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Primary Healthcare

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Assignment 1: The Primary Care Clinic
Rosalyn R. Gatson
HSA 3007/28/2013
Dr. Kate Milburn |

Assignment 1: The Primary Care Clinic
1. Discuss the key political, economic, and social forces that may have influenced the development of the clinic.
Several economic, social, political and religious factors tend to impact the lives of people and ultimately influence health status. People from the middle-class and the upper crusts of society are at a better position to seek care in case they are affected with any health issue. This is because socioeconomic status plays a major role in one’s ability to access and use the healthcare system. Besides, another factor that could be playing a role is educational levels, occupational status, and awareness of the need to have better control over one’s health. Social and economic factors are very important when consideration is given for health status, as they can shape the health condition of the entire community and the individuals that live in that community. Primarily, social factors play a vital role in determining of the individual would stay healthy or would the health status deteriorate. Hence, an important part of the social determinants of health is the Primary care center. Under the legislation and the functioning of the political policies, lie the political determinants of health. Political factors can play a major in ensuring that an appropriate policy is being implemented on a long-term basis so as to improve the health of the community and improve access and conditions in the healthcare center. One such legislation being proposed in the US is the Patient Protection and Affordable Care Act, 2010, which along with the universal healthcare access system aims to decrease the rate of uninsured people in the US and make healthcare more affordable in the US. Politics can improve the access and affordability of healthcare. Together, political, social and economic issues play a vital role in influencing the development of this clinic. The clinic has been setup on the basis of improving the access and affordability of healthcare to the local community, with huge concerns for the public health. 2. Create a comprehensive mission statement and explain what makes it a comprehensive mission statement. The mission statement of a healthcare organization should clearly mention the objectives of the organization and the means of achieving these objectives. The Mission statement would be: “With an intention to promoting the community health in a holistic manner and advance wellness of the community, along with provision of quality preventive, family, therapeutic, diagnostic, specialized and rehabilitative health services”.
The health clinic would aim to provide basic healthcare services along with specialized healthcare services for the communities of the area. Along with this it would also cater to some of the specialized requirements including specialty services, consultations, referrals, etc. The health center would be committed towards providing care for the lower socioeconomic groups and those sectors of the communities who are in need of good healthcare services.
3. Identify three (3) performance measures you would use to measure the clinic effectiveness and provide the rationale for each performance measure. As proposed by the Institute of Medicine, the performance measures need to a comprehensive, efficient and transparent means of determining and measuring performance through certain indicators which should be present and monitored through the system (CMSS, 2007). Performance measures can help to track errors, identify inequality issues and determine the presence of any lag in the care. Some of the organizations that have developed performance measurement tools include the Agency for Healthcare Research and Quality (AHRQ), Centre for Medicaid and Medicare Services (CMS), the Joint Commission (JCI) and the Leapfrog Group. The critical features of the primary care system is that it is first contact services, needs to be comprehensive services provided, the care should be patient-centered rather specialty-centered, and there needs to be greater coordination between the healthcare providers. The quality of care in a primary clinic needs to be determined at the individual patient level and the community level. Besides, access and effectiveness need to be taken into great consideration. Effectiveness would include interpersonal care and clinical care. For measuring the interpersonal care effectively, the General Practical Assessment Questionnaire is useful. This questionnaire concentrates on asking the patient feedback on appointments, communication with various professionals, and maintenance of continuity of care. In Europe the European Practice Assessment Practice Management (EPA-PM) is used in European Countries to measure the quality of management in the organization so as to improve the quality in 5 domains namely infrastructure, HR, information, quality and safety and finance (Smith, Mossialos, Papanicolas, and Leatherman, 2011). 4. Describe how you would approach decisions regarding clinic expansion and annual plan approval. To ensure that the decisions made are ethical, managers, need to carefully plan clinical expansion and think very toughly about the annual planning of approval. The first important thing is to actually determine if clinical

Expansion would be beneficial to the organization and the community at large. In case the expansion is expected to affect performance, then such expansion should be delayed till improvement of services can be made. A cost-beneficial analysis is vital before planning out for any expansion. The second issues are that the expansion itself should be within the scope of the goals and objectives of the organization. In this case, the mission statement should be taken into consideration and a strong examination should be made between the mission statement and the expansion plans. When decisions regarding annual planning approvals are final. The goals and objectives of the organization and future development of the organization need to be taken into consideration. The clinical expansion and annual plan approvals should be made only if these factors are constantly being met. The managers and the senior administration of the hospital play a vital role with respect to the strategic planning of the clinic (Hall, 2006). 5. Describe the role of the clinic as a component of the healthcare delivery system in your community. A healthcare system is made up of various resources in an organization or box aimed at functioning towards meeting the healthcare needs of the people present in the environment. In general, such an environment is composed of patients, healthcare providers and the institutions that provide the health services. The patients, society, family and the community would include the patients and would be receiving the services as consumers. The healthcare providers include various healthcare professionals including doctors, nurses, therapists, technicians and managers who work in the particular healthcare system towards fulfilling the goals and the mission statement of that organization. The institutions or organizations include healthcare centers, primary care units, hospitals, insurance companies, governmental agencies, etc., who would be playing a vital role towards the delivery of healthcare services to the patients. Residents in that particular area may be belonging to the lower-socioeconomic groups and hence such services targeted at these consumers. The clinic should be providing such services at an affordable price. The institution has to procure all resources required to provide the services (Smith, 2011). 6. Examine how public healthcare policy has influenced the formation of outpatient clinics in the healthcare system. Public health policy plays a vital role towards the ambulatory services that are provided in the healthcare system. As the focus shifts from therapeutic and rehabilitative to preventive, screening and wellness management, greater would be the need for the government to develop an adequate public health policy in this regard. When the public health policy has been created there is a need for greater creation of outpatient clinics in this regard so as to reduce the cost of healthcare, improve outcomes and reduce the length of stay in the hospital. In order to make the healthcare system more affordable and accessible, it has proposed to launch primary clinics in various rural and far-flung areas. The primary care center would function as a one-stop solution for healthcare and provide referrals to patients if needed. In this way, the health of the community and the population can be improved.
Reference
CMSS (2007). ‘The Measurement of Health Care Performance: A Primer from the CMSS Hall, R. (2006). ‘Patient Flow: Reducing Delay in Healthcare Delivery (International Series in Operations Research & Management Science) Smith, P.C., Mossialos, E., Papanicolas, I. & Leatherman, S. (2011). ‘Performance Measurement for Health System Improvement’,…...

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...The change to a value‐based system of healthcare reimbursement is something that I find rather  daunting and somewhat scary.  The traditional fee‐for‐service system, with all of its flaws, was quite  simple to understand—you pay for the care that is given and if you don’t want to pay more, take care of  yourself outside of the physician’s office.  But, I guess my fear and apprehension about value‐based  reimbursement have their foundation in not fully understanding the change and not being able to  foresee its impact far into the future.  Now, nobody can predict the future, but as I’ve come to find out,  that plays a big role in remaining profitable in a value‐based system.  Despite my initial thoughts on moving from a fee‐for‐service system, I’ve come to believe that it is the  right move, insomuch as it is forcing providers and organizations to focus on preventative care for their  patients.  Under a fee‐for‐service model, healthcare organizations and providers profited from the  ailments of their patients.  More procedures meant more money.  Less and less thought was given to  prevention because it wasn’t profitable.  This is one of the factors that has led to an increase in  healthcare costs over the years.1  Under a value‐based system, the physicians and organizations are  incentivized to improve quality of care delivery and cut costs.  The Centers for Medicare & Medicaid  Services (CMS) has indicated that there needs to be more focus on primary care and pr......

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...Understanding Healthcare Financial Management David Linger HCM565-1 Understanding Healthcare Financial Management Colorado State University – Global Campus Dr. Robert Woerner June 5, 2016 Understanding Healthcare Financial Management CHAPTER 1. The Johnson Family Care Inc. (JFCI) is a multi-specialty primary care facility in suburban Pennsylvania. It provides healthcare in an ambulatory setting that provides 24 hour comprehensive care. It recently purchased clinical equipment for their laboratory for approximately $1.1 million and spent $22,000 to renovate and accommodate the equipment. The equipment has a useful life of 10 years after which may be sold for $75,000. JFCI uses the straight line depreciation method to calculate its book depreciation and pays taxes at 40%. The equipment also falls into the seven-year class MACRS structure. 1. What is the annual depreciation expense that will be reported on their income statement for the JFCI organization? 2. What is the annual depreciation expense that will be reported on the JFCI center for tax purposes? 3. JFCI decided to sell the equipment at the end of the 4th year for $400,000, what would be tax implications for LFCI? Understanding Healthcare Financial Management |ANSWER | | | | | |1. | ...

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...the U.S. can reduce spending. The Federal Government is projected to spend $925.2 billion on their Department of Defense budget. Those funds include but are not limited to costs of military combat equipment, installations, salaries, retirement, and healthcare. Among those, the Active Duty, Retirees, and Military families’ healthcare is currently proposed to be cut saving the Federal Government approximately $1.8 billion by 2013. TRICARE, the health care program for active duty, retirees, and military families, was enacted May 1997. TRICARE replaced Civilian Health and Medical Program of the Uniformed Services “CHAMPUS” and was intended to increase quality of care for eligible beneficiaries. TRICARE has several different plans that make up the overall TRICARE health care program. TRICARE Prime the plan for active duty, their dependents and retired personnel. TRICARE Prime is a HMO style plan with no enrollment fee. Beneficiaries have a primary care provider, typically at a military installation’s medical facility; they see and attain referrals from for all specialty care. TRICARE Reserve Select is available to all military reservists. TRICARE Reserve Select has a monthly premium and allows beneficiaries to see civilian healthcare providers that are payable under TRICARE regulations. In May 2001 TIRCARE for life was added for retired military personnel and their families who prior to TFL lost their TRICARE benefits once enrolled in Medicare. TRICARE for Life pays the......

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...Health Care Utilization Paper Wendy Witt HCS/235 8/13/2012 Delores Usea Healthcare Utilization Paper For many individuals acquiring and using a regular source of medical care is often influenced by many factors. Perceived and evaluated need, and potential access are connected with both predisposing (immutable) and enabling (mutable) factors. Predisposing factors determining the use of health services include demographics, age, gender, race, ethnicity, education, occupation, location, health and cultural beliefs. Immutable factors cannot be changes. Immutable factors are connected with mutable beliefs regarding health values, beliefs, and knowledge. Mutable factors are enabling factors that can be changed. Enabling factors consist of personal and community factors. For example, a personal factor would be an individual s income changed, or the individual gained health insurance or lost health insurance. Community factors include health services resources, health facilities, and transportation. Location has an effect on John’s ability to utilize health care because John recently has moved to a rural community and the nearest physician is 40 minutes away. Providing a healthcare facility within John’s community he would be able to utilize healthcare on a regular basis will help John to live a healthier longer life. Factors that may affect John’s utilization of health care include transportation. Transportation has a large impact on the ability for individuals who......

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