This presentation/lecture was given on Monday, May 18th, 2015 as part of the International Week lecture series at FH-OBEROSTERREICH (FH-Steyr Campus - Upper Austria University of Applied Sciences) in Steyr, Austria. This lecture covers the historical perspectives that led to the 2010 legislation that has once again changed how healthcare is delivered in the United States; whereas, it discusses in more detail the impact, outcomes and future.

1. Healthcare Delivery in the United States
Patient Protection and Affordable Care Act (PPACA) and the Paradigm shift for
Leadership, Quality and Change in Healthcare
By: Erik Hollander, MBA
Milwaukee, WI (United States)
May 2015, Upper Austria

2. Overview
• Overview
• History of Healthcare in the US
-Prof. Hollander
• Current State
• Future State
• Review

3. Slide Title

4. Bio
• Retirement
• Work
• Education
• Teaching
• Family
• Leisure

5. History of HC in US
Source: Adapted from: A Brief History: Universal Health Care Efforts in the US: transcribed from a talk given by Karen S/ Palmer, MPH, MS in San
Francisco at the Spring, 1999 PNHP meeting
Source: Adapted from: PBS Healthcare Crisis: Healthcare Timeline,
Source: Adapted from US Dept. of Health and Human Services, Historical Highlights, 2014
Source: Adapted from Kaiser Family Foundation, Timeline: History of Health Reform in the US, May 2013

6. Source: Adapted from: CIS Portfolio, Julieth Rojas, St. Olaf College, 2015

7. Current
Source: Adapted from: Are Healthcare Consumers at the Forefront of Digital
Health? By Barbara Ficarra, RN, BSN, MPA and Ben Heubl
Source: Adapted from: Experts say rural healthcare in crisis: OIG report,
Medicaid opt-outs cause concern; August 29, 2013 by Zack Budryk
Source: Adapted from: 8 Issues Affecting Population Health Management Right
Now; Dec. 16th, 2012, by Matthew Smith

8. United States Census Bureau
http://www.gwu.edu/~forcpgm/Ortman.pdf
Source: Adapted from: U.S. Population Projections 2012 – 2060; Presentation for the FFC/GW Brown Bag Seminar Series on Forecasting; Washington, D.C.,
February 7, 2013 by Jennifer M. Ortman, Population Division, United States Census Bureau

9. Current
Source: Adapted from: How to Effectively Implement Organizational Change; By Brad Sugars, 2014

10. Charity Care
Source: Adapted from: Milwaukee-Area Hospital Systems; Milwaukee Business Journal,
Charity Care, bad debt increased in 2011; Corrinne Hess, December 23, 2011
Source: Milwaukee Business Journal, More Charity at Hospitals, June 29th, 2006, by Ben Fishcer
Source: Hospitals seeing drop in bad debt, charity care, October 22, 2010, by Corrinne Hess

11. Current – Medicare / Medicaid

12. Current
Source: Adapted from: The Joint Commission, Quality logo, 2015
Source: Adapted from: Commission on Cancer, Logo, 2015
Source: Adapted from: NCI, Community Oncology Research Program, 2015
Source: Adapted from: ASCO, QOPI, 2015
Source: Adapted from: Univ. of Nebraska, FACT, 2015

13. Price per Capita - OECD

14. Growth in Total Health Expenditure Per Capita, U.S. and
Selected Countries, 1970-2008
Source: adapted from:
Organization for Economic Co-operation and Development (2010), “OECD Health Data”, OECD Health Statistics (database). doi:
10.1787/data-00350-en (Accessed on 14 February 2011).
Notes: Data from Australia and Japan are 2007 data. Figures for Belgium, Canada, Netherlands, Norway and Switzerland, are OECD
estimates. Numbers are PPP adjusted. Break in series: CAN(1995); SWE(1993, 2001); SWI(1995); UK (1997). Numbers are PPP adjusted.
Estimates for Canada and Switzerland in 2008.

16. Quality and Benchmarks
• Quality and Reports
– Hospital Comparison Benchmark Reports (HCBR)
– Rapid Quality Reporting System (RQRS) Flyer
– Quality Care Measures
Source: Adapted from American College of Surgeons, Commission on Cancer, Quality Cancer
Tools, 2015

17. Survivorship – Distress, Psychosocial
Source: Adapted from NCCN, Distress Management Tool, 2015

18. Survivorship
Source: Adapted from
ASCO, Breast Cancer
Survivorship Care Plan, 2015

19. Current / Future
•Reform
Source: Adapted from: Does the Private Option sink or save providers by Katie Bo Williams, March
14, 2014
Source: Adapted from: Dances with Fat: Fat Chance for Healthcare Access, January 20, 2011
Source: Adapted from: The Case for Single Payer, Universal Health Care for The United States:
Outline of Talk given to the assocaition of State Green Parties, Moodus, Connecticut on June 4, 1999;
by John R. Battista, M.D. and Justine McCabe, PhD.

20. Future of Healthcare Delivery
• Fee for Service (FFS) vs. Episodes
• ER Utilization
• Length of Stay (LOS)
• Insurance Coverage (40 million)
• Tiered System
• Best Health System in the World (Videos)

21. Healthcare Video
• Healthcare Video
Source: Concordia University Wisconsin, MBA 920, Economics and Policy in Healthcare, 2013 by: Erik Hollander, MBA

22. Future of Healthcare Delivery
• Cultural Beliefs / Values
• Social
• Technological
• Aging Population / Population
Health
• Providers

23. Review
• Review
–Prof. Hollander
• History of Healthcare in the U.S.
• Current State
• Future State
• Review

24. Thank you!
Thank you for your time and attention!
Questions? / Fragen?