Health Care Delivery Systems Essay
In this assignment, you will compose an essay of 750–1,000 words examining the similarities and differences among health care delivery systems that currently exist in the United States.
Include the following in your assessment:
1. Select two or three health care delivery systems to examine.
2. Provide a description and relevant details of the selected delivery systems.
3. Summarize the mission or philosophy statement for each of the health care delivery systems you selected.
4. Formulate your own mission or philosophy statement, with rationale as to why you chose these elements to include.
Support your statements with appropriate and scholarly sources from the GCU Library or other qualified sources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Health Care Delivery Systems
Health Care Delivery System refers to the collective group of people, organizations, who come together to formulate one system whose responsibility is to enhance health promotion, disease discovery, illness treatment, and rehabilitation. The US has a unique Health Care delivery system that was developed due to market forces and the difference in health needs among people. These systems include Managed Care, military care system, integrated delivery, and health care delivery system for valuable individuals (Stevens, & van der Zee, 2017). However, this study will focus on the description of managed care, military, and integrated health care delivery systems. It will also provide relevant information on three systems and give a summary of mission or health statements rational to the reason for choosing managed, military, and integrated health care delivery systems.
Description and Relevant Details of The Selected Delivery Systems
Managed Care Delivery System
Managed Care refers to a health care model that is involved in healthcare provision by reducing the cost of medical services and the elimination of infective service in the healthcare system. United States residents are subjected to insurance or medical cover that reduces the cost of health care services. This model is one of the most dominant health care delivery systems in the United States. The system was implemented in the late 19th century when physicians and several companies organized their medical provision models for their workers and other stakeholders. Managed care is conducted through two organization that is preferred providers organizations and health maintenance organization (Jones and Bartlett, 2017).
Additionally, this model of healthcare provision employs different strategies during the health delivery process and medical financing. The essential strategy used include the use of innovative economic incentives, use discriminatory contracts, and application review. Selective agreements were developed through a comparison of different hospital and physician charges for a similar medical condition. This enhances the determinations of the lowest possible price for a particular medical service. Through selective contracts with various hospitals, the managed care health care delivery model ensured the provision of medical services with substantial discounts to enrollers. This strategy reduced competition and increase the quality of health care services in the United States. This strategy also minimized the cost of doctors and physicians by implementing payment and salary increment basing on performance. Also, managed care system organizations have implemented the use of computer systems for monitoring critical internal information. These computers provide feedback on medical services prices and the quality of healthcare. This ensures continuity of quality medical care provisions. Finally, utilization review strategy uses different programs, for example, preadmission screening. This program is used during the determination of the necessity of performing medical services or procedures to avoid unnecessary expenditure, yet the organization cannot perform such operations (Jones and Bartlett, 2017).
Advantages and Disadvantages of Managed Care
This model health care delivery system ensures a general reduction of patents expenses during the medication process. It also provides proper coordination of patients and medical providers. The system also ensures continuity of quality care provision through the use of computers to monitor health care provisions. Some organizations using manage care system offer transport facilities to patients enrolled in the model. Unfortunately, organizations using managed care model care not to provide medical services to patients suffering from chronic diseases and disabilities. This because organizations using a managed care model primarily focus on targeting the needs of normal individuals that medical necessity that trend to illuminate some individuals. Also, people with reading disability doesn’t fit under the restoration of function criterion that requires the patient to provide consent medical care.
Medicare Health Care Delivery System
Medicare health care delivery model concerns the provision of medical services to people who are sixty-five years older and above. Four different insurance techniques govern this model. These insurance plans include Part A, which entail the use of additional health cover plan and Part B. The other two are privately managed, which is Part C that involves Medicare Advantage and Part D that include drug prescription during medical cover. Patients’ medical care requirement is financed through social security payroll taxes. This model also helps in payment of inpatients hospital services, home health care, and expert home nursing.
Additionally, this model of health delivery system provides cover of patients up to ninety days for every episode or befit period for a particular disease. This period starts from the time the patient was admitted to the nursing facility or hospital up to the time the patient is out for sixty successive days. But every patient pays an initial deductive fee for the health facility care that is used during the first sixty days of the benefit period. Also, the patient is supposed to pay a daily fee that is called co-payment, which is used for hospital care in the next 3o days. However, all the remaining medical expenses are covered by the Medicare health service payment model.
Furthermore, this model of healthcare delivery also pays for professional nursing care for a hundred days in a nursing facility. This payment plan comes after patients have been hospitalized for the first thirty consecutive days in that particular nursing facility. Therefore, the early twenty days after hospitalization are always free. Every patent under this cover has sixty more days in the hospitals that can be utilized any time, even if the patient exhausts eligible ninety days in the hospital. Besides, Part B of the medical plan pays eighty percent of the total bill incurred for the surgeon’s and physician’s services. Individuals enrolled in this model are also enrolled in an add-on medical plan. But, Part C that involves Medicare advantage plans is usually governed by private entities that are controlled and approved by Medicare. These private entities provide all medical cover for their stakeholders. Finally, Part D of Medicare that entails coverage of prescription drugs is usually managed by private sectors. But for an individual to be eligible for this Medicare plan, he/she must be enrolled in Part A or Part B medical plans (Jones and Bartlett, 2017).
Military health care delivery System
The military health care delivery system provides free medical cover to individuals who are active members of the United States army, Coat Guard, Navy, and Air force. This system if highly integrated and well organized. This system covers all the medical services, including prevention as well as treatment processes provided by the same military officers or other people on service. It also combines health care services with public services that are ambulatory medical care, routine medical service, complicated care, and long-term care—the regular ambulatory health care at the military’s workplace, sickbay, medical station, and dispensaries. Complicated medical care services are usually executed at a regional military hospital. On the other hand, long term care is offered through Veterans Administration facilities to cater to retired military officers. This system provides high-quality medical care though patients have no choice over the kind of medical service being provided.
Furthermore, a family member of military personnel is covered by TRICARE, a dispensaries or hospital under the military. Those disabled are also given a priority during medical services. The Veterans Administration health care focuses on providing mental health services, hospital care, and long-term care. This is the oldest and largest in the entire United States. Its primary aim is to provide health care, training education emergency management, research, and contingency support in defense medical care systems (Jones and Bartlett, 2017).
Summary of Mission or Philosophy Statement
Managed Care Mission Statement Summary
Managed care health care delivery system is to be known as resources and professionals in the health care nursing sector in the United States. Another essential Mission of Managed Care is to have an impact on public policy relative to managed health care provision. It also aims at the establishment of standards necessary for managed care nursing practices. It also has the mission of assisting educating people about managed care.
Mission Statement of Medicare delivery System.
The mission of the Medicare health delivery system is to enhance change is the health care sector by finding new techniques to deliver and pay for medical services at a lower cost. It also aims at improving medical services through the establishment of reliable standards. Medicare also is focusing on ensuring widespread and adoption of their innovative healthcare that pays at low cost but of high quality and the new model of payment. Medicare mission in categorized into three essential groups that are better care., smarter sending, and healthier people. Better care aims at the improvement of patients’ experience, along with the significant six domains of the Institute of medicine.
On the other hand, healthier people entail encouragement of quality health for the whole United States population. This will be achieved by looking at things that are a significant cause of poor health in the entire country—finally, smarter spending aim at lowering the cost of health care across medical care institution.
Mission Statement of Military Health Care Delivery System.
The military health care delivery system has three essential missions about their health delivery services. The delivery system aims at ensuring entire medical personnel in military uniform are educated to prepare them for medical care. This will provide excellent support for all operations around the globe. It also aims to ensure all over 9.5 million military personnel benefit from all medical services to commensurate with their sacrifice and effort towards public services. Finally, this model of healthcare aim at strong safety of over 1.4 million and other around three hundred thousand reserved active duty military personnel.
Formulate your mission or philosophy statement
My mission is to ensure every single individual in the entire United State Population gets quality medical services at an affordable cost. These will be achieved by offering adequate medical cover that will cater to almost the total cost of medical bills. I will also ensure the delivery of quality health services by setting critical standards. I make sure that people with disabilities have their particular medical cover that can affect sure safety of medical service delivery. My mission also is to incorporate technology in training people on the value of taking medical cover for chronic diseases that will reduce the cost of treatment in case of diagnosis (Mohammed et al., 2016)
The rationale as To Why You Chose These Elements to Include
Some people in the United States do not have health care coverage. Therefore, the emphasis of putting forward is to ensure universal medical cover in the US health care system. Also, some existing health care delivery system does not have protection for individuals who cannot read well or reading and writing disabilities. Hence these elements are included to ensure coverage of people with disabilities. Technology is also an essential element include in the mission statement because it will increase the effectiveness of the health care delivery system. This because technology will contribute to the creation of awareness about choosing the right health care delivery system that will cover almost all medical services (Mohammed et al., 2016).
The health care delivery system refers to a group of individuals and health care institutions that formulate a joint partnership whose aim is to ensure the delivery of safe, quality, and affordable health services. United State has various health care delivery systems since its doe not have a conventional universal health care system. Some of the health care delivery systems in the US are: military, managed care, Medicare, Medicaid, integrated health delivery, and health care delivery system for vulnerable individuals.
Managed care entails the provision of health care services under reduces costs and high-quality medical services. This model subject individuals in the United States on the medical cover. These are achieved through the use of innovative economic incentives, application review, and use of discriminatory contracts; on the other hand, the Medical health care delivery model entails the provision of medical cover for individuals who are 65 years old and above. This method of health care delivery is subdivided into four major parties. That is part A that involves the use of additional medical cove; Part C and D are privately controlled. Part C ensures the provision of therapeutic advantage for eligible people. Part D of this medical delivery cover medical prescription of people under Plan A and B cover. Finally, the military health care delivery model ensures the provision of free medical cover to people in the army, air force, and other retired military personnel.
The mission of Medicare is to enhance change in the health care system through finding new ideas of health delivery and provide medical service at a lower cost. But, military health care aim at ensuring people in uniform understand quality medical services and also give free cover for individuals on active duty. However, a managed care mission if to be recognized as a professional health care nursing entity in the United States and establish standards that will have an impact on public policies. Finally, my mission is to ensure every individual in the US population get quality and affordable health care through provision almost 100 per cent medical cover.
Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., & Murad, M. H. (2016). Creating a patient-centred health care delivery system: a systematic review of health care quality from the patient perspective. American Journal of Medical Quality, 31(1), 12-21.
Stevens, F., & van der Zee, J. (2017). Health Care Delivery Systems. The Blackwell Encyclopedia of Sociology.
Jones, F., & Bartlett, P. (2017). Retrieved 15 March 2020, from https://samples.jblearning.com/0763763802/63800_CH01_Final.pdf
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