Managing Quality Across Various Health Care Settings
• Complete a page assessment template discussing the continuum of patient care, care quality, and communication between physician practices and hospitals.
As a health care administrator, you will likely spend a great deal of your time focused on operations. You may find yourself working in a hospital, clinic, long-term care facility, hospice, urgent care center, home health agency or a number of other types of organizations. Regardless of the type of organization, many of the operational responsibilities are the same.
Health care financing has become quite complex. Because most health care organizations are reimbursed primarily from a third party (insurance company), health care administrators must manage the communication between the patient, the insurance company, and the organization. Consumer-directed health plans (CDHPs) have increased in popularity as a way to reduce insurance premiums; however, the patient has a larger financial responsibility for services compared to managed care plans. This concept is known as cost sharing (Niles, 2021). It is very important to understand the payer mix of your organization, so you understand where and how revenue is coming in.
Information technology is another huge area of focus right now for health care administrators. The health care industry has lagged behind other industries in the area of information technology. The U.S. health care system has seen a large increase in the number of electronic medical records implemented across health care organizations (Niles, 2021). In addition, other technologies such as telehealth, electronic data warehouses (EDWs), and computerized physician order entry (CPOE) are quickly expanding and improving the delivery of health care.
Niles, N. J. (2021). Basics of the U.S. health care system (4th ed.). Jones & Bartlett Learning.
For this assessment, imagine you have accepted an administrator position at a physicians practice. One of your first tasks is to gather your team to introduce yourself and discuss operational priorities for the practice at a lunch-and-learn.
Using course resources along with a minimum of three peer-reviewed articles based on your own research, complete the linked assessment template to address the following:
• Describe where the physician practice and the hospital fall on the continuum of patient care.
• Analyze how providers at each location try to return their patients to their highest level of functioning.
• Explain how a physician practice communicates with the hospital to foster high-quality, efficient, and effective patient care.
• Analyze three peer-reviewed articles that each discuss one of the topics above.
o Description or summary presents the what of the article, but analysis will pursue the question of so what?
o Why do these ideas matter and/or how are these ideas connected?
o What are the potential gaps or questions that remain?