Changes in the health care industry
| Title
ABC/123 Version X |
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| Weekly Overview: Week 6
HCS/514 Version 3 |
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Weekly Overview
Week 6
Overview
Changes in the health care industry affect an organization in many ways. One external change is health care reform. The Patient Protection and Affordability Care Act (PPACA) is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress. PPACA reforms certain aspects of the private health insurance industry and public health insurance programs. For example, it broadens populations that receives health care coverage through private and the public sectors, allows for prevention and wellness, and forces improved quality of care by ensuring the expansion of pay-for-performance where payment will be linked to patient care outcomes. Other changes that may affect organizations in health care include empowered customers, alternative forms of medicine, technology advances, social media, and community-based integration systems. Internal factors also affect change in health care organizations. Examples include changing work force, shared leadership, changing reimbursement and health care entity alignments.
There will also be future challenges and benefits for health care organizations. Notable challenges include the provision of health care in nontraditional avenues such as department and drug stores. Schools and urgent care centers also provide components of health care and service as supplements to traditional forms of care delivery. Roles of health care providers are also changing; for example, nurse practitioners will provide more primary care, and the nursing shortage will continue requiring greater need for job redesign. Still other challenges include universal insurance; states will take on a greater role in health care financing in the form of exchanges and health care providers will receive fewer dollars for services.
Despite all of that, there will be new and exciting benefits for the changing health care industry as well. Some examples include the redesign of the health care delivery in the forms of primary care medical homes (PCMH), accountable care organizations (ACOs), and clinically integrated network systems (CINS). These entities will drive higher quality, reduced hospitalizations and ER visits, and favorable patient and provider experiences.
What you will cover
1. Future challenges
a. Describe how changes in the health care industry affect an organization.
1) Health care reform
a) Broadened population that receives health care coverage through private and the public sectors;
b) Prevention and wellness
c) Improved access to health care specialties
d) Improved quality of care; this would be accomplished by ensuring the expansion of pay-for-performance where payment will be linked to patient care outcomes
e) Decreased health care costs
f) Addressing challenges
(1) Patient-centered medical home (PCMH): http://www.pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483
(2) Accountable care organizations (ACOs): http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/ACO/
(3) Clinically integrated networks (CINs)
2) Empowered customers
3) Alternative forms of medicine
4) Alternative environments for health care provision
5) Economic factors
6) Advances in technology
7) Internet
8) Community based integration system
9) Regional diversity
b. Explain how internal factors affect change in health care organizations.
1) Changing boundaries
2) Changing workforce
3) Shared leadership
4) Changing relationship with the community
5) Changing relational networks
6) Changing reimbursement
c. Forecast future challenges and benefits of health care organizations.
1) Challenges
a) Health care will be provided in different environments
(1) Walmart and other department stores
(2) Drug Stores
(3) Urgent centers
(4) Schools
b) Health care providers will take on different role
(1) Pharmacists will prescribe and manage medications.
(2) Nurse practitioners will provide more primary care.
(3) The nursing shortage will continue requiring greater need for job redesign.
(4) Education of health care providers will be multi-disciplinary.
c) Health care financing will change.
(1) Universal insurance of universal health care
(2) States will take on a greater role in determining health care financing.
(3) All health care providers will receive fewer dollars for services—may in turn cause greater shortages in providers
d) Advances in technology
(1) Increased access and quality to rural areas
(2) Greater use of telemedicine
(3) Less invasive procedures
(4) HIPAA
(a) Assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high-quality health care
(b) Protect the public’s health and well-being
e) Fear of the unknown
2) Benefits
a) Greater access to care
b) Improved quality of care
c) Less expensive care
d) A complete redesign of the health care system resulting in a redesign of health care organizations
Copyright © XXXX by University of Phoenix. All rights reserved.
Copyright © 2013 by University of Phoenix. All rights reserved.
