What are the main roles of the government in the US health services system? Why is it important for healthcare managers and policymakers to understand the intricacies of the healthcare delivery system?

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Week 1 Discussion

 

Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right,” the expanded grading rubric for the forum, and any specific instructions for this topic.

Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.

 Healthcare to US Citizens

Many organizations, departments, and individuals provide healthcare to the US citizens. The complex nature of the US healthcare delivery system has driven much legislation for change over many years. Using the South University Online Library or the Internet, research about the healthcare organizations and their delivery of healthcare services in order to fully understand the magnitude of the US healthcare delivery system. Based on your readings and research, answer the following:

  1. What are the main objectives of a healthcare delivery system?
  2. Name some of the basic functional components of the US healthcare delivery system. What role does each play in the delivery of healthcare?
  3. Who are the major players in the US health services system? What are the positive and negative effects of the often conflicting self-interests of these players?
  4. Why is it that despite public and private health insurance programs, some US citizens are without any coverage?
  5. What are the main roles of the government in the US health services system?
  6. Why is it important for healthcare managers and policymakers to understand the intricacies of the healthcare delivery system?

 

Week 2 Discussion

Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right,” the expanded grading rubric for the forum, and any specific instructions for this topic.

Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.

 

 Healthcare Spending and Services

Healthcare data at a community, county, or region level and state level determine healthcare spending and services allocated for individuals. Using the South University Online Library or the Internet, research about these data as it will help you build a reality of costs of care for the healthcare system and beyond.

Research your own geographic region (town, city, county, or state) for data that is commonly used in health services systems. This includes census data, vital statistics data (birth, deaths, marriages, and divorces), surveillance data, administrative data, and survey research data. Keep in mind that most of this data will come from federal, state, or local offices that are federally mandated, but don’t stop there. You may find data in other surprising places.

Based on your readings and research, answer the following:

  1. Which office contains the health-related data identified above?
  2. How do people go about enrolling for Medicare and Medicaid in your community? Describe the eligibility requirements and costs, if any, for each of these types of subsidized care.
    • Coverage for acute care, including hospitalization
    • Coverage for preventive care
    • Outpatient services
    • Specialty services, such as mental health, rehabilitation, etc.

 

Week 3 Discussion

 

Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right,” the expanded grading rubric for the forum, and any specific instructions for this topic.

Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.

Government Versus Private Funding

Explore the difference between the following:

Medicare, Medicaid, and a private insurance of your choice (such as Major Medical, PPO or HMO):

Respond to the list of questions below for each, supporting your answers with resources appropriate to the topic

  1. Describe how this insurance is paid for? Who pays for it?
  2. Who is eligible to have this insurance? Why?
  3. How does the insurance work? (Co-payments, Deductibles, Premiums, Capitation, etc.?
  4. Give an example of a healthcare service covered under this insurance type? Evaluate how the service is paid for and what is needed for the individual to obtain the service.
  5. Is their any political impact on the financial support of these insurance types?

 

Week 4 Discussion

Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right,” the expanded grading rubric for the forum, and any specific instructions for this topic.

Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area..

Healthcare Quality and Health Promotion and Prevention.

Discuss the role of quality in healthcare organizations. Evaluate the need for quality by answering the following questions:

What is quality in healthcare?

What are some of the ways quality is measured in healthcare?

Who is responsible for quality in healthcare?

Week 5 Discussion

Standard Performance Measures

Standard performance measures are a way of collecting data across similar functions, processes, costs, and providers. Benchmarking against these standards has proven to be useful in healthcare as a tool to measure many facets of quality. Carefully evaluating these measures allows for management to design appropriate programs to assist with healthcare service needs and patients to make decisions about facility and provider services. Best Doctors, Inc. and WebMD are examples of these tools. Your discussions will focus on the use of information from these websites to make healthcare decisions.

Using the South University Online Library or the Internet, research about these measures and how they allow management to design appropriate programs to assist with healthcare service needs.

Based on your readings and research, answer the following:

  • Present a brief overview of the purpose for each of the Best Doctors, Inc. products. How are the “Best Doctors” of each type determined? Click here to visit the official Best Doctors website.

Next, click here to read a case study about Mary Jones.