United Health Care has been around for many years. It’s mission statement is to help improve people’s lives by allowing them to live a healthier. Furthermore, the organization’s goal is to help make the health care system better where everyone will be satisfied. The system can be overwhelming for many. However, the organization makes it its priority to help people with their health care needs. Receiving the best and affordable care is one way to stay healthy and live longer. This organization serves more than 70 millions of people nationwide. Readiness for the next Decade United Health care is ready for the next decade. The organization wants to continue improving the quality of care for its customers. Lowering the cost for patient is their …show more content…
The company understand that the health care industry is constantly evolving and they must join. Their accountable contracts are expected to expand at least three times what its currently is in the next six years. Every year, the company see an increase in new costumers. Their networks include employer-based, Medicare and Medicaid. Health care providers are expected to provide the best care possible in other to be reimburse. As the network is expanding, health care providers will continue to provide quality care at an affordable price. Nurse Staffing The organization not only care for its patients, they believe in other for the patients to receive the best care possible, staffing should not be an issue. They are planning to invest more in customer service representative and individuals who process claims to allow the organization to run effectively. According to the president to the organization, United Health care is planning to add about 125 new position which consist of primarily registered nurses and nurse practitioners. They will be responsible to make house calls to customers who have Medicare and are chronically ill with diabetes, hypertension, kidney failure and congestive heart failure. These diseases are long term illnesses that cannot be treated. Therefore, patients can become frustrated and lost hope when they do not understand what is going on and what to expect. The …show more content…
The resource management team is there to ensure that company met everyone needs in the best way possible. The company goal is to promote healthier lives by offering quality health care to everyone. However, the resource management is responsible to make sure every dime that is spent is well spent. The company cannot afford to waste money on unnecessary things while others are dying and are unable to receive proper care. the team is there to make sure physician are doing what they are expected to do. Preventive care is something that the company stress a lot. Physicians are even rewarded for providing education and perform preventive care to patients. According to UHC (2015), to understand competing proposals on management and delivery of health care services, one needs to be familiar with factors and policies influencing the health care systems in the United States and other
Membership Services (MSD) at Kaiser Permanente used to be a modest department of sixty staff. However, over the past few years the department has doubled in size, creating minor departmental reorganization. In addition the increase of departmental staffing, several challenges became apparent. The changes included primary job function, as well as the introduction of new network system software which slowed down the processes of other departments. These departments included Claims (who pay the bills for service providers outside of the Kaiser Permanente network), and Patient Business Services (who send invoices to members for services received within Kaiser Permanente). Due to the unforeseen challenges created by the system upgrade, it was decided that MSD would process the calls for both of the affected departments. Unfortunately, this created a catastrophic event of MSD receiving numerous phone calls from upset members—who had received bills a year after the service had been provided. The average Monday call volume had risen from 1,800 to 2,600 calls per day. The average handling time for each phone call had risen as well—from an acceptable standard of 5.6 minutes to an unfavorable 7.2 minutes. The department continued to be kept inundated with these types of calls for the two years that these changes have been effect.
Over the last 5 years the healthcare system has begun to transform. This transformation includes a focus change to preventative care to the new health conscious consumers and the reduction of healthcare costs (PR Newswire, 2013). This change comes from the consumers of healthcare as well as new laws such as the Patient Protection and Affordable Care Act (PPACA). This has created a need for hospitals to enter in partnerships to create hospital systems such as Centura Health. These hospital systems are expanding the continuum of care to include everything from preventative care, emergency care, and finally end-of-life care. This creates a need to monitor competition and create ideation plans to increase likelihood the consumer will use Centura Health over the competitors.
Formed in 1998, the Managed Care Executive Group (MCEG) is a national organization of U.S. senior health executives who provide an open exchange of shared resources by discussing issues which are currently faced by health care organizations. In the fall of 2011, 61 organizations, which represented 90 responders, ranked the top ten strategic issues for 2012. Although the issues were ranked according to their priority, this report discusses the top three issues which I believe to be the most significant due to the need for competitive and inter-related products, quality care and cost containment.
Overall, the increase within health care costs is effecting our nation significantly. Not only does it affect consumers but also organization. As it continues to increase everyone is finding themselves unable to pay for such changes. Reducing such growth within the health care costs requires a collaborative, inclusive, and dual-party approach. Strategies for reducing the costs include but not limited to: promoting prevention and healthy living, improving patient safety, and promoting transparency on medical costs and quality. If the nation works on such improvements, hopefully we will be able to turn the health care system into something we can all afford once again.
Despite the established health care facilities in the United States, most citizens do not have access to proper medical care. We must appreciate from the very onset that a healthy and strong nation must have a proper health care system. Such a health system should be available and affordable to all. The cost of health services is high. In fact, the ...
...e crucial change needed in health services delivery, with the aim of transforming the current deteriorated system into a true “health care” system. (ANA, 2010)
The purpose of this paper is to describe how I visualize my future role as a mastered prepared nurse professional. The Association of American Medical Colleges estimates that by 2015 the nation will face a shortage of 62,100 physicians, 33,100 primary care practitioners and 29,000 other specialist. The nursing shortage evaporated during the recession, because many nurses returned to the workforce, but nurse practitioners remain a scarce resource in many areas (Expanding the Role of ANP Risk and reward). American Association of Retired Persons (AARP), a supporter of transforming health care to meet the challenges of an aging population and a shortage of primary care providers, agrees that advance practice registered nurses (APRNs), could provide seamless, accessible, affordable, and equitable quality care if they are utilized to the full extent of their education and training (AARP). In 2010, the Institute of Medicine published The Future of Nursing: Leading Change, Advancing Health, a report which offered an intensive examination of what the nursing profession is now and should become. It states that nursing is at the heart of patient care and is therefore crucial to changing the way health care is delivered so that patients receive care at a cost they can afford. Nurses are a linchpin for health reform and will be vital to implementing systemic changes in the delivery of care (AARP).
By the year 2020, there is expected to be over 54 million senior citizens age 65 years or older. Despite medical technology and advanced medications, seniors older than age 65 have four times the number of hospitalizations days as compared to younger age groups (Curtain, 2007). Health care demands are increasing due to the aging United States population, and the present-day Medicare system is not capable of funding this. Health insurance emphasis is now on efficiency, profits, customer satisfaction, ability to pay, and competition (Curtin, 2007). Social and political aspects are major influencers of our health care. The shift of focus from patient care to a business model has caused hospitals to maintain a tight budget, often affecting nursing staff ratios. Lean staffing ratios is associated with an increase in malpractice suits due to adverse events (Curtin, 2007).
The person pursues healthcare service with great expectations such as quality health care, latest technological interventions and low cost for their service. Nowadays, one of the challenges facing by the health care providers is providing appropriate care and identifying their needs in a cost effective and comprehensive way without compromising the quality of care. Center for Medicare and Medicaid Services (CMS) reported “an rise in healthcare spending from $2.34 trillion in 2008 to $ 2.47 trillion in 2009, the largest one year increase since 1960” (Pickert, K, 2010). “The action to improve the American health care delivery system as a whole, in all of its quality dimensions such as efficiency, effectiveness, equitability, timeliness, patient-centeredness, and safety for all Americans” (IOM, 2011).
Today healthcare cost is constantly rising. It is important to ensure that patient 's health are maintained and supported outside the clinical settings such as their homes and communities. Healthcare organizations play an important role in serving people to provide an effective health care and improve the patients ' outcome. They focus on activities and strategies to provide a high quality care for many communities. This is their way of helping people and their community healthy. Organizations have a way of improving the patient 's outcome through monitoring of patients especially those who have high medical needs.
Managed care, managed care has become the dominant health care delivery source. Gaining popularity in 1990s, managed care increased from 27% in 1988 to 99% in 2009 and enrollment in Fee for Service plans decli...
Healthcare is considered of one of the most complex business models in the American Industry because it is one of the only industries where the consumer actually does not technically pay for the service he or she receives (Kudyba, 2010, p. 2). When consumers go to nail salons or hair salons, he or she pays the beautician for the specific service he or she asks for. In the healthcare industry it is totally different and most consumers do not understand the complexity of this business model. The consumer actually pays insurance companies and the insurance companies pay the provider/hospital based on negotiation arrangements from the data exchanges they receive (Kudyba, 2010, p. 2).
“Employment of medical and health services managers is projected to grow 17 percent from 2014 to 2024” With the generation of baby boomers heading towards retirement age, more of them will need to use the healthcare system, and this generation contains more people than previous generations have. Also, because this generation is probably living longer than any previous generations, they are more likely to have more chronic diseases as they age, which means more demand on the healthcare system as a whole. The medical and healthcare management will be highs demand to organizer information that and other need that a patient will be required.
Health care system is a prominent subject all over the world. Every country wants to provide the best health facilities and services to their people. Even than there are so many lapse in the health care field? As regard to U.S there are also so many short comings in the health care organizations. I have gone through and studied the background of the health care system being run by clinics, primary health care centers, and hospitals etc. People has to pay very high charges on every visit to the doctor or surgeon for medical treatments, follow-up and as indoor patients. Theses health care organizations demand plenty money and other hidden expenditures from the patients which is some time beyond the reach of the patients.
...mplications that allow for opportunities of change. One of the presumptions is for training and staffing (Shi & Singh, 2012). With the utilization of health care improvements, the staff will need additional instructions on the performance of equipment and how to efficiently achieve the desired results. Managers or supervisors recognize the need for supplemental staffing and training to optimize patient satisfaction and quality of care. The health care administrator must also focus on changes in insurance policies and rules governing the provision of medical assistance (Shi & Singh, 2012).