New delivery systems are rapidly changing the face of healthcare, and staying abreast of new developments can be a constant challenge. As a student in a graduate-level Executive Master of Health Administration degree program or a practicing health professional, you should understand how the following four healthcare delivery systems are changing the way people interact with the larger healthcare system.
Managed Care
Managed care plans aren’t new, but these plans are continually undergoing changes due to President Barack Obama's healthcare law. As the National Institutes of Health (NIH) explains, a managed care setup includes agreements among a predetermined network of doctors, facilities, and healthcare providers to offer services at the lowest cost possible.
According to the American Academy of Pediatrics, the most common managed care plans include Health Maintenance Organizations (HMOs) that offer preventive care and other services for a monthly fee and Preferred Provider Organizations (PPOs) that offer a fee-for-service system. Other managed care plans include Point of Service (POS) plans that allow for out-of-network referrals for a higher cost and increasingly common High Deductible Plans (HDPs) that hold the patient responsible for higher healthcare costs.
Concierge Services
Concierge medicine, according to Healthline, is a new healtchare delivery system that’s quickly gaining traction. In fact, as Healthline's Nina Lincoff explains, about 20 percent of physicians now offer concierge services or intend to do so in the near future.
This system is remarkably straightforward, requiring a flat monthly payment in exchange for medical services. Essentially a form of private practice, concierge medicine allows doctors to charge a type of retainer to give patients complete access to the services they offer.
Self-Directed Services
Self-directed services typically apply to Medicaid and allow patients to make their own care-related decisions that would typically be left to an agency. As the Centers for Medicare & Medicaid Services explain, one of the benefits of a self-directed delivery system is that the care focuses on the individual patient and can even allow people to recruit and hire providers for their own needs. This healthcare delivery system has its roots in the 1990s, but in 2010, the nation's new healthcare law expanded the number of patients who could take advantage of self-directed services.
Telemedicine
A particularly innovative healthcare delivery system, telemedicine doesn’t require patients to meet their doctors in person. Instead, telemedicine allows patients to use phone or video technology to interact with physicians. While telemedicine has long proven helpful in rural communities where the distance between patients and doctors can be a factor in accessibility, Forbes contributor Bill Frist explains that telemedicine is also changing the face of urgent care.
Instead of demanding that both patients and health care professionals dedicate resources to in-person urgent and emergency care, telemedicine allows patients to get professional medical advice efficiently. As Frist explains, opting for telemedicine instead of non-emergent care in a hospital emergency room can reduce a patient’s medical costs from as much as $3,000 to as little as $40.
Since 50 percent of U.S. healthcare costs come from about 5 percent of the nation’s population, according to The Commonwealth Fund, additional reform can be both welcome and necessary. As a future public health professional, you can help drive reform and policy changes to improve healthcare systems nationwide.
For more information please visit USC's Executive Master of Health Administration Online program.
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Sources Linked to in the Article:
https://www.nlm.nih.gov/medlineplus/managedcare.html
http://www.healthline.com/health-news/the-future-of-healthcare-could-be-in-concierge-medicine-063015
http://www.commonwealthfund.org/grants-and-fellowships/programs/health-care-delivery-system-reform/
Sources Consulted for the Article:
http://www.drsforamerica.org/learn/policy-center/healthcare-delivery-system