore the roles of other professions in the hope of creating a successful health care team. This approach is referred to as the Interprofessional Collaboration Practice (IPC). To become an effective leader and follower, each professions will need to work together
Proximately, the Affordable Care Act increases quality of care through innovative health care systems called Accountable Care Organ...
Pay-for-performance (P4P) is the compensation representation that compensates healthcare contributors for accomplishing pre-authorized objectives for the delivery of quality health care assistance by economic incentives. P4P is increasingly put into practice in the healthcare structure to support quality enhancements in healthcare systems. Thus, pay-for-performance can be seen as a means of attaching financial incentives to the main objectives of clinical care. However, reimbursement is a managed care payment by a third party to a beneficiary, hospital or other health care providers for services rendered to an insured or beneficiary. This paper discusses how reimbursement can be affected by the pay-for-performance approach and how system cost reductions impact the quality and efficiency of healthcare. In addition, it also addresses how pay-for-performance affects different healthcare providers and their customers. Finally, there will also be a discussion on the effects pay-for-performance will have on the future of healthcare.