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hsa500_w10_c16.pptHealth Services Organization and Management
HSA 500
The Future of Health Services
Williams, S. J., & Torrens, P. R. (2008). Introduction to Health Services (7th ed.). New York: Cengage Delmar Learning.
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Welcome to Health Services Organization and Management.
In this lesson we will discuss the future of health services.
Please go to the next slide.
Objectives
- Upon completion of this lesson, you will be able to:
- Explain the impact that policy, social and financial forces have on health care access and quality of care in the United States
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Upon completion of this lesson, you will be able to:
Explain the impact that policy, social and financial forces have on health care access and quality of care in the United States.
Please go to the next slide.
Challenge of diseases and health disparities
- Morbidity and Mortality
- Diseases
- Health disparities
Overall, United States mortality continues to decline as our success in disease prevention and intervention mount. Although the total mortality rate continues to drop and life expectancy continues to increase, these macrotrends mask concerns involving specific illnesses, diseases, injuries, and population groups. Differential morbidity and mortality between men and women, among different ethnic groups, in different age groups within the population, by geographic region, and in other important population comparisons highlight limited successes for certain populations and the challenges that we face going forward.
Certain disease categories present us with a sobering reality and contrast sharply with the successes that we have achieved in such areas as cardiovascular and cerebrovascular disease. Formidable challenges remain, including most types of cancers, certain infectious diseases, particularly HIV/AIDS, and influenza, accidents, injuries and violence, mental illness, and emerging diseases. Recent epidemics and threats including SARS, avian bird flu, hemorrhagic fevers, and a host of endemic infectious diseases, which have long vanished from our shores, such as diphtheria, malaria, and polio, and unknown and undetermined threats lurk in the future.
Differences in access to health care and how individuals are treated within the system are measurable through physical, financial, and attitudinal indicators. Reducing health disparities, particularly those that could potentially be associated with poorer outcomes of care, should be a high priority for the United States health care system currently and in the future. Disparities truly affect all segments of our nation’s population. There are few, if any segments in our population that could not benefit from a more efficient system that removes or minimalizes disparities of all types.
Please go to the next slide.
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Paying for Health Care
- Reforming health insurance
- Health insurance and managed care
- Uninsured
The evolution of health care in the United States typically follows an incremental approach with modest short-term changes and occasional dramatic realignments. Looking toward the future, opportunities for a least incremental change and improvement in health insurance plans and operations are likely. In recent years it has been a shift from indemnity to service insurance and the introduction and widespread adoption of various forms of managed care. Further changes in national entitlement programs, particularly Medicare and Medicaid, are also probable, following on the heels of the implementation of Medicare, Part D, the prescription drug benefit. Recently, the development of mechanisms designed to entice consumers to be more cost aware and discriminating when purchasing health care services has grown dramatically.
Most private and voluntary health insurance in the United States has permanently adopted the utilization of managed-care mechanisms to structure, monitor and control most individuals’ health care systems. Further evolution of managed-care mechanisms is likely to accrue as a result of the implementation of more sophisticated information systems and monitoring capabilities. The criteria for improved managed care systems included the following: Liberal access to needed health services; Cost-efficient care; Consumer and provider satisfaction.
Individuals without any health insurance whatsoever are a heterogeneous population in the United States, comprising a range or situations including those chronically unemployed, underemployed, employed without benefits, and people between jobs; dependents without access to employer-sponsored health insurance plans; individuals and families losing insurance coverage due to divorce, death and other circumstances. The number of uninsured in the United States was estimated at about 50 million people in 2007 including children.
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Health services
- Public Health services
- Ambulatory Care services
- Hospital and Health Systems
Many public health challenges remain. Funding for public health services represents only approximately 3 percent of the United States national health care expenditures, a relatively modest investment. New initiatives and expansion of existing efforts are needed to address primary prevention, screening of populations, protection of the environment, more rapid interventions for heart attacks and strokes, better public awareness and education programs, enhanced terrorism preparedness and preparation, further protection of the food, water, and milk supplies, and other tradition public health priorities.
With the hospital’s inpatient role increasingly focusing on tertiary and other complex services, and with improvements in technology combined with cost and efficiency pressures in the systems, ambulatory services will increasingly be relied upon as the principal source of health care for the nation’s population. Cost pressures in the ambulatory sector will continue to escalate yielding an increasing emphasis on efficient management of practices and careful use of resources, particularly for capital investment and health care personnel.
The priorities for hospital and health systems include further development and implementation of management information systems incorporating computerized medical records that will allow for comprehensive tracking of patients, utilization patterns and fiscal flows as well as aid in quality assurance; contractual reporting requirements; and other legal, regulatory, managerial, and financial activities and requirements. Continued formation of appropriate alliances, affiliations, and networks for the improvement of the quality and efficiency of care is also essential.
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Health services, continued
- Future of Long-Term care
- Mental Health services
Among the most significant challenges in the area of long-term –care services are issues of financing and health care personnel. From a financing and health care personnel. From a financial perspective, among the key policy decisions to be faced in the future is the role government in ping for long-term care services. Identifying additional sources of revenue that can be utilized for long-term care services is a very tough challenge for our nation. Today’s reliance on a consumer’s own resources, particularly for those in nursing homes through the spend down provision, may still represent the most financially and politically viable alternative for the future.
Over the past 30 years, the application of scientific and biomedical knowledge to the mental health field and advances in neuroscience and pharmacology has feed mental health services from the shackles of misconceptions and miscommunications. A scientific-based recognition of the etiologies of mental illness, and the identification of biomedical pathways for cures have brought mental health closer to the medical, economic, and political mainstream.
Please go to the next slide.
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Check Your Understanding
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Health Care Personnel
- Technology
- Shortages in personnel
- Leadership
The increasing sophistication and complexity of health care technology demand ever-more highly trained and expensive technical personnel. Increasing specialization and quality enhancement pressures have induced institutions and professional to enhance employee training, monitoring, and staffing level.
Shortages of adequately trained personnel, particularly for nursing, have already reached crisis proportions in many areas of the nation. The need to train, attract, motivate, and retain high performing health care professionals has been a constant theme through the industry. Whether it be medical staff, technicians, personnel, or support individuals, creating a motivating workplace in the face of the challenges of patient care and cost pressures is a constant issue for virtually all areas of the health care industry.
The need to develop leadership among the nation’s physicians, nurses, and other health care personnel should also be a high national priority. Clinical and administrative leaders are essential to ensuring the success of the health care system. Excellent leaders have harnessed the power of information systems, employee motivation, fiscal discipline, and patient outreach.
Please go to the next slide.
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Future of health care
- Health care policy and politics
- Quality of Care
The design and operation of the nation’s health care system is interwined with the nation’s economic and political environments. The political environment defines the broad spectrum of government involvement in health care, raging from financing to regulatory intervention. Ultimately, the future of health policy and politics in the United States will be determined by the political will of the people in combination with economic, political, ethical, and practical forces.
Providers, consumers, and payers are increasingly demanding not only improvements in the quality of care, but also institutionalized safe guards to protect against adverse consequences during the care process. Increasingly sophisticated computerized information systems and other technologies for assessing quality of care and for providing protective interventions and feedback to those in the system are slowly enhancing the quality of care that patients receive.
Please go to the next slide.
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Check Your Understanding
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Summary
- Challenge of diseases and health disparities
- Paying for Health Care
- Health services
- Health Care Personnel
- Future of health care
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We have reached the end of this lesson. Let’s take a look at what we have covered.
Discussed first was challenge of diseases and health disparities. Overall, United States mortality continues to decline as our success in disease prevention and intervention mount. Although the total mortality rate continues to drop and life expectancy continues to increase, these macrotrends mask concerns involving specific illnesses, diseases, injuries, and population groups. Differential morbidity and mortality between men and women, among different ethnic groups, in different age groups within the population, by geographic region, and in other important population comparisons highlight limited successes for certain populations and the challenges that we face going forward. These differences highlight the health disparities that still exist even though progress has been made with the treatment and elimination of certain disease in the United States.
Next we discussed the Paying for Health Care. Looking toward the future, opportunities for a least incremental change and improvement in health insurance plans and operations are likely. In recent years it has been a shift from indemnity to service insurance and the introduction and widespread adoption of various forms of managed care. The number of uninsured in the United States was estimated at about 50 million people in 2007 including children.
Next we discussed Health services. We discussed some of the current and future challenges in public health, Ambulatory Care services
Hospital and Health Systems, Future of Long-Term care and Mental health services.
This followed by discussing Health Care Personnel. The increasing sophistication and complexity of health care technology demand ever-more highly trained and expensive technical personnel. Increasing specialization and quality enhancement pressures have induced institutions and professional to enhance employee training, monitoring, and staffing level. Shortages of adequately trained personnel, particularly for nursing, have already reached crisis proportions in many areas of the nation. The need to train, attract, motivate, and retain high performing health care professionals has been a constant theme through the industry. The need to develop leadership among the nation’s physicians, nurses, and other health care personnel should also be a high national priority. Clinical and administrative leaders are essential to ensuring the success of the health care system.
We concluded the lesson with examining Future of health care. The design and operation of the nation’s health care system is interwined with the nation’s economic and political environments. The political environment defines the broad spectrum of government involvement in health care, raging from financing to regulatory intervention. Ultimately, the future of health policy and politics in the United States will be determined by the political will of the people in combination with economic, political, ethical, and practical forces. Providers, consumers, and payers are increasingly demanding not only improvements in the quality of care, but also institutionalized safe guards to protect against adverse consequences during the care process.
This concludes this lesson.
