Ambulatory Care Model

Urgent care centers bridge the gap between emergency rooms and primary care physicians. By doing so such facilities are able to fill a niche in the market. However, one of the main drawbacks of urgent care centers is that continuity of care is low. Many patients, particularly the elderly, place a high importance on building relationships with their providers. Convenient care, with its episodic nature, poses the risk of fragmenting and disrupting such relationships.

Despite higher spending on health care, the U.S. health care system ranked last on patient safety, efficiency and equity according to the Commonwealth Fund survey. Our aim should be reduction of high healthcare costs without decreasing people access to health care or sacrificing quality. A collaborative effort is required to work on above recommendations to solve the problems besetting our health care system. References: 1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096004/ 2.

Introduction For several decades, government officials and healthcare experts have been discussing the broken and dysfunctional US healthcare system. The US ranks highest for cost and lowest for outcomes. Healthcare accounted for 17.4 percent of the gross domestic product in 2013 (CMS.gov). The Institute for Healthcare Improvement highlighted the quality of healthcare in the US or lack of quality with the 100,000 lives campaign. The Institute for Healthcare Improvement brought national attention and awareness to the epidemic of hospital errors and the loss of life related to those errors.

According to Garment (2013), “The American Association of Medical Colleges (AAMC) estimates that the U.S. will face a physician shortage of over 90,000 physicians by 2020; a figure that’s expected to reach over 130,000 by 2025” (p.4). The increasing amount of money required for health care services from a physician is a driving force to pursue alternative ways of receiving primary care. According to The American Association of Nurse Practitioners (2013), “NPs in a physician practice potentially decreased the cost of patient visits by as much as one third, particularly when seeing patients in an independent, rather than complementary, manner” (p. 2). NPs are maintaining the standard of care and for a lesser amount for patients to pay. Mid-level practitioners are completing the same amount of work and improving the quality of care.

Accountable Care Organizations (ACOs) are comprised of doctors, practitioners, and hospitals, to give healthcare services to patients. The goal of coordinated care is provide high quality of care through an integrated service model while avoiding unnecessary duplication of services and preventing medical errors. The ACO is evaluated through a quality metrics to assess care provided to patients in a cost efficient manner. CMS has established five domains in which to evaluate the quality of an ACO 's performance which include 1) patient/caregiver experience, 2) care coordination, 3) patient safety, 4) preventative health, and 5) at-risk population/frail elderly health. When the ACO is successful in providing care through this system, the savings

Physicians and Hospitals go hand in hand when it comes to the medical care of patients, and it is this relationship that allows the patients to receive the care they need and deserve. It is also this relationship that we as health care administrators need to understand. In order to fully understand this relationship we need to define the concept of the integrated physician model. We also need to explain the importance of clinical integration in the strategic planning process, and the dynamics of and controversies surrounding accountable care organizations and alternative approaches to the current health system. I will also explain the advantages and disadvantages for hospitals and physician’s models.

In the film Escape Fire the Fight to Rescue American Healthcare, there were many insightful examples of why our Unites States healthcare revolves around paying more and getting less. The system is designed to treat diseases rather than preventing them and promoting wellness. In our healthcare industry, there are many different contributors that provide and make up our system. These intermediaries include suppliers, manufacturers, consumers, patients, providers, policy and regulations. All these members have a key role in the functionality of the health care industry; however, each role has its positives and negatives.

What is the projected demand for workers in the health care field over the next 20 years? The demand for primary care services has stimulated the training of nurse practitioners, physician assistants, and certified nurse midwives who can deliver basic primary care to patients without access to primary care physicians. How does the aging of the population, health insurance reimbursement, and consumer demand impact the practice patterns of health care clinicians? A physician shortage is expected by 2020, primarily driven by the demand for physician services.

This paper focuses on providing a brief history of PAs and evaluating the profession in relation to the US health system values of access, cost, and quality. Finally, patient satisfaction, crucial to MCOs in an increasingly competitive market, is discussed. Physician Assistants The physician assistant profession is a relative newcomer to healthcare. It originated in the 1960s with the return of medical corpsmen from the Vietnam War who had military medical skills they wanted to apply to the civilian health care market. These skills were seen as a way to extend the practice of a primary care physician, divert less acute or complex problems to the PA, and manage the need for primary care services in underserved areas (Benjamin et al., 1999).

Another group, the Quality Partners, a nonprofit group established to be a Medicare improvement organization, tested an intervention to reduce thirty-day hospital readmissions. As a Medicare-funded pilot program, it involved coaches meeting with patients to empower them to reach out to community providers when symptoms begin, rather than when waiting until there is a need for the hospital (“Intervention Lowers”, 2011). These studies display the opportunity for change when healthcare

The study of this program is beneficial because most elderly clients who come into the emergency department with pain or injury associated chronic illness. More often than not, these clients, who may be cared for with palliative or hospice care, do not have easy access to these services. In addition, Medicare does not always pay for necessary services that are so needed by clients with severe chronic illnesses, especially in urban areas. Sixty-nine percent of clients and their families’ who participated in this study expressed true satisfaction in the services provided by nurses.

Some variability differs with the capability of providing out-of-network health providers and the services in which can be provided. By having a broad range of choices that can be provided, will cause a higher the cost for the individual that is paying. Most Medicare patients have received the managed care plans due to promises of a lower copayment amount and often medication benefits. Medicare post-acute spending has grown rapidly with the number of users between 1999 and 2007. The growth in Medicare short-term post-acute service use, in part, reflects short hospital stays and a growing demand for rehabilitation services.

“Healthcare facilities and practitioners are licensed and regulated by federal, state, and local governments and laws” (Gartee, 2011, p. 43). Having accreditation means that an organization has been recognized for upholding standards and compliance. In efforts to ensure quality care of patients, an organization must meet Joint Commission standards in which a facility is one of the accomplished facilities. The Joint Commission is better known as JCAHO stands for the Joint Commission of the Accreditation of Healthcare Organizations. JCAHO was established to recognize the best organizations but in the process to improve the quality care among disadvantaged institutions as well (Kobs, 1999).

According to a provision under the ACA, Medicare would be remunerating healthcare organizations from the savings acquired through care quality enhancement and cost reduction. It is mandatory for all the health care organization to be transformed into Accountable Care Organization to promote this shared savings program. This model also has a dominant contribution to a skillful patient treatment during the care course. Some affiliates of a particular accountable care organization provide health care same means to all the practitioners, hence the medical tests and appointments are conducted under that. If a patient pursuing second opinion or any specialist’s opinion rather than the insight of a primary care physician, he will be referred to the specialist within that organization in order to keep the patient from incurring additional

Previously, majority of healthcare systems were driven by other goals such as ensuring enhanced care access, containing the costs of healthcare delivery, and promoting patient convenience/customer service in a bid to improve the efficiency and quality of healthcare. However, the financial collapse had far-reaching consequences for the healthcare systems as it