25
HEALTHCARE ADMINISTRATOR by Modupe Sarratt

Healthcare administrator

Embed Size (px)

Citation preview

Health Administration

Healthcare Administratorby Modupe Sarratt

IntroductionHealthcare Administration is the field for leadership and the management for public health is the profession for health administrator.In many parts of the world, particularly in developing countries, people get their primary health care, or first-contact care, where available at all, from non-medically qualified personnel; these cadres of medical auxiliaries are being trained in increasing numbers to meet overwhelming needs among rapidly growing populations. Even among the comparatively wealthy countries of the world, containing in all a much smaller percentage of the world's population, escalation in the costs of health services and in the cost of training a physician has precipitated some movement toward reappraisal of the role of the medical doctor in the delivery of first-contact care.

-medicine. (2010). Encyclopdia Britannica. Encyclopaedia Britannica Deluxe Edition. Chicago:Encyclopdia Britannica.

The industry CodeThe North American Industry Classification Systems or NAICS is used by business and government to classify business establishments according to type of economic activity for process of production in Canada, Mexico, and the United States of America. NAICS is the North American Industry Classification System for business establishment for the types of activities and services for financial systems.The Mills article identified Healthcare Administration under the private sector for small businesses. NAICS sector 62 is for Health Care and Social Assistance as of October 24, 2012 to reflect the size of businesses for the type of financial assistance. - Mills, K. G. (2012).Health care for small business includes Fee-for-service that provides the services of a doctor or hospital with partial or total reimbursement depending on the insurance company. Health insurance offering programs or plan is geared toward small business.Preferred Provider Organization (PPO) is example of healthcare regarded as fee-for-service plan because of having in place some restriction to control the rate and the cost for care. Under the PPO, a doctor provides a service at alternative price or for a lower price.Others such as Point of Service for urgent care combines the for fee-for-service plan and HMOs, which an employee or a patient is responsible for deductible.HMO is more complex system for small business partnerships with other criteria that include independent appraisals or sometimes three independent appraisals valuation to determined for a fair market value

Trends in Healthcare Administration

Care Is understanding the nature of the individual and the culture of the community for well-being to provide assistance.

Healthcare for a patient is preventing an illness and curing a sickness . A concern for the community is education for healthy living. Outpatient care is the care of individual and the community for interaction Evidence showed that the understanding community improve health in the study of the elderly community.

Trends in Healthcare Administration

Care continuesThe study of the elderly community for well-being by Kothari et.al (2015) showed that involvement of the community support professional practices for healthcare to improve the care of seniors in the case study of elderly communities in Ontario, Canada. The study sheds light on using outpatient care to facilitate systems to include social worker in the care of the elderly. The study conducted on a yearly base helps to increase understanding of organizing outpatient care to affect system change by strategically analyzing individual cases. The community practice for outpatient care includes the care for the low income minority for lifestyles modification. For example, the obesity trend in the low income community for lack of activity is a health issues that should be included in the Affordable Healthcare Act. -Kothari 2015

care continuesOutpatient care is undergoing a diagnostic workup, evaluation, or treatment outside of a hospital in the community at a local clinic or from private therapists. A patient who receives care in a hospital without requiring an overnight stay; any patient who attends a specialty (consultant) or other medical clinic or is seen outside of a clinic by a consultant or senior member of his or her team at any location including the patient's homeAccording to Dorland (2007), a patient who comes to the hospital, clinic, or dispensary for diagnosis or treatment but does not occupy a bed. Therefore, outpatient is a checkup for well-being to prevent an illness or a sickness.Dorland's Medical Dictionary for Health Consumers. 2007

Levels of careThe levels of care for health according to the practice of Medicine (2010)

Are various forms of medical practice that are generally thought of as forming a pyramidal structure, with three tiers representing increasing degrees of specialization and technical sophistication but catering to diminishing numbers of patients as they are filtered out of the system at a lower level. Only those patients who require special attention either for diagnosis or treatment should reach the second (advisory) or third (specialized treatment) tiers where the cost per item of service becomes increasingly higher. The first level represents primary health care, or first contact care, at which patients have their initial contact with the health-care system.

Primary health care is an integral part of a country's health maintenance system, of which it forms the largest and most important part. As described in the declaration of Alma-Ata, primary health care should be based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development. Primary health care in the developed countries is usually the province of a medically qualified physician; in the developing countries first contact care is often provided by nonmedically qualified personnel.

The vast majority of patients can be fully dealt with at the primary level. Those who cannot are referred to the second tier (secondary health care, or the referral services) for the opinion of a consultant with specialized knowledge or for X-ray examinations and special tests. -Medicine 2010

How to measure care for outpatientIs the increase in the number of patients visiting Emergency Room (ER) for non emergency complaints related to the inadequacy of Medicaid and copayments for health services as a result of not able to afford paying for care in the private practice. In addition, many private health providers are not accepting outpatient for having Medicaid.

According to the Medicaid Access Study Group. (1994) New England Journal of Medicine,330(20), 1426. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8159198

The journal article indicates that the purpose of Medicaid is to assist low-income patients with access to health care. However, the Medicaid recipients have to wait for providers that will accept government payments. This article deals with patients using emergency facilities for nonemergency care because they cannot find providers who will accept Medicaid, given that the patient cannot walk-in without an appointment and copayment.

The study of Medicaid recipients in urban areas who have limited resources to outpatient care highlights the need to mandate Medicaid for unlimited coverage . The research to identify why Medicaid patients go to the emergency department for non-emergency procedures, such as complaints of back pain, sore throat, and lethargy instead of standardized visits to private primary care. The research was conducted as a telephone survey to make appointments for patients receiving Medicaid.

How to measure care for outpatient continue

As mentioned in slide 8.

The result of the survey showed that urgent care centers would not accept Medicaid, which was the most common reason for not granting appointments. Sixty percent of private provider practices agreed to see patient with delayed appointments for two to three weeks before scheduled to see patients with Medicaid instead of two to three days with private health insurance.

About 8 percent of private practices offer after-hours care within two working days while only a about 26 percent of private care facilities agreed to see Medicaid patient within two days. The relevance of the article is the limitation for care within private practices to include non-profit organization such as outreach centers to assist with patients overall wellbeing. The establishments include medical staff providing general or specialized care that ranges from outpatient pain therapy, outpatient community health, outpatient disorder clinic, and outpatient biofeedback center. Outreach care centers include holistic approaches, spiritual wellness, and health education. -According to the Medicaid Access Study Group. (1994)

Healthcare challenge

The hurdles for healthcare is a triangle of cost, quality and access for health insurance and for health services in contrast to the uncapped tax exclusion for Affordable Care Act to be faulty for the coordination of services for coverage relates to the laws for the states to control the implementation of Medicaid and Medicare. The dilemma to improve health with more testing and the dangling of pharmaceutical and drug side effects for ER visit are ongoing for constant reevaluation to adjust and to make changes. The tasks for Affordable Care Act is daunting and never-ending for management for accessibility to the patients to receive care without going through the bureaucracy of government control.

Rosenbaum et.al(2013) describes the challenges for the Affordable Care Act (ACA) gives states the option for expanding Medicaid coverage to nonelderly adults ages 19 to 64 with incomes at or below 138 percent of the federal poverty level who do not fall into other eligibility categories as parents, caretaker relatives, dependent children, pregnant women, and adults receiving Medicare based on disability. The law also provides states with flexibility to choose the level of coverage provided to such adults. The coverage model is based on a benchmark linked to the benefit designs used by private insurers, rather than the broader coverage rules used for traditional Medicaid beneficiaries. How states are implementing this benchmark approach to coverage is an important consideration for Medicaid policymakers and for Healthcare Management for adjusting and changing healthcare policies and practices.

Choosing the most suitable and cost-effective for providing healthcare is time consuming for medical benefit to designed computer that calculate cost of health-care based on individual need for care.

The question on how to measure healthcare systems for performance in the triangle of cost, quality and access to reflect individual organization or private providers for primary care, urgent care, and hospitals are ongoing measure which put pressure on three trends for healthcare administration.

The three trends for Outpatient care (OC), Health Information Technology (HIT) and Healthcare Management (HM).

Three Trends for Healthcare Administration

Outpatient care (OC) Health Information Technology (HIT) Healthcare Management (HM)

OCHITHM

Trends in Healthcare Administration

Outpatient Care for

Prospect for outpatient care is walk-in to receive treatment Patient comes first for providing care and fee for later for affordability.No more revisiting to the doctor office for the same problem or for more testing.Giving knowledge to the patientPatient knows as much about the doctor the cause for illness and the testing for providing treatmentA visit to the doctor or ER means patient is well for no further infection or nosocomial.Doctor for to restore health first for payment.Patients satisfaction is seeing a doctor to getwell not to return for getting sicker or for more testing.It is possible that the doctor can restore health first before getting pay.Giving knowledge to the patientPatient shouldknow as muchas the doctor the cause for an illness and the testing for providing treatment.

A visit toa doctor means thepatient received treatment to get well for no further testing.Likewise, a visit toER means patient is well for no further infection or reinfection for nosocomial.Healthcare for restoring health first for payment later.Healthcare for wellbeing is not for experiment with drugHealth services is empathy for caring

Anonymous, unknown publisher (2015) http://www.justwalkinmedicalcare.com

Health ManagementHealth Care Social Assistance

Hurdle (2001) publication reflects the facts and the practices of outpatient care for wellness and illness prevention includes the collaboration of social assistant. The article identifies social workers as a benefit to providing care. Social assistants help individuals to recover quickly from a serious illness and reduce the mortality rate. Social worker support is part of public health to promote wellness by educating the community about communicable diseases and promoting activities for healthy living.

Baby boomer is drift for outpatient care. According to Appari et.al (2009), the shift in the baby boomer demographic for longevity is the implementation of chronic care for outpatient care . Although chronic care has increased the cost of healthcare, it plays a critical role in the industry for expanding facilities to accommodate for social worker to provide social assistant to the senior citizens with mandate for privacy and security to protect health information.

Another drift for outpatient care is the involvement of the community. Kothari et.al (2015) indicates that studies of outpatients care increases the engagement of the minorities and the elderly to affect system change for affordable care. In the case study, Kothari indicated the involvement of the communities in the health sector to support professional practices in outpatient care showed improvements in the care of the seniors.

Problem with outpatient care is low income, the study of low income who received Medicaid creates drift to inpatient care for government handouts. According to Medicaid Access Study Group (1994) many Medicaid patient for outpatient care in urban areas have limited resources for why Medicaid patients go to the emergency department for inpatient carefor non-emergency procedures, such as complaints of back pain, sore throat, and lethargy instead of standardized visits to private primary care for outpatient care is primary .

Trends in Healthcare Administration

Social assistant isforming the relationship for services

Although, activities such as aerobics classes, personal and laundry services, nonmedical diet and weight reducing are found to be very important for maintaining personal health, the services for healthy living and lifestyle modification are excluded from outpatient care. Hurdles publication reflects the facts and the practices of outpatient care for wellness and illness prevention to includes the collaboration of social workers. The article identifies social workers as a benefit to providing social care. Social assistants help individuals to recover quickly from a serious illness and reduce the mortality rate. Social worker support is part of public health in order to promote wellness by educating the community about communicable diseases and promoting activities for healthy living.- Hurdle, D. E. (2001).

Trends in Healthcare Administration

For Health Information Technology (HIT)HIT for medical informatics is the field of medicine for allocating of resources, distributing information, taking patient history, retrieving test result, monitoring clients, teaching medical education, researching health issues, coordinating procedures in the medical office, billing and financial management are the reasons for government intervention.

HIT allocation of resources for public good is the market place for healthcare services. HIT is implementation for monopoly to fix external problem for costs and benefits related to providing care. For example, if a private provider fails to restore health for doing more harm or for any reasons, the government is empower to intervene through the technology that were in place to monitor benefit for special interests that influence politician rather than society as a whole. The range for government intervention is the application of HIPAA for funding medical research.

According to Shekelle, Paul, Sally C. Morton, and Emmett B. Keeler. "Costs and benefits of health information technology" (2006). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK37988/the cost and the benefit for Health Information Technology (HIT) is the primary care settings. The report showed that the used of HIT improved care in the 256 studies, 124 of the studies suggests that Electronic Health Records (EHRs) has the ability to improve the quality of care in the ambulatory setting. The studies conducted at four sites in the three U.S. Medical Centers and one in Netherlands demonstrated improvement in provider performance when clinical information and decision were made available within an EHR system to translate data into context-specific information empower the providers to perform better in their work. Therefore, the implementation of HIT has the potential to transform the delivery of health care for safer, more effective, and more efficient. HIT built around EHRs is predicted for substantial savings. However, there is limitation from a lack of generalizes knowledge on how to implement HIT to specific health organizations.

Shekelle article did not address the current trends for Electronic Medical Records (EMRs) used by the physicians for reimbursement and the Personalized Health Records (PHRs) used for patient data for health transaction. Although, the analyses of HIT for quantifiable benefits did not includes the Microsoft application programs for the administrative function. In addition, the study is limited in scope for marketing health products, advertising for care, and does not include the cost for securing data or the cost for data breach for HIPAA compliance. -Shekelle et.al (2006)

As of now, the computerized systems available fail to meet the rising expectations for service, privacy and transparency. Teoh and Cai studies aims to understand how innovation for three dimensional can be strategically nurtured, developed, and managed to upgrade the quality of care through integrating and reconfiguring to cope with changes in HIT. -Teoh, S. Y., & Cai, S. (2015).

Championship for Management

Is the combination of healthcare and social worker for acquisition of costs and sharing of government budget for providing health services. This includes a dedication to managing and treating patients to improve overall health and quality of life. The championship for management provides comprehensive medical evaluation and care, and the opportunity for the patient to join in the clinical trials to provide the best care for there is no limitation to individual health and the health of the community.

Griffith, J. R., & King, J. G. (2000). Championship management for healthcare organizations. Journal of Healthcare Management, 45, 17-31. Retrieved from http://www.biomedsearch.com/article/Championship-Management-Healthcare-Organizations/61837279.htmlDiscuss how the growth of technology betters performance tracking by creating boundaries for health reform on tough issues such as price reductions, negotiating professional care, meeting patient demand for quality service, and debating the prescription for expensive drugs. The article helps identify different views within several areas in the healthcare, such as conflicts in budget, negotiating for stakeholders, contract for employers, providing patient care as an expenses within budget considerations. The rising of healthcare costs for affordable and accessible quality care for low income families.

Although, there is no single legislation stated in the article to address social problems besides the Patient Protection and Affordable Care Act, healthcare management is designed to expand coverage by containing a host of provisions to tend to individuals issues for wellness and prevention. Public health fund and insurance requirements covering immunization and screening is implemented by cost sharing to reform the healthcare budget. - Griffith, J. R., & King, J. G. (2000

The championship for ManagementImprove process knowledge and standard of careImplement medical informatics for technologyProtect medical recordCreating guidelines for best practiceCollecting problems and providing solutionsInclude the community for improving health

The AdministratorIs by formal education for the evaluation of health problems to acquisition of health for implementing day to day of information technology systems and clinical functions within healthcare industry. Keeping in mind that there is more than one model to Healthcare administration, the fact is healthcare is about individual wellbeing in the community for practice of medicine to maintain health and improve the physical and mental vitality through the provision of medical services.

An administrator is a qualifying professional with a graduate degree in health science for the ability to process and coordinate the activity for running a health business which involves dispensing care by giving resources that were necessary for making improvement.

An administrator is the alliance for implementing and dispensing medical services for the applications of industrial code, the NAICS sector 62 is the classification for Healthcare and Social Assistant.

As an administrator, preventing and increasing performance for mental health and overall well being is transferable of care between the providers services and the patients care for coverage and reimbursement of services -Sarratt, M. O. (2015). For Administrator

Serving You,Double Click the link belowOpen web for servicesOutpatient care is come in for careClick the link for care

ReferencesAppari, A., Johnson, M. E., & Anthony, D. L. (2009, November). HIPAA compliance in home health: a neo-institutional theoretic perspective. In Proceedings of the first ACM workshop on Security and privacy in medical and home-care systems(pp. 13-20). Retrieved from ACM. http://dl.acm.org/citation.cfm?id=1655087

Anonymous, Unknown publisher (2015) Walk-In Medical care Griffith, J. R., & King, J. G. (2000). Championship management for healthcare organizations. Journal of Healthcare Management, 45, 17-31.Retrieved from http://www.biomedsearch.com/article/Championship-Management-Healthcare-Organizations/61837279.html

Hurdle, D. E. (2001). Social support: A critical factor in women's health and health promotion.Health and Social Work,26(2), 72-79.Retrieved from http://www.biomedsearch.com/article/SOCIAL-SUPPORT-Critical-Factor-in/75453645.html

Jong-Yi, W., Hsiao-Yun, H., Jen-De, C., Sinkuo, C., Chih-Jaan, T., & Yung-Fu, C. (2015). Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients. BMC Health Services Research, 15(1), 1-15. doi:10.1186/s12913-015-0896-y.Retrieved from http://eds.a.ebscohost.com.ezproxy.umuc.edu/eds/detail/detail?vid=45&sid=2bfc452c-41a9-

Kothari, A., Boyko, J. A., Conklin, J., Stolee, P., & Sibbald, S. L. (2015). Communities of practice for supporting health systems change: a missed opportunity. Health Research Policy & Systems, 13(1), 1-9. doi:10.1186/s12961-015-0023-x. Retrieved from http://eds.a.ebscohost.com.ezproxy.umuc.edu/eds/detail/detail?vid=43&sid=2bfc452c-41a9-

ReferencesMedicaid Access Study Group. (1994). Access of Medicaid recipients to outpatient care.The New England Journal of Medicine,330(20), 1426. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8159198

Medicine. (2010). Encyclopdia Britannica. Encyclopaedia Britannica Deluxe Edition. Chicago:Encyclopdia Britannica.

Mills, K. G. (2012). Small Business Size Standards: Health Care and Social Assistance. Federal Register, 77(185), 58755-58761.Retrieved from http://eds.a.ebscohost.com.ezproxy.umuc.edu/eds/detail/detail?vid=21&sid=2bfc452c-41a9-

Rosenbaum, S., Lopez, N., Mehta, D., Dorley, M., Burke, T., & Widge, A. (2013). Realizing Health Reforms Potential.Retrieved from http://www.commonwealthfund.org/~/media/files/publications/issue- brief/2015/may/1815_rosenbaum_medicaid_benefit_designs_newly_eligible_adults.pdf

Sarratt, M.O. (2015). The Administrator & the publisher

Shekelle, Paul, Sally C. Morton, and Emmett B. Keeler. "Costs and benefits of health information technology" (2006). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK37988/

Teoh, S. Y., & Cai, S. (2015). The process of strategic, agile, innovation development: a healthcare systems implementation case study. Journal of Global Information Management, (3). 1.Retrieved from http://eds.a.ebscohost.com.ezproxy.umuc.edu/eds/detail/detail?vid=32&sid=2bfc452c-41a9-475e-bbd7-

[{000214A0-0000-0000-C000-000000000046}]Prop3=19,2[InternetShortcut]IDList=URL=http://www.justwalkinmedicalcare.com/