- Identify The Three Key Factors of The Three Systems
The three key factors of integrated health care systems are technological advancements, the effects of reimbursement policy, and changes in the legal and organizational environment. Technological advancement continues to grow, targeting various areas in the society including hospitals. The advancement has played a major role in almost all hospital processes by accelerating development of structure and management. Patient registration, data monitoring, and lab tests are enhanced by technology. Disparate systems previously existed because one system was handling pharmacy, another one was handling orders and another documentation. However, integrating such systems into one platform has produced a structured approach that has resulted in integrated and efficient healthcare.
Reimbursement policy through reforms like Affordable Care Act is completely changing the traditional fee for fee value to fee for service program. The government has been urging providers to adopt the policy by promoting integrated networks. Reimbursement policy has facilitated coordination of care and strategic reasoning as well. In addition, the sector has witnessed decreased spending within the integrated systems with no negative impacts on the health outcome of a patient. Even though the initiative has improved the healthcare delivery, the financial performance of the systems has reported decreased gains in many instances (Auerbach et al., 2013). Private providers are finding it difficult to adopt the change due to the potential decrease in their benefits. Attention to the community has improved, but there are new risks created that should be addressed.
Changes within the hospital sector significantly affect general management within hospitals. The horizontal and vertical integration has brought a significant change in both governance and structure of hospital management eventually contributing to the development of financial efficiency within the sector by increasing levels of accountability. The changes have also increased the level of competition that has contributed to enhanced quality of medical care. The competition has brought tremendous effects including closures and consolidations, especially for smaller institutions.
- Why Do You Feel There Are Three Separate And Different Models?
I think the three separate and different models are in place to streamline governance and management operations within the industry in an effort to organize the structure. The healthcare industry is a large sector in the economy with many issues that need to be handled in an organized way. Issues like the actions of private entries that are driven by profit motive instead of healthcare needs should be handled by horizontal integration systems that control the activities of for-profit and not for profit healthcare sectors. By separating the systems, the efficiency of the whole industry is enhanced through specialization. The separate healthcare system is an approach that ensures quality and improves healthcare services.
- From Your Perspective What Are The Advantages (List 2) And Disadvantages (List 2) Of These Three Systems?
Some of the advantages of integrated systems are improved medical care and cost control because such systems bring coordinated healthcare to consumers. The objective of the systems is reducing costs and providing best healthcare. The US has been faced by increased spending in healthcare costs because the expenditure from the sector is an average of about $2 trillion each a year. Integrated systems are appropriate because they keep the costs under control while improving medical care to the patient. Integrated care systems also mitigate the moral hazards. By giving salaried remuneration, doctors do not make more money depending on the number of diagnostics done, buts are rewarded for work well done.
The integrated systems have changed the organizational structure of the hospital industry because the primary care specialists control services that were traditionally provided by the secondary care specialists. The situation has made it difficult to distinguish the secondary care specialists from the primary care specialists (Shi and Douglas, 2005). The difficulties of defining primary healthcare have resulted in the need for integrated systems in an effort to align the physician’s interests with the institutional objectives. Giving physicians the right of ownership has increased the competition and pricing pressure within the industry. The fact that physicians can own surgery centers, ambulances or specialty hospitals is a threat to hospital delivery systems. The physician trend has provided few evidence of the superiority of integrated models over key factors like patient quality care and cost effectiveness. The other disadvantage is failure of vertically integrated systems to account for greater degree risk created by providing chain delivery services to a wide range of health services other than specializing in one product. According to Williams and Torrens (2008), some vertically integrated systems have established their health plans. However, financial and legal perspectives that transfer the risk to the institutional provider have affected the trend.
The integrated delivery system is associated with certain issues in both risk management and financial perspective. New liabilities continue to evolve as the systems become integrated. Despite the challenges, many opportunities emerge that turn such risks into advantages. The government needs to be careful when implementing reform by first analyzing risks versus benefits and approving reasonable strategies that the majority support.
Auerbach, D. I., Liu, H., Hussey, P. S., Lau, C., & Mehrotra, A. (2013). Accountable care
organization formation is associated with integrated systems but not high medical spending. Health Affairs, 32 (10), 1781-1788.
Shi, L. & Singh, D. A. (2005). Essentials of the US health care system. Burlington, MA: Jones & Bartlett Learning.
Williams, S. J. & Torrens, P. R (2008). Introduction to health services. Clifton Park,
NY: Thomson Delmar Learning.