Healthcare Trends

WK 2 – Business Brief research
Healthcare Delivery Systems
2.2 Healthcare Trends
BOOK INFORMATION
Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett Learning.
ISBN: 9781284074635
Purpose
To assess your ability to:
• Interpret healthcare data and trends.
• Evaluate the management- and leadership-related aspects of project management topics, including strategic formulation and implementation.
• Evaluate healthcare system- and healthcare management-related topics, including governance structure and roles, operations assessment and improvement, and quality assessment for patient care improvement.
• Action Items- IMPORTANT
1. Complete the Week 2 Readings prior to working on this assignment.
2. Download the following report from the Centers for Disease Control (CDC): Health, United States 2011. https://www.cdc.gov/nchs/data/hus/hus11.pdf
o Review the data in the report about mortality and morbidity.
o Document your thoughts as you review the data.
o Specifcally state what the data shows and what are the data trends.
o Based on your review, comment on the following:
▪ Based on the mortality and morbidity data, identify changes that seem to be occurring – you must discuss more than one change.
▪ What might these changes be attributed to, and what do they mean for the future of healthcare delivery?
▪ Respond to what you have observed from your analysis of the CDC report: when is the use of regulation appropriate in the delivery of healthcare services?
▪ How would you evaluate the effectiveness of regulatory efforts aimed at hospitals and at physicians?
▪ What additional recommendations would you make to current healthcare leaders in order to address patient care improvement?
3. Conduct additional research for the issues above. Use the resources to obtain at least three relevant, scholarly sources.
4. Write a 3-4 page paper in which you address the items that you researched in the CDC Report.
o You must incorporate research into your paper from at least three relevant, scholarly resources.
o Follow all applicable APA Guidelines regarding in-text citations, list of cited references, and document formatting for this paper. Failure to properly cite and reference sources constitutes plagiarism.
o The title page and reference list are not included in the page count for this paper.
Submission Instructions
1. Submit your assignment to Turnitin.com.
Grading Rubric
Healthcare Trends Rubric: 0-70
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Week 2 Readings- Important to read
Learning Outcomes
Upon successful completion of this week, the student will be able to:
• Describe, analyze, and evaluate how the U.S. healthcare system is structured, organized, and managed.
• Evaluate the elements and process for quality assurance of healthcare services and the impact of technology on quality of care provided.
• Describe, analyze, and evaluate healthcare system- and healthcare management-related topics, including governance structure and roles, operations assessment and improvement, and quality assessment for patient care improvement.
• Interpret healthcare data and trends.
• Describe, analyze, and evaluate project management topics, including strategic formulation and implementation.
• Describe, analyze, and evaluate management- and leadership-related topics.
Required Readings
Read the following chapters in Shi and Singh (2015):
• Chapter 3 (The Evolution of Health Services in the United States)
• Chapter 4 (System Resources)
Research what the major public health issues are facing the U.S. healthcare system.
Introduction
This week underscores the pluralism of the U.S. healthcare system, namely the private and public sections. This week focuses on quasi-public and public healthcare sections since the private section will be discussed in Weeks 4 and 5. “Public” refers to a governmental role in providing necessary healthcare services. This week will describe the local, state, and federal governments’ roles in providing healthcare services to U.S. residents. Public health refers to the health of a population rather than an individual’s health.
The management of healthcare systems includes planning, administration, legislation, and regulation. This week focuses on these functions primarily from the public sector perspective. Again, management functions in the private sector will be discussed in Weeks 4 and 5.
Key Points
Roles of the Government
The government’s role at the local, state, or national level is central to any discussion on public health. While the Roemer Model in the text refers to a ministry of health, in the United States the equivalent is the U.S. Department of Health and Human Services (DHHS). Because the U.S. system is pluralistic, the DHHS has a much less central role than do ministries of health in European and other countries. That may be changing as healthcare reform moves us closer to the European models of healthcare.
DHHS
A review of all of the entities in the DHHS (Exhibit 4.2) should help you to understand the DHHS’s responsibilities. You may be familiar with some of these, for example the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA); but many of you may not be familiar with the major roles and responsibilities of such units as the Centers for Medicare & Medicaid Services (CMS).
National Institutes of Health
The National Institute of Health (NIH) (Exhibit 4.3) is the leader in much of the biomedical and applied research done in the United States. It does not engage in pharmaceutical research, except as a byproduct of other clinical research, but it is instrumental in the advancement of technology in healthcare. The NIH has begun to legitimize some therapies which were once discarded by traditional healthcare providers.
Various Roles of Public Healthcare
The various roles of public healthcare are defined in Exhibit 4.1. For example, in times of economic turmoil and reduced resources, do the ten services listed qualify as essential public healthcare services?
National Health Planning
National health planning existed until the mid-1980s. It was difficult to sustain because DHHS had authority over the public system but limited authority over the private system. National regulations can require the private sector to behave in certain ways, but if this mandated behavior is expected to happen it may affect the private sector’s ability to grow and develop. Such regulations, as we are currently seeing, usually face legal and other challenges that may eventually render them of little use.
Vestiges of the National Planning System
Vestiges of the national planning system remain. Aspects of the Certificate of Need (CON) program, which was created to control expensive growth and limit duplication of health services, are still in effect in a number of states. Some states retained their rules regarding the development of new services, such as hospitals and nursing homes, and expanded existing services because such expansions directly affect the state’s share of Medicaid expenditures. Many states oppose the expansion because they are concerned about allocating so many federal dollars to an already large public health program. See the Harvard Law School Center for Health Law and Policy Innovation’s report on the status of Medicaid expansion after the passage of the Affordable Care Act.
Healthcare Legislation
Both the public and the private sectors engage in planning and administration. Only the public sector has responsibility for legislation. Both sectors have roles in regulation, but the regulation discussed in “Management of the U.S. Health Services System” relates to the public sector’s responsibility.
Licensure of Professional Facilities
Both sectors have roles in the licensure of professional facilities. The public sector is responsible for healthcare services facility licensure. The private sector takes the lead in facility accreditation, but the public sector may mandate that a facility meet certain requirements before it can be accredited or certified.
U.S. Department of Health & Human Services (HHS)
The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and for providing essential human services, especially for those who are least able to help themselves.
HHS represents almost a quarter of all federal outlays, and it administers more grant dollars than all other federal agencies combined. HHS’ Medicare program is the nation’s largest health insurer, handling more than one billion claims per year. Medicare and Medicaid together provide health care insurance for one in four Americans.
HHS works closely with state and local governments, and many HHS-funded services are provided at the local level by state or county agencies, or through private sector grantees. The Department’s programs are administered by 11 operating divisions, including eight agencies in the U.S. Public Health Service and three human services agencies. The department includes more than 300 programs, covering a wide spectrum of activities. In addition to the services they deliver, the HHS programs provide for equitable treatment of beneficiaries nationwide, and they enable the collection of national health and other data.
Departmental leadership is provided by the Office of the Secretary. Also included in the Department is the Office of the Assistant Secretary for Health, the Office of Public Health and Science, the Office of the HHS Inspector General, and the HHS Office for Civil Rights. In addition, the Program Support Center, a self-supporting division of the Department, provides administrative services for HHS and other federal agencies.
National Institutes of Health (NIH)
The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services External Web Site Policy, is the nation’s medical research agency—making important discoveries that improve health and save lives.
Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.
NIH is the largest source of funding for medical research in the world, creating hundreds of thousands of high-quality jobs by funding thousands of scientists in universities and research institutions in every state across America and around the globe.
NIH is made up of 27 Institutes and Centers, each with a specific research agenda, often focusing on particular diseases or bodily systems. NIH leadership plays an active role in shaping the agency’s research planning, activities, and outlook.
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