Data from National Center for Health Statistic, National Health and Nutrition Examination Survey, 2009-2010. Discusses the challenges currently facing the U.S. health care delivery system. These incentives can include paying physicians for performance, especially when the performance includes health education for the patient and his or her family members. The goal for these patients should be to avoid the complications from their chronic diseases entirely. According to Marvassi and Stafford (2012), many modifiable risk factors for the development of chronic diseases are being ignored by the current U.S. medical care delivery system. However, there are still major problems in the U.S. health care system, and it is important to address these issues to get a more equitable, efficient, and effective medical system. These hungry entrepreneurs may ultimately discover new cures for diseases that were previously unprofitable ventures for the large firms. ", Wladimir Klitschko: F.A.C.E. Other possible problems with this care model are patients' limited choices of physicians and the possibility that patients may not see the same physician at each appointment. 1. Academic library - free online college e textbooks - info{at}ebrary.net - © 2014 - 2020. In order to increase research for new treatments for disease and because the drug industry reports that it costs between $800 million and $2 billion to bring each new drug to market, the FDA grants drug companies twenty-year patent protection for each new research discovery. Discusses the challenges currently facing the U.S. health care delivery system. Figure 15.2 Percentage of Adults Aged Eighteen and over Who Met the 2008 federal Physical Activity Guidelines for Aerobic Activity Through Leisure-Time Aerobic Activity: United States, 1997-September 2011. chronic diseases and their complications is going to continue growing and consuming increasing amounts of scarce resources unless we as a nation make the decision to prevent chronic diseases and their complications from occurring in the first place. This chapter addresses the issues of access, managing chronic disease, neglected health care services (i.e., clinical preventive services, oral, and mental health care and substance abuse services), and the capacity of the health care delivery system to better serve the population in terms of cultural competence, quality, the workforce, financing, information technology, and emergency preparedness. As discussed in Chapter Thirteen, these authors argue that a disruptive innovation represents the application of a new set of values in the production process, with results that overtake the existing market. To reduce fraud and waste in health care delivery we need to invest in the investigation of fraud and waste, set regulations, and prosecute offenders. The healthcare supply chain is unique to the supply chains in every other industry. Our country spends twice as much as other industrialized countries with far lower returns for our money in terms of improved health indices. According to Ogden, Carroll, Kit, and Fiegal (2012), more than one- third of adults and almost 17 percent of youth were obese in 2009 and 2010. By: Richard M.J. Bohmer and Carin-Isabel Knoop. encompasses a broader delivery system,and program and payment reform across the Medi-Cal program, ... to help address many of the complex challenges facing California’s most vulnerable residents, such as: • homelessness, • increasing behavioral health care access, • children with complex medical conditions, In an ACO various health care organizations, practices, and people – such as primary care physicians, specialists, hospitals, other providers, and payers – work together to provide and manage care. 4 Challenges Facing the Health Care Industry View all blog posts under Articles | View all blog posts under Master of Health Administration Medical and technology innovations have together produced radical service delivery advancements. A computer software program was written and used to record virtually every piece of medical information regarding every patient hospitalized in the VA hospital system. We also need a rigorous evaluation of the costs and benefits associated with medical testing, procedures, and treatment of medical conditions. Also during 2001-2002, the . In fact, until 2006, it was the most profitable industry in our country. Unfortunately, many of the challenges have actually been caused by government intervention in the health care sector. This escalation in obesity at such a young age is going to result in early onset of chronic diseases like type 2 diabetes, resulting in life-threatening complications in these individuals' prime of life during their working age. The U.S. healthcare system continues to experience phenomenal growth of recurring themes of important service delivery issues within the industry. It is extremely important to understand that we as a nation cannot sit back and allow this epidemic to slowly consume our young and our old. Demand for health care services is increasing as the population ages, chronic diseases become more common, and medical technology increases. This goal of reduced medical errors has been achieved by numerous health care facilities but has had its greatest success in the U.S. Department of Veterans Affairs (VA) hospitals. Healthcare systems today are struggling with rising costs and varying quality. As Hayes (2012) observes, the presence of large amounts of money has the ability to change individual and group behavior so that people participate in behavior they would usually avoid. Value-based purchasing programs are solidly in place for hospitals. The healthcare systems also are facing off-label-use challenges (see Chapter 5) that can also negatively impact the care delivery. This type of innovation makes products or services less expensive and more accessible, allowing more consumers to enter and make purchases in the disrupted market. As millions of Americans are added to the insured rolls because of the ACA, people will find it more difficult to get a physician appointment because of the shortages of providers. According to Fisher et al. A reduction of the lifetime illness burden through postponing the onset of health complications from chronic diseases. As discussed in Chapter Six, moral hazard refers to the perverse incentives that result when individuals are insulated from the costs associated with their actions. Here are the four most pressing issues panelists raised. A checklist system was developed by the VHA, so that each medical procedure had a checklist that included all the necessary steps in the procedure. Hayes also argues that reduced regulatory oversight and a culture of corruption are usually elements in successful attempts at fraud by both individuals and organizations. At the same time, we desperately need continued research and development on new drugs to treat the leading causes of morbidity, mortality, and disability found in our country today. Recall that the Institute of Medicine (IOM) (1999) defines a medical error as “the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim.” It seems that entering the medical care system, especially being admitted to a hospital, has become a potentially dangerous event Brownlee (2007) points out that the most common medical error found in the delivery of medical care today is erroneous or inaccurate drug administration. Delivery of care is fragmented and is merely focused on volume. According to the study report, this waste represents about thirty cents of every health care dollar, and immediate action to eliminate the waste is required. Goodman (2012) points out that “as many as 187,000 patients die every year for some reason other than the medical condition that caused them to seek care. The HealthCare Executive Group unveils its annual 2020 top 10 critical challenges, issues and opportunities healthcare executives expect to face in 2020. Public healthcare: three challenges. According to Longman (2012) the real cause of medical errors in health care facilities is the lack of a system designed to prevent these errors from ever occurring in the first place. By Stewart Gandolf Chief Executive Officer. According to Schimpff (2012) this epidemic offers the United States an opportunity to improve population health by focusing on personal behaviors that are detrimental to health. Yes, it does involve monitoring the acquisition of products and their path from origin to destination, but many of these supplies can be a matter of life and death. They will have insurance coverage but not necessarily providers of health care (Lowrey & Pear, 2012). Copyright © President & Fellows of Harvard College, "The Challenge Facing the U.S. Healthcare Delivery System. Fortunately, the Veterans Health Administration (VHA), which runs the numerous VA hospitals for veterans, decided to do something about this epidemic of medical errors. We have to take action against this chronic disease epidemic now because we are running out of time. For example, Shortell (2010) argues that the ACO model is particularly capable of serving the chronically ill cohort, where many patients have more than one chronic illness and are seen by multiple specialists. Healthcare leaders continue to put infrastructure and governance practices in place to support value-based models even as providers still have significant fee-for-service revenue. As health care administrators discover new ways to serve the health needs of our communities, our health care system attempts to stay up-to-date and serve patients. The five executives from healthcare organizations across the U.S. spoke about the most crucial changes facing their institutions. These error reports included operating on the wrong patient, operating on the wrong part of the body, medication errors, abuse, and even deaths during the delivery of medical care. The report identified six areas of waste: $210 billion in unnecessary services, $130 billion in inefficiency in the delivery of care, $190 billion in excess administration costs, $105 billion in inflated prices, $55 billion in prevention failures, and $75 billion in fraud. These innovations will come only from investment by government, academia, and pharmaceutical companies looking to make a profit. Hospital bed closures during the past decade have substantially weakened the … If we could postpone the complications from chronic diseases to a limited time period right before death, then we could reduce health care costs and improve the lives of patients at the same time. The Association of Medical Colleges is predicting a shortage of more than 62,000 physicians by the year 2015. The ACO, which looks a lot like a health maintenance organization (HMO), is a health care organization designed to link payment and delivery of health care services to improved quality and cost reduction for a certain population. The epidemic of, Figure 15.1 Prevalence of Obesity Among Adults Aged Twenty and over, by Sex and Age: United States, 2009-2010. (2009), “Fundamental changes that result in improvement in quality include, • Altering how work or activity is done or the makeup of a product, • Producing visible, positive differences in results relative to historical norms. Also, payment by credit card has been Source: Ogden et at, 2012, fig. “Data, analytics, technology, and interoperability are still ongoing challenges and opportunities. While South Africa’s public health care system has come a long way since the end of apartheid, three major issues are worrying Professor Laetitia Rispel. January 04, 2017 - From gauze and paper gowns to implantable medical devices and prescription drugs, provider organizations must implement efficient healthcare supply chain management processes to cut overall costs and standardize care delivery.. Telehealth Under Health Reform 19. We must deliver more healthy babies and raise healthier children • 8. Exciting new treatments, combined with greater administrative burdens and complexity of the health delivery system, have created unsustainable … But it had to be done in order to gain an understanding of the volume of errors, their location, and their cause. See what problems are facing 21st century healthcare, and what is currently being done to prepare and fight these issues. The amount of fraud and waste in the U.S. health care delivery system has risen to historic levels and has become one of the most important challenges facing our nation. In the low- and middle-income countries, the developing world, the poor access to healthcare services delivery is due to infrastructural, structural issues, and poor funding. Where Did We Begin? Activities may be handled awkwardly at first and, as a result, risks usually not present may emerge. Another major problem found in health care is the danger that patients face on a daily basis when they enter the health care system for assistance with their medical problems. You’ll deepen your understanding of the challenges facing today’s healthcare delivery systems, and gain insight into the workings of our integrated, not-for-profit healthcare system. Research shows that individuals who experienced adverse childhood experiences are at greater risk of heart disease, diabetes, and premature death. As health care administrators discover new ways to serve the health needs of our communities, our health care system attempts to stay up-to-date and serve patients. There also needs to be a commitment to legislation designed to free physicians from redundant paperwork and to allow physician extenders to perform more of the less skilled duties of physicians. By tailoring therapy on the basis of the disease and specificpatient characteristics, healthcare providers can give the right treatment tothe right patient at the right time. Common Challenges Together • 5.We must reduce readmissions • 6. There is an old adage that tells us, “You get what you pay for.” That statement seems to be true everywhere except when we are purchasing health care services. These diseases cannot be allowed to continue to increase in incidence and prevalence or our health care system is indeed doomed to failure because these chronic diseases cannot be cured and the costs of their complications continue to grow as our nation ages. (2009), in order to improve the value of health care we need to deal with three barriers: “lack of accountability for the overall quality and cost of care and for decisions about local capacity; a payment system that rewards volume, growth, and intensity, regardless of value (and that penalizes providers who adopt cost-saving innovations); and the widespread belief – often in the face of relevant evidence to the contrary – that more medical care means better medical care” (p. 220). The new health care law is actually replacing price rationing in health care with time rationing. These errors can be reduced only by better leadership along with empowered followers who are all working as a team to, first, discover why medical errors occur and, second, to rapidly move to prevent them from occurring in the future. implemented a system of online license renewal, which enables physicians to renew their licenses online through the Board’s Web site while paying by credit card. Healthcare for an aging population. “Nonetheless, healthcare executives always need to proactively stay on top of regulatory developments so they can position their organizations for the opportunities and challenges that may emerge as a result of changes,” says Kim Bell, senior vice president of health services, NFP, an insurance broker and consulting firm in Austin, Texas. This willrequire more efficient integration of relevant patient data, leading to precisediagnostics. This type of intervention needs to be looked at as a long-term investment. The more precise the treatment, the betterpatient outcomes will be. The biggest challenge facing healthcare is the need to improve value for patients. If this is so, then the lifetime illness burden could be compressed into a shorter period of time nearer to the age of death. During IDS formation, many persons are asked to perform functions and tasks for which they have never been previously responsible. It is ironic that although these solutions are not going to come from government, they will not be able to happen without the help of government. ACOs emphasize the alignment of incentives and accountability for providers across the continuum of care. 1. The chronic disease epidemic is growing rapidly in our country. The drug industry produces one of the highest profit levels on an annual basis of all American industries. ... 5 challenges facing health systems ... "Providers are recognizing the validity of value-based care delivery." Health education efforts need to begin in elementary school and continue on into the workplace. By the year 2030, the number of people over 60 years of age will increase by 56 percent, from 900 million to 1.5 billion . It helps us to better understand the challenges and concentrate on better solutions when we realize that rising costs in health care are only symptoms of much larger problems. Another concern of health policy experts is the lack of quality in the health care being supplied to consumers. But now, eligible physicians are starting to feel the penalty phase of CMSs quality reporting and Meaningful Use initiatives. It shouldn’t be surprising that costs and transparency are at the top of the list along with the consumer experience and delivery system transformation,” says Ferris W. Taylor, Executive Director of HCEG. 3. Duly, the medical field currently faces four prominent challenges: service integration, service quality, Internet connected medical device security and publicly sustainable pharmaceutical pricing. However, many providers are concerned that they may be reaching a point at which the cost of building and maintaining their value-based organization is not supported by their fee-for-service reimbursement … If our country were able to deal with this one area successfully, we could easily reverse the problem of escalating health care costs. It is fueled in no small part by the rise in obesity and is considered by most physicians and public health officials as the greatest medical threat to confront our system of medical care. Hospitals and health systems will face ever more pressure in 2014 to establish the core skills needed to thrive in a rapidly changing healthcare market. 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