Health Care Delivery Model Interview - Essay Example

? Health Care Delivery Model Interview Health Care Delivery Model Interview This is an interview of a primary care provider. The topic is about the future impact of the changing health care delivery systems. The physician in the interview will be Doctor McGann. He travels to different principal cities around the world like Wheeling, Boston, Cambridge and Morgantown, which are part of the physician group by the name EMCARE. This part of the group is a contracted company that provides doctors needed for emergency rooms. I decided to choose my interviewee since he was readily available, and considered one of the best primary care providers we have so far. Primary care provider is a medical doctor and one who gives both the first aid for people with an undiagnosed issues of health. They also continue in providing health care for the varied medical conditions, not limited either by diagnosis or cause. Managed care as they call it today began during the years of 1940s with Maintenance Organizations (HMOs). As the costs for health care rose, employers signed contracts with different companies that offered to manage the health care issues (Minnesota Department of Health, 2006). Managed care in the United States has become common since the early years of 1990s, and up to date it is still the most dominant health insurance. Managed care creates incentives for primary care providers so that they can reduce their services, which has been a case study for researchers in the recent past. Systems of managed health care do not face the challenges cost balancing control with the provision of quality care; hence the care providers forced to tell about their financial incentives to the public (Starfield, 2005). Q; what changes are taking place in the healthcare delivery model? Dr. MacGann: There has been rapid growth during the recent past in managed health care, but the restricted practices have drawn unending criticism from both patients and physicians. The role of managed care has also declined in the recent years, in the constraining of health care services. This is due to the uprising concern about the restrictions. Reforms in the healthcare department currently taking part nationwide are advantageous for significant change. The new model in healthcare will integrate a chain supply of payers, brokers, providers and employers. If managed care can become restrictive, then this could be hugely beneficial towards patient access and also their care. Q: Why should the employers take note? Dr. MacGann: the most fundamental thing is that due to changes in the current industry, compliance with the regulations, shifting concerns and related requirements will be extraordinarily challenging. This challenge makes changes that are regulatory that will continue to be processed, thus encouraging the employers more and more through the years. To this also is that the rising costs in the market are also bringing changes in the options of healthcare. Q: what are healthcare providers doing in order to stay ahead in this competitive market? Dr. MacGann: Those that provide healthcare must be able to think of not competition and also about competition in day to day changing marketplace. Implementations and initiatives implemented that are to be witnessed are driving efficiencies for the betterment of the market places. Most of the entrepreneurs are giving a helping hand in making sure that that offering are available to help maintain the higher efficiency and lower costs for those that provide healthcare, which in the ultimate end will provide a higher value to the employers. Q: What will this program provide to its attendees? Dr. MacGann: The program will try to provide brokers, providers, payers and employers of how the current health marketplace is and also concerning the future. It tries to open up an overview of the delivery marketplace as a whole. Q: What are the new opportunities under healthcare reform? Dr. MacGann: A good example to this would be the creation of new market of insurance for both small employers and individuals. Opportunities for the different providers may include incentive payments for those in primary care and also the funding to expand nursing and physician capacity. These are just some of the potential incentives likely to occur in the healthcare landscape. Q; what are the changes taking place in managed health care? Dr. MacGann: Managed care can be measured as capitate care in the previous studies. It proved that it also includes noncapitated forms like PPOs and also IPAs. Most of the individuals do not know the difference between noncapitated and capitated health care plans. To say the truth about this matter is that there is exceedingly little evidence on how these two financial incentives differ. More to this is that studies that exist as of now examine data that are exceedingly old which can be dated 10 years back (Lohr, 1990). Although managed care and documented to have its success in the achievement of controlling cost, there has been little evidence on the issue whether it affects its decline or not. It has used unique data over the period that used to provide information of the health care providers. This study intended to bridge the gap that has been there in the literature. We try to look at how the managed health care has affected the care providers’ incentives so as to have a reduction in the services to patients. What was intriguing is how the relationship evolved over time and whether there is a difference in the effects of noncapitated and capitated healthcare. Q: What can one describe in physician financial incentives? Dr. MacGann: They try to gauge incentives that affect health care provided. The physicians had to get questions like; to describe the financial incentives in the profession, and also if the incentives reduce their services to patients, expand or favor their services to individual patients. This is so because the study tries to focus whether care providers have incentives that are financial in nature so as to reduce their services. What is noteworthy is that the measures to the financial incentives undertaken by physicians could differ significantly from the real or actual financial incentives. My view to this topic is that I truly agree with Dr. MacGann. Over the years managed health care has changed but also, it has led to a lot of criticism. Its role has also declined in reference to the constraining of health care services. Employers should also be careful in taking note of the changing circumstances and also the rising costs that may bring changes to the health care industry. The changes in the health care industry have affected the health care providers’ incentives, which in return have affected the services offered to patients. These changes are negative since they affect the services offered to patients and thus putting them at a risk. With time, these changes may increase but this time to the betterment of the healthcare industry. The changes evaluated by scholars who try to examine the current changes and how they can be improved (Moscovice, 2003). Conclusion Since the introduction, of managed health care services in the 1990s, and up to date it still continues to be the best form of health care today. It tries to create incentives for the care providers so as to decrease the output. This has forced them to tell of their financial incentives. This interaction has helped me understand a lot of information concerning health care, and also about the care providers or physicians as called and what they face day to day in their duties. I will use this information to relate to my field of interest and also my work in the future. I will also try to come up with strategies that will help improve what managed health care tries to offer (Lohr, 1990). References Lohr, K. N. (1990). Building a Medical Neighborhood for the Medical Home. New England Journal of Medicine. Lohr, K. N. (1990). Medicare: A Strategy for Quality Assurance. Washington, DC: National Academy Press. Minnesota Department of Health, (2006). Minnesota Registered Nurses - Facts and Data Minnesota Office of Rural Health and Primary Care. St. Paul, Minnesota. Moscovice, I. W. (2003). Rural Health Networks: Evolving Organizational Forms and Functions. Rural Health Research Center, University of Minnesota. Minneapolis, Minnesota. Starfield, B. L. ( 2005). Contribution of Primary Care to Health Systems and Health. The Milbank Quarterly. Read More