Chapter 14: Future of Health Services

Forces of Change

social, economic, political, technological, ecological

Healthcare Reform Options

single-payer vs. incremental changes

What type of healthcare reform includes a national healthcare program in which the financing & insurance are taken over by the federal government (socialized)?

Single-Payer Changes

Which type of healthcare reform restructures enrollment criteria to be a true safety net and where tax subsidies reconstruct to give families a choice to enrolll

Incremental Changes

Value-Based Care

ACOs, PCHMs, payment tied to quality

What integrated group of providers are willing/able to take responsibility for improving overall health status, care effiency, and satisfaction with care for defined population?

Accountable Care Organization (ACO)

PCMH

provides the framework of primary care practice for the future, may involve community activism and changes beyond medical practice

Patient-Centered Care

delivery of healthcare that respects & responds to patients’ wants/needs/preferences so they can make choices about their care that best fit their individual circumstances

What is it called when a patient’s skills, confidence, mobility, and motivation become engeaged with their own healthcare

Patient Activation

Workforce Challenges

nursing shortages, primary care demand

Why is nursing a workforce challenge?

outdated state & federal laws/ institutional policies create barriers for nurses utilizing full scope; nurses should obtain higher levels of education to adequately address the needs of a patient population with adequate needs

Primary-Care

number of medical graduates entering field as PCPs have ben declining; health need to redesign systems to make PCP PCP face-to face clinical time

Long-Term Care Issues

cost, workforce, technology

Cost

significant demograhic & economic trends will make LTC less affordable and increase dependency on Medicaid

Workforce

constant need for institutional nursing/assisted living care staff + PCP demand

Technology

new tech expected to to replace some human functions or improve efficiency/productivity

New Frontiers

telehealth, precision medicine, gene therapy