Integrated Healthcare Systems Review
Integrated healthcare systems are systems set as strategies of improving healthcare systems in the United States. The systems suggest use of combined effort of medical practitioners in various fields to manage healthcare. The strategy is aimed at making the healthcare sustainable to people by reducing the costs involved, at the same time remaining effective. However, their definitions, implementation and how they work is an emerging issue, which this review addresses briefly.
One good definition of these systems is considering them a joint effort of hospitals and freelance health experts such as physicians, in providing effective healthcare to patients. The main idea is freelancing healthcare experts ranging from primary providers to specialists offering their services as incentives to other hospitals, in a bid to reduce the growing healthcare costs. The main structure of these integrated systems is making health personnel in private sectors and public ones work together to provide quality healthcare (American Hospital Association research 3).
These systems seek to provide primary healthcare to patients, which leads to comprehensive integrated services, which are wide-ranging. Their success in providing such a comprehensive service will mainly come from the incentives that are presented by the joint coordination between hospitals and private providers, which save costs that later, are divided among the providers. The system involves joint responsibility between a hospital, physicians, specialists, Medicare homes and other medical experts in providing healthcare, which stops competition for patients, and in turn, cost reduction measures are used. Quality of service is rewarded to encourage the providers in giving good care to patients, which uses primary services to manage care to patients and use preventive measures that reduce chronic ailment costs. Providers are left with responsibility of managing the patients, and conducting follow-ups of adherence to treatment. The main idea is physicians taking care of all the medical care given to patients, from basic, educative, and chronic ones, through integrating other professionals.
These systems have advantages and disadvantages to patients and the providers too.
One of the advantages is efficiency and cost reduction. When this two are achieved in any field, they are a great advantage. These systems, due to integration of providers of medical health, will help improve the quality, offer a wide range of services that fit patients, and accessibility of advanced healthcare will be available to patients without limitations of where to get them. When the providers are held accountable for quality, and benchmarked, they are bound to improve the services provided. In addition, they are paid for quality services, which motivate quality performance.
The integrated healthcare programs, allow payment structures that integrate with other payment schemes. According to McClellan, if the payment reforms suggested in these systems are embraced, cost reduction can be achieved in the long-term. In addition, he suggests that implementation can be supported by other performance measures that will improve consistency and clinical relevance (987).
Despite these advantages, there are disadvantages associated with it. One is the implementation of the system. The implementation may pose a major challenge to everybody, since not all people are well aware of how it will work. Many people do not know how viable this system will be in terms of the cost reductions suggested. The providers will incur greater costs in coordinating the system since the responsibility is mainly inclined to them. Others feel that primary care is not comprehensive enough for chronic medical care. The providers will be the ones to incur losses if they are not able to maintain any savings on costs. Using these models, of primary care, fewer chronic cases will reach the specialist. This will be a negative implication to the patients.
According to Deloitte Centre for Health Solutions, the current health systems in the United States are not sustainable, and a way of managing the chronic medical care is necessary to help sustain good healthcare (15). The system has a good objective behind it, which aims at proving quality healthcare to the patients through taking care of chronic and other medical needs in the hands of the providers. Cost reduction is always a welcome idea if quality is maintained. Considering this system, the balance of cost reduction and quality is the main emphasis. The integrated healthcare is recommendable since it seeks to favor the patients and the providers of the services.
In the implementation of these systems, there are going to be challenges associated with it. One is leaving full accountability to providers. This will need the involvement of the providers and the payers. According to McClellan, he says that achieving sustainable healthcare solutions using this system will need not only medical skills from the physicians and other professionals, but also leadership and management skills (989).
Integrated healthcare systems are a possible solution to the healthcare in the United States, especially after considering that the current system is not sustainable and another one will be needed soon. This system will be effective if all parties involved, including patients take up the challenge through learning more about it, to reduce the barriers to its implementation. According to an American Hospital Association research, those interested in the integrated system should do a thorough analysis of their potential ability in taking up this opportunity (11). They should know what is necessary or needed in making an Accountable Care Organization, and how to integrate it with other players such as paying policies to ensure smooth flow.
American Hospital Association. “Accountable Care Organizations.” 2010. PDF files.
Bruce, Landon, Gill James, Antonelli Richard and Rich. “Prospects for Rebuilding Primary Care Using the Patient-Centered Medical Home.” Health Affaires 29.5 (2010):827-834. PDF file.
Deloitte Center for Health Solutions. “The Medical Home.” 2008. PDF files.
McClellan, Aaron, Julie McKethan, Roski Lewis and Fisher. “A National Strategy to Put Accountable Care into Practice” Health Affairs 29.5 (2010): 982-990. PDF file.
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