Health Care Delivery Systems
Abstract The American health care system is designed to focus on the organizations of individuals, places, and to treat and prevent adequate health care for the target populations. The federal government conducts an immense portion of delivering health care systems in our world today. The purpose for health care delivery systems is to provide financial tangible benefits and provide health care services for the population and institutions. The results showed for the support of the hypothesis is elaborating in the importance of different health care delivery systems and the purpose in how they are utilized in today’s health reform.
Running Head: Health Care Delivery Systems Essay
Health Care Delivery Systems Essay Example
Health Care Delivery Systems Health care systems engage the initial contact of people and it is the foundation of primary health care. In order to receive primary health care it begins with providing a service to families, people, and communities through health professionals and their teams. The Health care delivery systems is involved with a proactive method to prevent health issues and to better ensure the organization and to investigate once a health issue has transpired. In addition, these type of services are publicly funded from general tax revenues without direct charges to the patient (Health Canada, 2011). The most two similar forms of health care delivery systems is managed care systems ex. (HMO) and fee for service (FFS). The fee for service plan is generally called Traditional Indemnity (Website 101, 2009). Fee for service offers flexible measures for the exchange of drastically high out of pocket expenses, it also requires a substantial amount of paperwork and premiums are high.
Furthermore, some advantages are having the privilege in selecting hospitals and physicians of your own, and having the opportunity in receiving treatment from a specialist without a primary doctor referral. The disadvantages are high deductibles and the patient is responsible of paying twenty percent and the physicians are obligated to reimburse eighty percent of the expensive. Also, fee for service solely pays for “reasonable and customary” health issues (website, 101). Doctors may have a different medical fee opposed to other areas, and the patients are obligated to pay their portion that is instated in health plan coverage. However, HMO is the less expensive and less flexible of all medical coverage’s. The advantages are consist of less paperwork and low copayments. It provides for a portion of improvement health preventive care plans.
Unfortunately, there is disadvantages that the health care holder will experience with in choosing a PCP which is a primary care physician, and the HMO plan only accepts a network of their physicians or they will not stand up to the obligation of their financial transaction argument. In addition, in order for the client to see a specialist they must obtain a referral from their PCP. The expression Alternative Delivery Systems is created to entail all techniques of health care delivery systems barring acceptable fee-for-service and private practice like IPAs, PPOs, HMOs, and all other health care systems that provide health care of who conducts organized care systems. (http://aspe.hhs.gov/Progsys/forum/mcobib.htm).
For example, Managed Care is a health care delivery system that merges payment and the delivery. It also accesses the use of treatments by engaging organization strategies creating to enhance the growth of cost-effective in the delivery of health care. Managed health care plan is a system that assimilates any management with in accordance of finance that delivers health care services of the covered population. In contrast, PPO also known Preferred Provider Organization is the delivery system that commits with medical care providers who gives discounted fees to clients. Nevertheless, clients have the opportunity to give health care to participants who are not members but can potentially become financial penalized due to any action of seeking out side providers and face consequences of not receiving discount and any deductibles of one’s health care plan and copayments. Goals of Health Care Delivery Systems.
The reason HMO’s are unique because they prepaid and they are managed care systems that initially were health care alternative to fee-for-service health care. There goals is to obtain affordable and comprehensive health care coverage.
This plan is conducted in advance by the option of a fixed fee from all members. Moreover, HMO delivers minimal cost for medical services that are needed for patients, and this health plan is responsible in conducting the deliver and finance portion of the medical health care services. They also arrange to provide the essential medical care which includes the benefit packages. Prepaid Health Plans (PHP) is known “to help make quality health care affordable for groups of people, including farmers, blue collar workers and their families” (Ahern, 2007) . In contrast, the traditional health care insurance only funds health coverage for hospital visits, and enrolled insures that receive health coverage in prepaid plans is charged a predetermined for acute and preventive health care from doctors who work in hospitals.
As for PPOs, their health care philosophy originally was to create simple concepts in delivering health care services to large groups with lower rates in order to substantially gain a business development for their management. To emphasize, insures can select their own physician’s however penalties can potentially occur if they are not with the network. This form of health coverage is engaged in receiving adequate power with lower health care prices for their clients in the standing of the dense health care system in America. The fee for service (FFS) is ultimately focusing in creating options to approach paid private insurances to gain more control relating with time and the forms of treatment. FFS is designed to reflect on an ideal perspective for private health care plans, instead of government-administered pricing and giving proper recognition in private health care plans that can utilize health care organizations productively. This method will enhance quality and proficiency in delivering a regenerated approach in the health care industry (Nicolas, O’ Malley, 2007). Mission Statement
If I had full control of conducting a health care delivery system I would focus in offering health care insurance for businesses, government organizations, people, families, groups, and schools. Also, I feel flexibility is significant for the process of selecting your own choice of primary doctors in the same network and receive great service with affordable payments. The health care delivery system will project and promote exceptional quality health care service is the HMO plan. This health plan will contribute in supporting by over exceeding expectations of all parties which includes employees, communities, work force, stake holders, investors, and customers.