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Characteristics of the US healthcare system
Healthcare in the USA
Characteristics of the US healthcare system
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Kaiser Permanente’s mission is to provide care assistance to those in need. As a health maintenance organization, Kaiser Permanente provides preventive care such as prenatal care, immunizations, diagnostics, hospital medical and pharmacy services. Also, they take responsibility and provide exceptional training for their future health professionals for better clinical performance and treatment for the patients. The organization is to ensure fair and proper treatment towards their employees for a pleasant working environment in hospital and to provide medical services especially in a growing population in suburban communities, such as Tracy and Stockton in California.
Operational Strategies
Kaiser Permanente operational strategy to maintain
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At Kiser Permanente large and small entities are included in a medical compound, such as medical clinics, hospitals and pharmacies. These facilities need to provide quality service for the Kaiser system to work. By doing this they can better serve and fulfil the expectation of their patients, to keep up and to clarify the demands and needs of their patients, and to insure their patients of excellent care that they will provide.
3. Process and Capacity Design:
For Kaiser Permanente to stay at the same level as other hospitals, they should plan their goals. Their goals should include what kind of resources and technology they are going to use. One way to do this is to have steps that will guide them to how to reduce expenses and increase their business efficiently.
4. Location:
When Kaiser decides to open a new facility, they rely on their marketing and public relations departments. They consider demographics of the area to serve their community in an efficient way. They do survey of surrounding areas to know who leaves around that geographic area. The chosen location should be in the heart of the community to be easy accessible for their members. Accessibility is one of the factors in choosing a location and also the location usually is in a close proximity of a major
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Supply Chain Management:
Kaiser Permanente is undergoing a supply chain transformation. It is the US’s largest none profit health plan, serving 9.5 million members with 38 hospitals and over 17,000 doctors and 48,000 nurses. Kaiser Permanente success depends on effectiveness and efficiency of their supply chain. Kaiser Permanente is successful because there chain management enhances performance and productivity with strategic combination of system, technology and people compare to other health care providers.
8. Inventory:
The medical supplies that is sourced by Kaiser Permanente headquarters is handled by an governmental agency DME (Durable Medical Equipment) department which handles equipment and supplies that are for repeated use and it may also provide crutches, oxygen equipment, wheelchairs or blood testing strips for diabetics. The rest of the supplies are handled locally by hospitals. Clinical engineering department is responsible for handling the medical supply inventory. They can distinguish which equipment needs to be included in the inventory after following guidelines of some government
Membership Services (MSD) at Kaiser Permanente used to be a modest department of sixty staff. However, over the past few years the department has doubled in size, creating minor departmental reorganization. In addition the increase of departmental staffing, several challenges became apparent. The changes included primary job function, as well as the introduction of new network system software which slowed down the processes of other departments. These departments included Claims (who pay the bills for service providers outside of the Kaiser Permanente network), and Patient Business Services (who send invoices to members for services received within Kaiser Permanente). Due to the unforeseen challenges created by the system upgrade, it was decided that MSD would process the calls for both of the affected departments. Unfortunately, this created a catastrophic event of MSD receiving numerous phone calls from upset members—who had received bills a year after the service had been provided. The average Monday call volume had risen from 1,800 to 2,600 calls per day. The average handling time for each phone call had risen as well—from an acceptable standard of 5.6 minutes to an unfavorable 7.2 minutes. The department continued to be kept inundated with these types of calls for the two years that these changes have been effect.
This group is more focused on satisfaction, access and quality of care. Providers, or practitioners, are also key stakeholders within an organization. The term provider can encompasses not only physicians and surgeons, but also nurses, physical and occupational therapists, technicians, and other members of a clinical staff. Providers fall into two categories, primary, which includes hospitals and health departments and secondary, which includes educational institutions and pharmaceutical companies. Providers are focused on the best treatments for patients and are involved in delivering health services and products. The final element of the MCQ model is the employer who by far is the largest paying and purchasing stakeholder of an organization. The employers focus is primarily on their return on investment within an organization. Cost and quality is a focus for employers when choosing health benefits but are mindful that access is just as important. Within the Patient Healthcare model, MCQ explains the interactions between the four elements of employer, patient, provider and payer while the Iron Triangle focuses on the factors of cost, quality, and access. The Patient Healthcare model charges healthcare leaders with the task of balancing satisfaction with the stakeholder (employer, patient, provider, and payer) in relation to cost, quality and access. This may be very difficult since stakeholders may have competing priorities. Changes and variations made in how healthcare organizations operate may have profound effects on how stakeholders perceive the quality, access and cost. For instance, a patient may consider cost to be a top priority when seeking healthcare and at the same time the healthcare organization may consider raising costs and therefore devaluing access and quality. Patients who begin to incur high out-of-pocket costs may begin to perceive a financial
The government controls and regulates healthcare somewhat because healthcare organizations are in a position to take advantage of the elderly and sick so there are regulations that protects them. It seems as though healthcare facilities are being paid less for their services today. Some critical measures for the survival of a healthcare organization are to optimize performance and quality. Finding system-wide efficiencies and cost reduction healthcare will help. In order to get better and keep high quality and performance while still raising reimbursements, it is necessary and important to involve doctors with the ideas and plans for any management strategies.
To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization's own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must modify its network strategies accordingly to remain competitive in the rapidly changing healthcare industry. Coventry Health Care, Inc and its affiliated companies recognize the importance of developing and managing an adequate network of qualified providers to serve the need of customers and enrolled members (Coventry Health Care Intranet, Creasy and Spath, http://cvtynet/ ). "A central goal of managed care is containing the costs of delivering care, but the wide variety of organizations typically lumped together under the umbrella of managed care pursue this goal using combination of numerous strategies that vary from market to market and from organization to organization" (Baker , 2000, p.2).
The competing external stakeholders seek to attract the focal organization’s dependents. These competitors may be direct competitors for patients or they may be competing for skilled personnel. The patients hold the role of seeking care. They demand that they receive quality care in the organization and that the care is consistent. The patients play a role in the organization because the organization needs the patients to run the facility. The organization provides a service that the patients need and demand. The source of influence from external stakeholders comes from control of strategic resources materials, labor and
“KP is the largest non-profit health care delivery system in the United States, and operates in 8 states and the District of Columbia. KP is made up of 3 entities: the Kaiser Foundation Health Plan (KFHP), Kaiser Foundation Hospitals (KFH), and the regional Permanente Medical Groups,” (Selevan, Kindermann, Pines, and Fields (2015). Selevan al et (2015) state that the members of Kaiser Permanente can be compared to other insurance companies in regards to age, race, and employment status, although the members are known to have lower income levels. Additionally, they found that Kaiser Permanente’s model of care focuses on improving the health of patients, promoting population
Competitive advantage matters greatly to those responsible for the management of healthcare institutions. Together with rapidly escalating healthcare costs, increasingly complex medical technologies, and growing regulatory and legal pressures, healthcare organizations face a critical need to improve the quality of care at reduced costs (Cu...
As part of the health care reform, many hospitals have focused their marketing strategies on population health management as part of the transformation to value-based care. Managing population health requires a close relationships with physicians, partnerships with organizations in the community, and expansion into preventive and outpatient care and therefore must be implemented further. Likewise, comprised as key components are investing in technology - to connect with physicians, customers and the community and gather data necessary for improving quality (Takvorian, 2015) and merging with other hospitals and health care systems - consolidation as a strategy to gain capital necessary for health IT investments, outpatient facility construction, physician partnerships and other projects (Johns Hopkins Bloomberg School of Public Health, 2015; Ropak, 2012).
There are several issues concerning the uninsured and underinsured patient population in America. There are many areas of concern the congressional efforts to increase the availability of health insurance, the public image of the insurance industry illustrated by the movie "John Q", the lack of good management tools, and creating health insurance coverage for all low income Americans. Since the number of uninsured Americans has risen to 43 million from 37 million in the flourishing 1990s and could shoot up even more severely if the economy continues to decrease and health care premiums keep increasing (Insurance No Simple Fix, 2001).
Access to health care refers to the ease with which an individual can obtain needed medical services. Many Americans face barriers that make it difficult to obtain basic health care services. These barriers to services include lack of availability, high cost, and lack of insurance coverage. "Limited access to health care impacts people's ability to reach their full potential, negatively affecting their quality of life." (Access to Health Services, 2014) Access to health services encompasses four components that include coverage, services, timeliness, and workforce
As a result of the recovery of the market, Howard County Hospital want to procure a leading role in investing in the community it serves with a rewarding lifestyle, professional development. Product by promoting a culture that diversity within the community and the work place changing standing out and showing who we are as an organization. Furthermore, in order to understand the companies need the organization requirement in uphold the market using the dynamic of the four Ps product, price, place and
...ue to numerous medical errors. With the amount of medical errors that currently do occur which is a current health care issue it cost the health care billions of dollar each year to fix the mistakes that were made.
... and time was spent assessing the internal and external factors that would impact the business. Success would mean longevity and a greater potential for future growth. Failure could mean a possible closure of the business. The Medical Center of Plano has had nearly 40 years of success. The Center has proven itself as a staple in the community and continues to thrive in an industry that is constantly evolving. This success can only be attributed to the design of the controlled (internal factors) and management of items that are uncontrolled (external factors).
Health care has always been an interesting topic all over the world. Voltaire once said, “The art of medicine consists of amusing the patient while nature cures the disease.” It may seem like health care that nothing gets accomplished in different health care systems, but ultimately many trying to cures diseases and improve health care systems.
With regard to the healthcare organization, it is essential to develop strategic plan and a clear vision so that the patient focused care will be at par with the organization process that is conducted on operational and on a daily basis.