Delivery Models in Healthcare

Delivery Models in Healthcare

Introduction

Improvement of public health is one of the primary objectives of the healthcare delivery industry. There are, however, many issues such as high costs, an aging population, and poor healthcare outcomes affecting the United States healthcare system. There are many healthcare delivery models in the United States. There have their advantages and limitations that determine their use in clinical settings. Many healthcare frameworks such as the Triple Aim have been introduced to optimize and improve the performance of the healthcare delivery industry.

Triple Aim Framework

The Institute for Healthcare Improvement (IHI) developed the Triple Aim Framework in 2008 to help optimize the performances of healthcare systems using several metrics. This framework has three objectives. The objectives include “improving patient experience, reducing healthcare costs, and improving population health” (Al Jasser & Almoajel, 2020). Achieving Triple Aim is critical in the success of hospitals that aims towards shifting to value-based patient care. Furthermore, it may encourage healthcare managers to implement strategies that improve community health beyond clinics and healthcare organizations that are part of the healthcare system. Even though this framework has three components, they are not steps. All three components should be pursued simultaneously. Healthcare organizations can take several measures to help them effectively implement the Triple Aim. These steps may involve identifying community needs and populations at risk.

One of the major objectives of the Triple Aim is enhancing patients’ experience when seeking healthcare services. Effectively achieving this require healthcare systems to assess community health, identify risk factors, and evaluate overall mortality (Al Jasser & Almoajel, 2020). They can also implement several strategies to help patients navigate the healthcare delivery industry more easily. These changes may include collective documentation, patient-centered care, and technology integration into healthcare. Healthcare organizations can evaluate the effects of these strategies by conducting surveys and implementing quality improvement initiatives.

The United States has the highest healthcare costs globally (Anderlini, 2018). However, these high costs are not commensurate with the quality of services. It is thus important to increase quality while lowering costs which is a tough balance act. Many factors affect the cost and quality of healthcare. Some of the factors include an aging population and chronic healthcare conditions (Anderlini, 2018). These chronic conditions are expensive to diagnose and manage. They also have a poor prognosis and patient outcomes. The cost reduction aspect of the Triple Aim motivates the healthcare system to find strategies of reducing healthcare costs while providing care while increasing quality (Al Jasser & Almoajel, 2020). It also encourages them to identify populations at risk and address community healthcare needs.

One of the critical components of the Triple Aim is identifying populations at risk and addressing community needs (Al Jasser & Almoajel, 2020). This helps in improving population health. All people living in the community are potential patients for healthcare organizations. Comprehending the community’s risk factors and healthcare needs can help healthcare organizations develop strategies to reduce healthcare costs, implement patient-centered care and improve healthcare quality (Al Jasser & Almoajel, 2020). The IHI has five recommendations that can help healthcare organizations design new care delivery models that can better serve the community to help achieve the objective of the Triple Aim. They include patient engagement, redesigning care structures, improving population health, financial management and supporting system incorporation and implementation (Al Jasser & Almoajel, 2020).

Current Trends In Health Care Delivery Models.

There is an increasing need for high-quality but low-cost health services that have led to value-based care models. Many healthcare providers are implementing value-based care delivery models. In these models, healthcare professionals and organizations are paid for assisting patients to recover. They implement evidence-based strategies to lower the impacts and prevalence of chronic conditions. Value-based services differ from volume-based services such as capitation and fee-for-service. In volume-based services, healthcare professionals are reimbursed for the number of services they provide (Erickson et al., 2020). Value-based reimbursement is based on different metrics such as cost, effectiveness, patient satisfaction, and quality. Value-based delivery models being used currently include “pay for performance, Medicare Quality Incentive Program, bundled payment, Accountable Care Organization, capitation and payment for coordination.”

Insurance payers, the government, and healthcare consumers are pressuring the healthcare system to deliver quality and cost-effective care. The switch to value-based care is driven by calls to improve healthcare quality and lower costs (Erickson et al., 2020). Value-based care puts patients at the center of the healthcare system. There is a coordination of care in a multidisciplinary healthcare team to improve healthcare outcomes (Erickson et al., 2020). Patients are more engaged in the healthcare process. There is the implementation of preventive care. Proactive care helps manage and prevent chronic conditions, which keeps patients well (Erickson et al., 2020). There is sharing of data among healthcare professionals. This helps them to improve operations, manage risks and enhance patient care. The reimbursement models are based on value as the new benchmark.

Patient-centred care is another trend in the current healthcare delivery models. Patient-centered care enhances healthcare outcomes, promotes patient safety, and lowers healthcare costs (JKuipers et al., 2019). Collaborating with patients is essential in enhancing the patient experience and improving physician satisfaction. Patient-centred care is essential in healthcare improvement. Patient-centred care considers the values, preferences, and needs of a patient in a responsive and respectful manner (JKuipers et al., 2019). Individual patients have unique hereditary history, lifestyles, culture, socioeconomic status, and other factors that can affect the risk levels and response to care. They also have different values and healthcare goals. Healthcare organizations are thus tailoring care to meet the individual healthcare needs of patients. Patients actively engaged in the treatment process have improved experience and medication adherence, enhancing clinical outcomes (JKuipers et al., 2019). Technology has a vital role in value-based care models since it allows health information exchange and enhances patient engagements (Alotaibi & Federico, 2017). Many patients prefer technology that allows them to book appointments and engage with their healthcare providers. Healthcare technology also allows healthcare professionals to coordinate care and improve patient outcomes (Alotaibi & Federico, 2017). Many healthcare organizations are integrating technology into the service delivery models.

Impact of Safety and on Delivery Models in Health Care

The Healthy People 2030 initiative sets data-driven objectives to enhance population health and well-being (Office of Disease Prevention and Health Promotion, n.d.). These objectives make healthcare systems more resilient to implementing strategies to enhance the quality and safety of healthcare. Quality is paramount in healthcare. Quality and safety measures determine the care delivery model that a healthcare organization implements. Regardless of the objective of a healthcare delivery model, the common goal is to enhance patient safety and healthcare quality. Healthcare delivery models are thus influenced by safety and quality metrics. The delivery models are developed to enhance population health, reduce healthcare costs, and improve healthcare quality. There has been rising pressure from insurance payers and consumers to improve healthcare quality and safety. This has made the healthcare system develop value-based delivery models that improve patient experience and satisfaction (Erickson et al., 2020). There are many trends in healthcare delivery models. Since safety is crucial in healthcare, healthcare organizations incorporate technology into their delivery models to enhance patient safety. Technologies being incorporated into the delivery models include bar code medication administration. This technology reduces medication errors (Alotaibi & Federico, 2017). Quality and safety are characteristics of an effective healthcare system. Healthcare must be safe and satisfy consumers seeking it. This is the basis of current healthcare delivery models. They are value-based and aim to enhance the safety and quality of care.

Conclusion

The United State’s healthcare system is the most expensive in the world. There is increasing pressure to provide quality and cost-effective healthcare services. Due to this fact, there has been the implementation of value-based delivery models to reduce healthcare costs and improve the quality of care. Some value-based delivery models include Accountable Care Organizations and Patient-Centered Medical Homes. Insurance payers also incentivize healthcare providers to implement value-based care. Many payment models are being based on high-quality and cost-effective healthcare. There are current trends in the value-based delivery models, including patient-centered care, use of technology, care coordination, and interdisciplinary collaboration.

References

Al Jasser, B., & Almoajel, A. (2020). Adopting the Triple Aim framework in the Saudi healthcare system: A Delphi study. Risk Management and Healthcare Policy, 13, 2189-2197. https://doi.org/10.2147/rmhp.s251008

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173-1180. https://doi.org/10.15537/smj.2017.12.20631

Anderlini, D. (2018). The United States health care system is sick: From Adam Smith to overspecialization. Cureus, 10(5). https://doi.org/10.7759/cureus.2720

Erickson, S. M., Outland, B., Joy, S., Rockwern, B., Serchen, J., Mire, R. D., & Goldman, J. M. (2020). Envisioning a better U.S. health care system for all: Health care delivery and payment system reforms. Annals of Internal Medicine, 172(2_Supplement), S33. https://doi.org/10.7326/m19-2407

JKuipers, S. J., Cramm, J. M., & Nieboer, A. P. (2019). The importance of patient-centered care and Co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. International Journal of Integrated Care, 19(4), 315. https://doi.org/10.5334/ijic.s3315

Office of Disease Prevention and Health Promotion. (n.d.). Healthy people 2030. Healthy People 2030. https://health.gov/

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Write a 1,250-1,500-word essay about delivery models in health care. Include the following in your essay:

Address the triple aim as it relates to population health management and delivery models.
Discuss current trends in health care delivery models.
Describe how quality and safety impact delivery models in health care.

Delivery Models in Healthcare

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