What are the advantages of using the gatekeeper system

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Reference no: EM132574700

Assignment: For these assignments, I need 150 words for each of the assignment and individual references

Unit 1: The U.S. health care system has undergone many changes in its history. Complete the following for this Discussion Board:

1. What do you believe is the greatest achievement that the health care industry has made from both the patient and provider perspectives? Why?

2. Do you believe that there is too much or too little redundancy in our health care delivery system? Where does most of the redundancy occur? Where should we have more redundancy (second opinions)?

Unit 2: Quality of care has always been a concern in the U.S. health care system. Although great strides have been made to improve the quality of care delivered, many critics still believe that the United States has a long way to go before truly delivering uniform quality care.

1. How would you define quality of care from the provider and patient perspectives?

2. Why do you believe that quality can be viewed as a strength and a weakness of the U.S. health care system?

3. Be sure to provide at least 2 reasons for this and provide specific examples for discussion.

4. Identify several difficulties and several benefits of working with licensed independent practitioners to improve quality in a typical hospital. What considerations should managers keep in mind when working with them?

Unit 3: Although preventative services such as routine well-care visits and immunizations have often shown to be beneficial in terms of preventing future, more expensive, health care encounters, not all insurance plans offer reimbursement for such things. In addition, health care policies have only recently begun to recognize the "worth" of funding prevention-related services.

1. Why do you believe that funding preventive health care services has taken so long to become a major component of health plans?

2. What do you think will need to happen to change the prevailing mindset of funding health care services reactively versus proactively from a third-party payer's and a provider's? Why?

Unit 4: In an HMO, the primary care physician acts as the "gatekeeper" to all higher levels of care that the patient may need. In theory, this means that the physician decides what is best for the patient and coordinates his or her care, while at the same times working to control costs and trying to ensure the delivery of care in the most efficient manner possible.

Thinking about this from both a provider's and a payer's perspectives, answer the following questions:

1. What are the advantages and disadvantages of using the gatekeeper system in terms of progressing through the levels of care? Provide an example of each perspective.

2. What are at least 2 advantages and 2 disadvantages for each group? Provide a rationale for your choices.

Unit 5: Although both for-profit and not-for-profit hospitals provide a certain amount of charitable services to the public, there is debate as to which provides a higher level of charitable services to its respective community.

1. Which type of hospital do you believe provides more charitable health care services, and why?

2. In your answer, be sure to provide at least 2 to 3 reasons for your choice using a specific example for each type of organization.

Reference no: EM132574700

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