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Related Concept Videos

Introduction To Health Care Delivery System01:18

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Integrated Healthcare System01:20

Integrated Healthcare System

An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...

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Related Experiment Videos

Using Medicare payment policy to transform the health system: a framework for improving performance.

Stuart Guterman1, Karen Davis, Stephen Schoenbaum

  • 1Commonwealth Fund, New York City, USA. sxg@cmwf.org

Health Affairs (Project Hope)
|January 29, 2009
PubMed
Summary

Medicare can improve healthcare quality and reduce costs by offering bundled payment options. This strategy encourages integrated care delivery and coordination for beneficiaries, serving as a model for other health system payers.

Related Experiment Videos

Area of Science:

  • Health economics
  • Healthcare policy
  • Health services research

Background:

  • Medicare is the largest health services payer in the U.S.
  • Current payment policies have limitations in driving quality improvement and cost containment.
  • There is a need for innovative payment models to enhance healthcare organization and delivery.

Purpose of the Study:

  • To propose a framework for Medicare to offer new bundled payment options.
  • To incentivize greater integration and coordination in healthcare delivery.
  • To serve as a model for other payers to improve system-wide quality and efficiency.

Main Methods:

  • Proposal of a new Medicare payment framework.
  • Inclusion of bundled payment options for various provider types (physician groups, hospitals, delivery systems).
  • Incentive structures to promote integrated care and coordination.

Main Results:

  • Potential for Medicare to influence healthcare organization and delivery.
  • Stimulation of integrated care models.
  • Mitigation of healthcare cost growth.

Conclusions:

  • Medicare's payment policies can be leveraged to foster integrated and coordinated care.
  • Bundled payment options offer a mechanism to improve healthcare quality and efficiency.
  • The proposed framework can guide other payers in optimizing health system performance.