Sunday, June 9, 2013

Learning Module 1: Achieving Health Care


Healthcare in the United States is changing constantly with different reforms from different ideas of the president and Congress. I found this article about how achieving health care reform and how physicians can help.  There are two threats in particular that put reform at risk: conflicting doctrines (regarding the creation of a new public insurance option and government support for comparative-effectiveness studies) and opposition to change among some current stakeholders (Fisher,2009). The good thing about a physician position they have the chance to wait and see what happens or to lead the change our country needs. The article explains that physicians should first help to create a shared vision that could overcome doctrinal divides — and bring providers together to create a system better aligned both with public needs and with providers' fundamental interests and values (Fisher,2009).

I think the Healthcare reform is a challenge for anyone that has the opportunity to make changes because you will never be able to satisfy everybody in the U.S with different Acts for Healthcare.
If stakeholders can agree on such a vision of health care reform, perhaps we could shift our focus from the conflict over whether a new public plan should be created to a more constructive insistence that all health plans, whether public or private. However, neither physicians nor anyone else on the front lines can improve care much on their own. Their most important source of support for improvement is the third level described by the IOM — the health care organizations that house almost all clinical microsystems and can ensure coordination among them (Fisher,2009). The article explains that physicians can help by their support and help to develop integrated systems of care. So I feel like the U.S. Healthcare can become better over time if the physicians and congress, and legislation become one.

Reference

Fisher, Elliot. (2009, June, 9) Achieving Health Care Reform-How Physicians Can Help

http://www.nejm.org/doi/full/10.1056/NEJMp0903923






Leadership in Today's Changing Healthcare Environment



 While rising costs have driven the healthcare industry to think outside the box, it is only by having good leadership that this can be accomplished. It is one thing to be able to see the overall plan for the future, but another to be able to make it happen. Good leaders are multifaceted in their ability foresee the future or at least the direction they perceive the future to be (Meyer & Ron, 2013). Another characteristic in a good leader is their ability to be flexible and have the capability to change directions when the time comes to make the needed adjusts to adapt to the environment of the present. Good leaders also know that they need to provide the tools needed to help those managers and others in the leadership roles be able to accomplish their tasks at hand. Some of these important tools are time, resources, and the authority to get things done (Meyer & Ron, 2013). This article is about the new model of Accountable Care Organizations which include Medicare and Medicaid payer bases. The Centers for Medicare and Medicaid Services define an ACO as "an organization of healthcare providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it (Meyer & Ron, 2013).”  This is a tremendous undertaking by an organization, so many choose to organize affiliations with other facilities in order to incorporate all the needed services in order to make this happen. Of course by doing so, they must research, plan, and make wise decisions about who to affiliate with and when in order to accomplish these goals and stay within their focused directional vision. As long as schema within all the affiliated entities are the same in general, they will be able to stay on track and provide all the services needed without great expenditure, which is a cost savings provision as well (Buchbinder and Shanks, 2011).

References
Buchbinder, S., and Shanks, N. Introduction to health care management. 2nd edition. Burlington,MA: Jones and Bartlett Learning, 2011. Print.
Meyer, M., & Ron, A. (2013). Leadership is the key to a successful accountable care organization. American Journal of Managed Care, Retrieved from http://www.ajmc.com/conferences/NAMCP_2012/Leadership-Is-the-Key-to-a-Successful-Accountable-Care-Organization/

http://www.ajmc.com/conferences/NAMCP_2012/Leadership-Is-the-Key-to-a-Successful-Accountable-Care-Organization/

Saturday, June 8, 2013

Management Strategies

Planning and evaluation is always at the front line of health care today. Take information as an example. In the past there were log books and paper charts to keep track of patients, patient’s medications, and test results. Today there is extensive planning on the best way to collect patient information and also great planning in the evaluation of this information. Over the last decade, pharmaceutical companies have been aggregating years of research and development data into medical databases, while payers and providers have digitized their patient records (Kayyali, Kuiken, & Knott, 2013). Recent technical advances have made it easier to collect and analyze information from multiple sources—a major benefit in health care, since data for a single patient may come from various payers, hospitals, laboratories, and physician offices (Kayyali, Kuiken, & Knott, 2013). With these changes it is important of health-care stakeholders to compile and exchange information to keep up with the needs of patients and quality of service.

While health-care costs may be paramount in big data’s rise, but now care is based more on evidence based need. Physicians have traditionally used their judgment when making treatment decisions, but in the last few years there has been a move toward evidence-based medicine, which involves systematically reviewing clinical data and making treatment decisions based on the best available information (Kayyali, Kuiken, & Knott, 2013). Although the health-care industry has been the last to join the big data—partly because of concerns about patient confidentiality—it could soon catch up. If stakeholders are not on board they can find themselves left behind in the healthcare field.  Patient data is of great value due to it shows the trends and needs of today’s healthcare patients while provided much needed data for physicians and hospitals.



References



Kayyali, B., Kuiken, S. V., & Knott, D. (2013, April). The Big-Data Revolution in US Health Care: Accelerating Value and Innovation. Retrieved from McKinsey Insights on Health Systems: http://www.mckinsey.com/insights/health_systems/the_big-data_revolution_in_us_health_care



http://www.mckinsey.com/insights/health_systems/the_big-data_revolution_in_us_health_care

Friday, June 7, 2013

U.S. Health Care


Health Care in the United States is undergoing drastic changes as a result of the Affordable Care Act (ACA).  One of the main goals of health reform is to expand medical coverage to more Americans.
One way it is accomplishing this is by allowing parents to carry their young adult children on their medical plans up to the age of 26.  The law also allows young adult children who are married, attending school, not living with their parents and eligible to enroll in their own employer’s plan to continue coverage under thier parents medical plan (U.S. Department of Health and Human Services, 2013).  However, one stipulation is that they must not be financially dependent on their parents if they are not attending school nor have employment.  
The whole purpose is to increase the access to more people and reduce the amount of uninsured Americans.  An article published by New England Journal of Medicine reported that since the law took into effect, an increase of emergency room visits increased by 3.1%.  In a one year period it was calculated that $147 million in medical costs were now covered by newly insured young adults (Harris, Ph.D, et al., 2013).  Emergency room care is very expensive and increasing the coverage to young adult children will save money for both the parent and the adult child.  
The data shows, in at least one area of health reform, it is helping to increase coverage to young adults who otherwise would have gone without medical coverage needed to seek emergency care.

References
Harris, Ph.D, K., Finegold, PhD, K., Kellermann, M.D., M.P.H., A., Endelman, B.Sc.Adv., L., Sommers, M.D., PhD, B. D., & Mulcahy, PhD, M.P.P., A. (2013, June 07). Insurance Coverage of Emergency Care for Young Adults under Health Reform. Retrieved from www.nejm.org: www.nejm.org
U.S. Department of Health and Human Services. (2013, June 7). Young Adult Coverage. Retrieved from HealthCare.gove: HealthCare.gov

EHR Incentives


US Healthcare Systems
Module 1 – Article Summary

Jon Reed

Conn, J. (2013). Riding the wave

            This article deals with the government’s requirements for electronic health records (EHR), and how different health care providers are taking vastly different approaches. Some providers are striving to get to and stay on the cutting edge of information technology (IT), while others are still using paper records with the vast majority of providers left somewhere in between. One health group in California which includes a 409 bed hospital and multiple providers working out of multiple facilities plans on implementing a bar-code medication administration system and setting up a data warehouse for patient records, which should enable it to track patients as they move through the system, manage the overall health of its patient population and learn from its experiences (Conn, 2013). The hospital also plans to add a patient portal, which it sees as key to involving patients in their own care and a crucial part in improving population health while lowering overall healthcare costs (Conn, 2013). I thought this related to the article that James posted about our ranking in population health.  Some analysts are predicting a huge explosion in IT spending over the next few years from providers doing more of what this California provider is doing. On the flip side the more pessimistic analysts are predicting that these expenditures are strictly due to the government incentive programs that have already spent most of the funds.  Many are predicting that as soon as the government mandates are met that the care providers will turn to making all of the budget cuts possible due to lower reimbursement checks causing them to operate on thinner margins (Conn, 2013). Who knows what will happen in the next few years as the government mandates for providers and the government insurance programs go into effect.  From this article I gathered that there are a lot of predictions, but no one really knows. The one thing that I think we can all be sure of is that there are changes coming to our field, and we all hope they are good ones.

Reference

Conn, J. (2013). Riding the wave. Modern Healthcare,43(20), 6-7.
Retrieved from 

Tuesday, June 4, 2013

US Health Care

      It is almost unbelievable that there are that many countries who are doing better than the U.S. in the healthcare realm. The infant and adult mortality rates really make you think about whats going on, and mainly how are we as a country going to fix it. I really like the part where it mentions guarding households from destitution from medical expenses.  In my opinion that is one of our biggest problems that needs to be solved.  First the average American family has to budget low on groceries to afford some kind of insurance, and then their bank accounts are wiped out with one little emergency.  I wonder how in depth that study went and if it looked into the causes of death in all those mortality rates.  I am not down playing the study, but I would have a few more questions.  In these other countries how many of them have soda and candy available on every corner? How many of them have all you can eat buffets at a high percentage of restaurants.  What does the average families normal diet look like, and how much stress is placed on the bread winner at their place of employment?  Are most of the families struggling to make ends meet, or do they have a decent amount of disposable income?  With all that said I think my biggest question is, how does the lifestyle of these mortality rates compare from country to country.  Again, just some questions to further understand the numbers.

US Healthcare

US Healthcare


The World Health Report 2000, Health Systems: Improving Performance, ranked the U.S. health care system 37th in the world, a result that has been discussed frequently during the current debate on U.S. health care reform and the passage of the PCAA. Evidence shows that 36 other countries perform better than the US in ensuring the health of their residents. The framework of the WHO rankings proposed that health systems should be assessed by comparing the extent to which public health and medical care were contributing to serious social objectives; such as improving health, decreasing health disparities, guarding households from destitution due to increasing medical expenses, and providing services that are responsive and that respect the dignity of patients.
Many people the U.S. health arena claim that international comparison is not useful because of the uniqueness of the United States.  With that said Murray; etal. stated in 2010, “It is hard to ignore that in 2006, the United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy. These facts have fueled a question now being discussed in academic circles, as well as by government and the public: Why do we spend so much to get so little?

                                                                     Reference

Murry, C., Phil, D., & Frenk, J. (2010, January 14). Ranking 37th — Measuring the Performance
          of the U.S. Health Care System. In The New England Journal of Medicine. Retrieved  
         June 4, 2013, from http://www.nejm.org/doi/full/10.1056/NEJMp0910064