A quick glance at the most striking facts and information found within the 2012 State of the Safety Net report.
For more information visit http://www.directrelief.org/usa/state-of-the-safety-net/
Single Payer Systems: Equity in Access to Caresoder145
Presentation by Lynn Blewett at "The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform' conference sponsored by the Journal of Health Politics Policy and Law, May 10 2008.
Achieving Universal Coverage through Comprehensive Health Reform: The Vermont...soder145
Presentation by Ronald Deprez at the AcademyHealth Annual Research Meeting adjunct State Health Research and Policy Interest Group meeting panel, "Early Results from the State Health Access Reform Evaluation (SHARE) Program," Chicago, IL, June 27 2009.
MRC/info4africa KZN Community Forum | July 2013info4africa
This special forum took place after the 2013 SA AIDS Conference and reflected upon the important goal of "Getting to Zero with HIV Prevention and Treatment Interventions". This vibrant and enlightening panel discussion included Prof Quarraisha Abdool Karim – Associate Scientific Director – Centre for the AIDS Programme of Research in South Africa (CAPRISA); Prof Hoosen Coovadia – Director – Maternal, Adolescent and Child Health (MATCH) and Dr Heidi Van Rooyen – Research Director – Social, Behavioural and Biomedical Interventions Unit – Human Sciences Research Council (HSRC).
Single Payer Systems: Equity in Access to Caresoder145
Presentation by Lynn Blewett at "The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform' conference sponsored by the Journal of Health Politics Policy and Law, May 10 2008.
Achieving Universal Coverage through Comprehensive Health Reform: The Vermont...soder145
Presentation by Ronald Deprez at the AcademyHealth Annual Research Meeting adjunct State Health Research and Policy Interest Group meeting panel, "Early Results from the State Health Access Reform Evaluation (SHARE) Program," Chicago, IL, June 27 2009.
MRC/info4africa KZN Community Forum | July 2013info4africa
This special forum took place after the 2013 SA AIDS Conference and reflected upon the important goal of "Getting to Zero with HIV Prevention and Treatment Interventions". This vibrant and enlightening panel discussion included Prof Quarraisha Abdool Karim – Associate Scientific Director – Centre for the AIDS Programme of Research in South Africa (CAPRISA); Prof Hoosen Coovadia – Director – Maternal, Adolescent and Child Health (MATCH) and Dr Heidi Van Rooyen – Research Director – Social, Behavioural and Biomedical Interventions Unit – Human Sciences Research Council (HSRC).
James G. Kahn, MD, MPH
Pharmacy Leadership Institute
Kaiser Permanente Development Program
Debate on Health Care Reform
Youtube: http://youtu.be/2ed0qRXMRBE
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
Seminar 9 health care delivery system in united states of americaDr. Ankit Mohapatra
Health care organization
Health financing in US
Payment mechanism
Health expenditure
Human and physical recourses
Public health
Patient pathway into health care
Provision of services
ACA
US vs India Healthcare
Economic Impact on Minnesota's Health Care Delivery Systemsoder145
Presentation by Lynn Blewett to the Minnesota State Legislature at a joint meeting of the health care and human services finance and policy committees in Saint Paul, MN, February 10 2009.
James G. Kahn, MD, MPH
Pharmacy Leadership Institute
Kaiser Permanente Development Program
Debate on Health Care Reform
Youtube: http://youtu.be/2ed0qRXMRBE
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
Seminar 9 health care delivery system in united states of americaDr. Ankit Mohapatra
Health care organization
Health financing in US
Payment mechanism
Health expenditure
Human and physical recourses
Public health
Patient pathway into health care
Provision of services
ACA
US vs India Healthcare
Economic Impact on Minnesota's Health Care Delivery Systemsoder145
Presentation by Lynn Blewett to the Minnesota State Legislature at a joint meeting of the health care and human services finance and policy committees in Saint Paul, MN, February 10 2009.
Page 35 Journal of the International Academy for Case Stud.docxbunyansaturnina
Page 35
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
COMMUNITY HOSPITAL HEALTHCARE SYSTEM:
A STRATEGIC MANAGEMENT CASE STUDY
Amod Choudhary, City University of New York, Lehman College
CASE DESCRIPTION
The primary subject matter of this case concerns strategic management of community
hospitals in the United States. This case has a difficulty level of five; appropriate for first year
graduate level students. This case is designed to be taught in four class hours and is expected to
require twenty-four hours of outside preparation for students. For the graduate student, it
should be a half semester long group project with a presentation and report at the end of the
semester.
CASE SYNOPSIS
This case study analyzes the turbulent social, legal and technological issues that are
affecting today's suburban community hospitals in United States. The soaring health care costs,
increasing number of uninsured or underinsured patients, reduced payments by government
agencies, and increasing number of physician owned ambulatory care centers are squeezing the
lifeline of community hospitals whose traditional mission has been primary care. Furthermore,
with the enactment of Patient Protection and Affordable Care Act in March 2010, community
hospitals are facing new challenges whose full impact is unknown. This case study would help
students learn about Strategy Formulation including Vision and Mission Statements, internal
and external analysis, and generating, evaluating & selecting appropriate strategies for a
healthcare organization.
COMMUNITY HOSPITAL HEALTHCARE SYSTEM
With the enactment of Patient Protection and Affordable Care Act in March 2010 (Health
Act), and President Obama's professed goal of making heath care in the United States more
accessible and affordable, the next few years are sure to be very turbulent in the healthcare
industry. The Health Act is expected to provide healthcare coverage to 95% of Americans,
which will include an additional 32 million persons nationally (New Jersey Hospital Association,
2010). The Health Act goes into effect in 2010 with many of its requirements not becoming
effective until 2019. Directly because of the enactment of the Health Act, insurance premiums
are expected to increase anywhere from 2% to 9% depending on who is quoting them (Wall
Street Journal, 2010). The Health Act requires children to remain on their parents’ health plans
Page 36
Journal of the International Academy for Case Studies, Volume 18, Number 1, 2012
until age 26, eliminates copayment for preventive care, bars insurers from denying coverage to
children and adults (in 2014) with pre-existing conditions, eliminates lifetime caps on insurance
coverage, and requires setting up of insurance exchanges in all states (by 2014) through which
individuals, families and small business can buy coverage (Adamy, 2010; Pear, 2010).
United.
Telemedicina i pacients crònics / Telemedicine in chronic patientsAntoni Parada
Telemedicina i pacients crònics. Conferència impartida pel Professor canadenc Denis Protti Health Information Science - Victoria University. Barcelona, 2 de febrer de 2012. Organitzada per la Fundació TicSalut i l’Agència d’Informació, Avaluació i Qualitat en Salut.
2 8 5L e a r n I n g o b j e c t I v e sC H A P T E R.docxlorainedeserre
2 8 5
L e a r n I n g o b j e c t I v e s
C H A P T E R 1 0
Q U A L I T Y M A N A G E M E N T I N
T H E P H Y S I C I A N P R A C T I C E
Quality and reliability are system properties.
—W. Edwards Deming
➤ Articulate the nature of performance management.
➤ Describe the approaches to performance improvement.
➤ Appreciate the impact of variation on performance.
➤ Discuss the components of the Triple Aim.
➤ Describe process improvement.
In t r o d u c t I o n
One of the most important issues to address in the medical practice is the quality and
safety of the care provided to patients. The Institute of Medicine (IOM 2001), a presti-
gious branch of the National Institutes of Health, stated in its landmark report Crossing the
Quality Chasm: A New Health System for the 21st Century, “In its current form, habits, and
environment, American health care is incapable of providing the public with the quality
health care it expects and deserves.”
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EBSCO Publishing : eBook Academic Collection (EBSCOhost) - printed on 4/16/2020 7:48 PM via SUNY CANTON
AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management
Account: s8846236.main.ehost
F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 8 6
Another historic IOM (2000) report, To Err Is Human: Building a Safer Health
System, indicated that a shocking number of people—an estimated 44,000 to 98,000 per
year—are harmed by the healthcare system. A more recent study found that this number
has increased since publication of the 2000 IOM report despite substantial efforts to
improve. Medical errors have now become the third leading cause of death in the United
States (Makary and Daniel 2016).
The complexity of medical service and the inconsistency with which these services
are delivered, not to mention the fragmented nature of the system, have led to a number
of quality concerns (Mosadeghrad 2014), including a lack of systematic approaches to care
delivery and quality improvement. Efforts to improve quality in the medical profession
have a long tradition of focusing on individual performance versus system performance.
Exhibit 10.1 illustrates the potential flaw in this thinking. The bell-shaped curve, P-1,
represents the overall performance of any given system. Curve P-2 illustrates an improved
system of performance where the median performance is moved from M-1 to M-2. If an
organization seeks to improve by only focusing on the low performers, it experiences only
a small improvement, shown as I-1. By improving th ...
#1Jason Grant is the current CEO of Summit Regional Hospital in De.docxAASTHA76
#1Jason Grant is the current CEO of Summit Regional Hospital in Denver, Colorado. Summit Regionals financial health has been quite poor over the first year that he has been CEO and was suffering due to rising costs, static revenue, and declining quality of care. When he was hired he was told the mandate was to improve the quality of care and get the financials in order. Grant has less than a week to finalize his $70-million-dollar budget so it can be approved by the hospital’s board. As he looked over the budget, one issue was the building the future of the off-site clinics. The man who was there before Grant had set up community based clinics five years earlier to help to deliver care to the city’s poor. Even though these clinics were very valuable in delivering care to these neighborhood residents, the clinics took away funds from the Hospital’s in house services in which many of these were already underfunded.
As Grant thought back to early March he remembered one of the clinics he went and visited with a sign out front that was covered in graffiti, the building showing signs of serious aging and, a small waiting room. He met with Brett Dawson who was the clinic doctor and the administrator. The look of the facility was in rough condition with the paint peeling everywhere, and in one examining rooms he found a bucket that was stuck in the floor catching a drip.
When Grant asked Dawson how she puts up with the facility being in this bad condition and she said, ”What are my options?” Last year’s clinic financials showed they cost 1.1 million to operate at a loss of $256,000. Grant believed that the clinics wear draining revenue. Summit Regional is needing funding for a new neonatal ward, operating theatre, MRI unit, upgraded business office computer system, and the emergency department needed another full time physician. Without these additions the the ability to attract top paying patients and doctors are very slim. Due to the location on the east side of Denver, Summit Regional had a high percentage of Medicaid patients in which the payments rarely covered the cost.
There was a rival hospital called St. Johns which was a for profit had better facilities and technology. Their financial condition was better than Summit Regionals as well because it was located on the west side of Denver in a better neighborhood and owned a 50% share in an MRI unit. Grant requested a possible merger with St. Johns but the Ceo of St. Johns responded back, “Competition is the only way to survive.” Grant knew he could either borrow or cut costs, but he hospitals ability to borrow money was low because of their debt so he figured the best alternative was to cut cost.
Grant wanted to cut some of the 1400 employees to take care of the current 350 beds. However, cutting personnel would affect the quality of care. Rising costs of these clinics and Denver’s budget deficit was causing the clinics revenue to decrease more. Closing the clinics would be a personal b.
Physician Expectations and Primary Care Shortages: Evidence from the Affordab...Gerrit Lensink
This paper is the first installment in my undergraduate thesis on physician expectations and their effect on primary care shortages in the United States. Over following semesters I will be strengthening my research with econometric models and further analysis. Updates will follow as completed.
Direct Relief’s annual report on Fiscal Year 2014: During this period—July 1, 2013, through June 30, 2014—Direct Relief responded to more requests for assistance, fulfilled its humanitarian mission more expansively, and provided more assistance to more people in need than ever before in the organization’s 66-year history.
Nonprofit community health centers and clinics that provide preventive and primary healthcare services for 24 million people – or one in 13 persons in the U.S. – report that the first year of the Affordable Care Act’s implementation had uneven effects, particularly between facilities in Medicaid expansion and non-expansion states.
The findings were released today by Direct Relief in The State of the Safety Net 2014, an annual report that examines issues and trends within the extensive network of nonprofit, community-based health centers and clinics, which are the principal point of access to healthcare and the medical home for persons with low incomes, without health insurance, and among the country’s most vulnerable. Such facilities include Federally Qualified Health Centers (FQHCs), nonprofit community-based health clinics, and free and charitable clinics.
Child and Maternal Health in Kenya 2011 ReportDirect Relief
This report evaluates access to maternal and child healthcare and health outcomes in Kenya using geographic information systems (GIS), statistical analysis, and a comprehensive review of existing literature.
It seeks to aid in identifying distributions of health facilities and services relative to key maternal and child health indicators (e.g., safe delivery, care and treatment of birth injuries, antenatal and postnatal care, immunization, and nutrition).
It also seeks to contribute a portfolio of geospatial maps for identifying, analyzing, and monitoring health needs in one of the world’s poorest, most densely populated, and most vulnerable regions. In addition to identifying and analyzing information currently available, the report highlights limitations of both Kenya’s existing data sets and overreliance on distance as a measure of “access” and “use.”
This report responds to a request from Direct Relief International (DRI) to identify healthcare access and health outcomes in Kenya as part of its multi-organizational collaborative project to enhance health services in an integrated and efficient manner.
Along with the African Medical Research Foundation (AMREF), Marie Stopes International (MSI), and district-level health ministries in Kenya, Tanzania, and Uganda, DRI is attempting to determine critical gaps in health infrastructure.
1. /// FINDINGS
STATE OF THE SAFETY NET 2012
KEY
D > majority (79%) saw a rise in the number of
ata in the State of the Safety Net 2012 comes A TWO CASE STUDIES HIGHLIGHTED:
from the most recent U.S. Health and Human patients in 2011 Detroit, Michigan The safety net
—
Services 2010 Uniform Data System results and a A majority (86%) expect an increase in the
patient community has been growing
Direct Relief original survey. number of patients who lack insurance in 2012 in the city while the overall population
Of the more than 1,000 nonprofit clinics Direct is dwindling and unemployment is
A majority (83%) thought 2012 will be more
Relief works with, 546 from 49 states and D.C. high. The city also closed its Health
challenging than 2011
responded to the Direct Relief survey. Results provide Department Pharmacy and adult
a current snapshot of their clinic environment and 1% increased their hours of operation
4
medical services in February 2012,
what they anticipate for 2012. (Note: there are more Chronic conditions continue to rise among
increasing strain on community
than 8,000 nonprofit clinics in all 50 states which patients visiting Federally Qualified Health clinics.
serve a patient population estimated at 21 million). Centers with 10% of all visits being for two
Joplin, Missouri — Following the
Overall, findings indicate that providers face conditions diabetes mellitus and hypertension
—
deadly EF5 tornado that tore through
continued pressure and concern with their ability
2010 was the first year Medicaid patients
the city May 2011, community clinics
to care for an increasing number of patients. The
exceeded uninsured patients in total numbers were key providers to whom storm
survey was distributed earlier in the year and the
and as a percentage of the overall patient survivors turned for care.
results came in the spring, thus all data is before the
population at FQHCs
Affordable Care Act was deemed constitutional.
DIRECTRELIEF.ORG/USA