Healthcare Management Presentation

8/18/2019 Healthcare Management Presentation

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Management

Managed Care

Organizations

Group 2HSC100


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History of Healthcare

Management• 1929- r! "ustin #ord $im%all at &aylor Hospital in 'e(as esta%lishes 'he &aylor

)lan* a prepaid hospitalization plan that +rst uses the &lue Cross logo

• 19,- Henry " $aiser recruits r! Gar+eld to esta%lish prepaid clinic and hospitalcare for his Grand Coulee am pro.ect in /ashington

• 19,9- &lue Shield program adopted for participating prepaid physician plans

• 19 -Group Health Cooperatie of )uget Sound esta%lished in Seattle* /3

• )ermanente Health )lans opens to the pu%lic in California* in addition to sering$aiser employees

• 194- Health 5nsurance )lan 6H5)7 of Greater 8 esta%lished to sere 8 cityemployees

• 192- )ermanente Health )lans changes name to $aiser* :hile medical groupretains )ermanente name! $aiser mem%ership at 20*000

• 194,- HMO 3ct of 194, signed into la: %y )resident 8i(on* using federal fundsand policy to promote HMOs

• 192- California legislation enacted allo:ing selectie contracting for Medicaidand priate insurance* paing the :ay for other states to enact similar la:sfacilitating )referred )roider Organizations 6))Os7

• 1990- 8ational total HMO enrollment reaches ,,!, million

8ational ))O enrollment surpasses HMO enrollment :ith ,!1 million mem%ers

8C;3 esta%lished

• 199s leel

• 200,- Medicare Modernization 3ct esta%lishes )art drug %enerenames Medicare?Choice program to Medicare 3dantage an

rates to Medic

• 200- 8ational total HMO enrollment is


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History of :ithin the School o

3llied Health• r! e:is has %een a faculty mem%er in the Health Care Management ii

fourteen years! uring this time she has sered as 5nterim iision irectoseparate occasions* in 2001* and for the period 200< D 200!

• 'he primary mission of the iision of Health Care Management at #loridaEniersity is to proide high Auality education in the theoretical and technaspects of health serices administration to aspiring and practicing health

managers! 'he undergraduate curriculum is designed to deelop the Bno:attitude* and sBills reAuired for entry-leel managerial positions in arious 'hese settings include hospitals* am%ulatory care facilities* :ellness centemedical group practices* goernment agencies* insurance corporations* mehealth agencies* managed care organizations* hospice agencies and long-tefacilities


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)urpose of the )rofession

• /hat do professionals in the +eld actually doF

• 'hey are in charge of Beeping medical practices running smoothly

• 'hey do not :orB :ith the patients liBe other health specialists* %uinstead focus on the %usiness aspects of operating a medical o@ice

• esponsi%ilities include Hiring sta@* ordering supplies* oerseein

mem%ers* insurance* and maBing sure there is a %udget!

• How do they practice the profession?

• They obtain a job either in a hospital, physician office, or nursing homes and fulfill

listed above.


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Iducational eAuirements a

)rograms• 3 2!0 G)3 or higher is reAuired for the &SHC 6#3ME7

• 3n associates degree in a +eld releant to health caremanagement is sometimes accepted!

• 3 %achelors degree is often recommended rather than

associateJs degree!• Some employers today may een reAuire a masters de

• 'here are


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3ctiities of the )rofessiona

3ssociation'he professional association is inoled in

• Computer programing

• #inancial systems

•

Clinical actiities• Clinical research


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/orB Settings

• Hospitals and Medical Centers

• 8ursing Homes

• 3m%ulatory Care Centers

• Outpatient health facilities

•

Medical Supply Companies• Health 5nsurance Companies

• Managed Care Organizations

• Community-%ased eha%ilitationCenters

• Home Health 3gencies

• Health Care )rofessional 3ssociations

• 3dult ay Care Centers

• Medical Group )ractices

• Mental Health Centers

• Community Health Centers

• rug 'reatment #acilities

• Health Care Consulting #irms

• Goernment Health 3gencies


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8um%er of )ractitioners

• 3ccording to the &ureau of a%or Statistics* in 2012:ere ,1*00 Healthcare Management .o%s in the EStates!


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'ypes of actiities that professionals :ithin thisprofessional association engage inF

• Managed care organization participate in programs as ones that e(pand manage care to traditionally e(epopulations* and a %oarder set of serices liBe long-tcare and %ehaioral health!

• 'hey contract :ith risB-%ased managed care orgs anreporting a primary care case management program


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'ypes of actiities that students a@iliated :ith thprofessional association engage in

• Shado:ing professionals and or interning in localhospitals or clinics

• 'here students :ill demonstrate appropriate %ehaiareas of health care ethics* :orB ethics* maturity* an

%usiness etiAuette!


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Current issues :ithin the +e

• Inhancing patient e(perience through personalizatihealth serices

• 'riage in times of drug shortage

• acial and health disparities

• Gender disparities


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Ma.or Contri%utions of the #i

• Health care management allo:s opportunities to maBe contri%utionhealth care settings!

• One idea in health care management can %e used in a hospital* nurshome* doctorJs o@ice* or clinic!

• 'he idea of using a checBlist or no: electronic records :as an idea

a@ected all aspects of the health care management settings!• /ith health care reform in place* the sBills and Bno:ledge of health

management is needed to ensure that patientJs needs are met in ee

• Most of the decisions made %y goernment entities* such as CMS 6cfor Medicare and Medicaid serices7* are health care management %


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escription of an actiity of this professional g:ith a particular clientKpatient population

• 5n managed care organizations* health care managethe ones :ho partaBe in actiities such as orderingsupplies needed for the center* %udgeting funds on torganization* and hiring sta@ mem%ers

• 'hey are in charge of dealing :ith insurance in mancare organizations :hich can include either HMOJs ))OJs!

Healthcare Management Presentation

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