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Introduction to the U.S. Health Care Delivery System SLP

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The overall goal of the Session Long Project is to examine health care delivery in the United States from a strategic perspective.

Assignment for Module 1:

President Obama signed a new bill that changed the landscape of the health care industry. This new law has resulted in uncertainty for patients and health care organizations. In his article, “Three Brutal Facts That Provide Strategic Direction for Healthcare Delivery Systems: Preparing for the End of the Healthcare Bubble,” Nathan Kaufman discusses that the health care industry is heading for a fall and that organizations need to prepare now by focusing their strategies on new market realities. This will be the focus of this assignment. Please read the article by Kaufman (will be uploaded) and then respond to the following questions.

-Why does he believe the health care bubble is going to burst? Do you agree or disagree with his views?

-Discuss what he means by “Physician autonomy and the organized medical staff will become less relevant.” Do you believe this will improve patient care?

-Discuss what a prepared organization is to Kaufman. Do you believe this is what it will take to effectively deal with the health care bubble? What are some suggestions that you have based upon this article and your own research?

SLP Assignment Expectations

LENGTH: 2 page typed and double spaced using 12pt Times New Roman font and 1 inch page margins. Please use headers throughout the paper. This will aid you in not overlooking vital elements of the assignment and make the document easier for the reader to follow.

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Description

 

Nathan Kaufman believes the health bubble is headed for an imminent state of bursting. His reason for such an assertion is based on the fundamental state of national debt that has taken an upward trend due to health care provision. The Affordable Care Act has resulted in more uncertainty than its original purpose of reducing deficit as reflected in the baseline projections. According to his evaluation, Kaufman believes that both federally funded and state-funded health care will exert more pressure on providers to decrease the per capita cost of care. The short-run effect of this action is that there will be reductions in the fee schedules. The long-run effect entails the transition of government-funded health care from the free-for-service reimbursement mechanism to population-based payments or bundled payments (Kaufman, 2011). Kaufman assertions are in fact correct given the current reductions in fee schedule reflected in Medicaid programs for some states. Moreover, the transition in payment methodologies is a common trend in the U.S. Thus Nathan’s assertions are true.

According to Nathan, physician autonomy, and the organized medical staff will become less relevant. The conventional way of medical functioning involved medical staff having the responsibility of observing and upholding high-quality health care in hospitals. Moreover, the health care costs ordered by the physicians was a financial risk borne by the hospital. Nonetheless, this is no longer the case given the introduction of a value-based purchasing program (VBP) for Medicare inpatient services. The brutal fact is that VBP puts the revenues of the hospitals at a risk subject to the communication and practice skills of their physicians. This has led to a situation whereby hospitals are no longer at a position of delegating responsibility and accountability for quality and cost of health care to an independent medical staff of physicians. With this adoption, hospitals are perpetuating the conventional autonomous highly variable model of care. Thus, physician autonomy and the organized medical staff will become less relevant (Kaufman, 2011). Nathan’s assertions are true, since most current health delivery systems emphasize on value of service so much so that hospitals adjust their systems to incorporate more customer satisfaction with physicians merely following laid down regulations. VBP may improve patient care in the short-run but in the long-run; the cost of financing such programs will surpass the affordability of health care accorded to patients

According to Kaufman, while other health organizations (unprepared organizations) will dismiss or shun the incremental approaches such as first-generation clinical integration and Medicare Shared Savings ACO, prepared organizations will do otherwise. Prepared organizations will focus on instituting reasonable transformation into a provider system that entails patient-centered, digitally-connected, data-driven, physician-led teams that constantly provide evidence-based health care (Kennedy, 2010).  Having prepared organizations will ensue in positive steps towards improving patient care and dealing with the health care bubble, through the physician-led teams. The teams will be at a position of treating immense patients at considerably lower predictable costs per session, thus, evincing measurable high quality and delivering outstanding patient experience.

Kaufman’s suggestion of a prepared organization is very vital to dealing with the health bubble. However, there are other suggestions that are vital towards better healthcare delivery. Health care delivery reforms are most efficient when they are integrated and ensure real and technical accountability from the providers as well as patients to improve results. For instance, the efficiency of a single disease management program may be limited for patients having numerous chronic conditions and those who require coordinated care from several specialists. Thus a multiple approach is preferred. Moreover, the efforts towards coordinated care will have a