HEALTH CARE DELIVERY SYSTEM IN THE UNITED STATES
Assignment Overview
Please view these short video clips before starting your assignment:
How Health Insurance Works: https://www.youtube.com/watch?v=A4-pklsDT_Q
Health and healthcare disparities in the US: https://www.youtube.com/watch?v=7qAld9bGwlA
Comparing Health Care Quality: A Road Map to Better Care: https://www.youtube.com/watch?v=5seWqqYBL4s
Health Insurance Basics: How Do I Choose the Right Plan? https://www.youtube.com/watch?v=OPTejyvg6Qg
The Healthcare System of the United States https://www.youtube.com/watch?v=yN-MkRcOJjY
Assignment
Read the attached readings, you should now have a basic understanding of the characteristics and components of the U.S. health care delivery system. For the Assignment, conduct additional research as needed and prepare a 3 page paper to address the following questions:
Discuss the interaction of the major components of the U.S. healthcare system on
(1) Access to Health care (physically and financially),
(2) Health care Expenditure, and
(3) Quality of Care. Answer the questions from the perspective of two of the internal factors and one of the external factors identified below in assignment INTRODUCTION —–BELOW.
Assignment Expectations
• Cite all sources and provide a reference list at the end of the paper (include at least five references).
The paper should be 3 pages typed and double-spaced.
****Introduction
The course begins with an overview of the U.S. Health Care Delivery system (Module 1).
We will then explore the various organizations responsible for delivering health care: the physician practices, hospitals, and integrated delivery systems. We will also examine the structure of the system, including the types of institutions that comprise it and how they interact with each other, the flow of money and services among them, and the paths that patients follow through the system.
Finally, we will delve into government-supported health care coverage: Medicare and Medicaid.
The U.S. Health care system is influenced by the following forces:
Internal factors:
Financing:
• Public health insurance programs such as Medicare, Medicaid, State Children’s Health Insurance Program, and TriCare.
• Employer-provided health insurance.
• Commercial health insurance.
• Out-of-pocket payments.
Payment:
• Payment mechanisms used by public and private health insurance programs, including but not limited to fee-for-service, capitation, per diem, global budget, pay for performance, shared savings, gain sharing, bundled payments.
Delivery:
• Health care delivery institutions such as hospitals, ambulatory care clinics (e.g., community health clinics, and physician offices), pharmacies, and rehabilitation centers.
Resources:
• Health care human resources, including all types of health care professionals (physicians, nurses, therapists, pharmacists, technicians, and so on) as well as management and administrative personnel.
• Health IT infrastructure.
• Medical equipment.
Regulation:
• Federal and state legislation that regulates all agents in the health care system (e.g., Patient Protection and Accountable Care Act [PPACA], Health Insurance Portability and Accountability Act [HIPAA], Consolidated Omnibus Budget Reconciliation Act [COBRA], and Employee Retirement Income Security Act [ERISA]).
External factors:
• Economic development.
• Political climate.
• Population characteristics such as demographic composition and health outcomes.
• Social and cultural values.
• Technological development.
The combined interaction of these forces influences the structure and the development of the U.S. health care system.
Major Characteristics of U.S. Health care Delivery
• No central governing agency to integrate and coordinate health care.
• High in cost, unequal in access, and average on outcome.
• Access to health care services is selectively based on insurance coverage.
• Technology-driven delivery system focusing on acute care.
• Legal risks influence practice behavior.
• Multiple players and balance of power.
• Quest for integration and accountability.
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