The U.S. Health care system (USHCS) seems to be the world’s top health care system but it is now overtaxed and fails to meet the expectations and needs of the patients. The United States invests a lot than rest of the countries but it is found that US health care qualities are disappointing. Organization of Economic Co-operation and Development (OECD) reveals that among wealthy nations, the US has the lowest expectancy of life and the rates of suicide are also higher. The US health care system is failing to get the expected outcomes as per the investment. So it’s better to rethink the health care in the United States and how health care can be restructured and operated. The new health care is named USHCS 2.0 and is the triple-aimed framework that will address the elemental structural and functional shortcomings of the present U.S. health care.
Mission of USHCS 2.0 – The new health care system in the United States USHCS 2.0 aims at enhancing the health and well-being of all its citizens. Through the triple aim approach, it strives to provide universal coverage with necessary benefits and decrease administrative costs. It will promote healthcare interconnection by forming care groups that have signed a contract with the government to enhance the provision of healthcare for a specified patient population. There is currently no organizational or system-level infrastructure in place to allow for more rapid transmission of data, patients, and vital resources across hospitals in the present healthcare system.
The key values of USHCS 2.0 are:
i. It will be fully dedicated to patient care.
ii. It will use innovative and creative approaches.
iii. It will be focused to encourage healthy living and making non-communicable disease prevention, early identification, and management easier.
iv. t will identify and address community health risks and the environment.
v. It will include various treatment and prevention initiatives into public and commercial insurance policies, as well as encourage health-system efficiencies such as the decrease of false claims and inefficient funding mechanisms.
The main objective of the proposed USHCS is to improve people’s health and strive for the best possible health for the entire population, taking into account both morbidity and mortality.
There will be three major components of the proposed USHCS 2.0. It will include the following components.
1) The patient – It will be a patient-centered healthcare system in which the needs and requirements of the patient will be considered in priority. The clinicians will consider the patients and its family as a member of the healthcare and their values and wishes will be incorporated into the care process. The patient, as well as his or her physician or family member, must have access to instructional, judgment, knowledge, and interactive tools that can assist them in integrating crucial information from many sources.
2) Providers – Providers will not be only doctors, nurses, or caregivers but anyone who will provide health facilities to the people (Bleß, & Kip, (2018)). They may be small organizations, NGOs, or any private health agencies. The main aim of these providers will be effective communication and coordination with the patient.
3) Insurers – The proposed USHCS 2.0 will ensure that the majority of people should have insurance. In the US, many people suffer from chronic illness, obesity, and many other life-threatening diseases that risk their lives. An organization will be assigned to make sure most people get the benefits of insurance. Even the people who are uninsured will get the facilities from the government agency developed by the proposed health care system.
Advantages of the proposed USHCS 2.0 over the current healthcare system
In the current health care system, there is not any central agency of government to control the system. But in the proposed system there will be an agency to control and coordinate the health care system. Also in the current healthcare system, the individuals who are covered with insurance can only access the health care services when needed but in the proposed health care system any patient who needs health services can access them with the help provided by the government agency.
While planning for the management project plan, it is necessary to identify and engage with the key stakeholders. The leaders of the hospital must start by identifying which particular department will get affected by the plan. The leaders of the hospital should also make sure that all these departments are well familiar and represented within the major stakeholder groups. The most important stakeholders in the healthcare system are professionals, patients, and policymakers. In the healthcare system, stakeholders play a crucial role in directing the industry of healthcare. the support of stakeholders is very important as they provide funding to the healthcare industry. They also provide support and solutions to the overall Health Care Organisation. The stakeholders in the healthcare industry can have a greater influence on the opinion and viewpoints of the public in terms of the health care system (Xyrichis, et al., 2021). The four major stakeholders have been discussed below –
1. Policymakers – policymakers in the healthcare industry are the ones who introduced the framework within which the healthcare industry is given to the people of the country. The policymakers collect the required data and information from the patients, the providers, and the payors in order to make population-level metrics (Rawlinson, et al., 2022). This matrix will be helpful such that it will provide information on health and the health economic policies. Following written critical questions are asked in the policies –
– the care is received by whom?
– the care and services provided are of what kind?
– what are the manner in which services are being paid?
– whether the services are delivered properly or not?
– whether the services are easy to access?
– what improvements and concerns regarding healthcare are needed to be implemented in the management plan for the next time?
2. Patients – Predominantly, patients are the voters, citizens and also sometimes they are the tax-payers. Policymakers have depository jobs for these patients or populations. The policy framework of a particular country is organized in order to benefit the patients. These patients then receive care and services from donors and contributors (Gottlieb, et al., 2019). Such patients are also the heir customers of the payors. Patients can also have easy access to data and information regarding their health care services through a computer system or mobile phones.
3. Providers – Providers are the ones who operate the delivery of care within the framework of policy. Providers give healthcare services to the patients. They also maintain the information of the patient’s health (Garrick, et al., 2019). The providers are the ones who have coordinated patient healthcare with several other providers. These other providers can be the team members of the health care system. Most of the providers are independent businesses and they should also manage their own finances, functions, and operations of the health care system.
4. Payors – Payors are the ones who operate the financial aspects and elements of the policy substructures (Singh, et al., 2020). Payors sign up the patients in the form of beneficiaries. Payors obtain and acquire the healthcare facilities from the stakeholders on the patient’s behalf (beneficiaries). It should also be ensure that the financial supportability and effectiveness of the healthcare program. Payors report to the policymakers.
Each and every stakeholder plays a different role while relating with the other stakeholder. Every stakeholder has a different point of opinion on the health care system.
In the current system of the US health care, funding is generally provided by the government programs like Medicare and Medicaid and by private insurance companies (Carè, R., & Ferraro, G. (2019)). In the proposed health care system funds will be collected through the government by increasing more programs like Medicare. Currently, the federal government has very little role in supplying providers. Most funds are coming from the public and private sectors. Changes will be done in previous programs like the Affordable Care Act and by taking cost control initiatives. New and reliable funding sources will be provided to support public health (Halminen, et al., 2019). More programs will be launched for raising funds for the proposed health care system USHCS 2.0.
The challenging problems that can be faced are –
The planning of risk mitigation is a process of developing all the available actions and options in order to enhance the opportunities and to reduce the threats that are required to project the main objectives (Stoicea, et al., 2019). Implementation of risk mitigation is the method of applying the actions of risk mitigation. The monitoring of a risk mitigation process involves the tracking of identified risks, identifying the newly occurred risks and assessing the effectiveness of the risk process throughout the whole project. The risk tracking apparatus is utilised in order to record the outcomes of risk ranking analysis which gives input to the risk mitigation and the risk impact assessment. The steps for risk mitigation include the making of a mitigation plan that is designed in order to eliminate, manage the Agenda to reduce the risk to a sustainable level. When the plan is established, it has been continuously overlooked and monitored to check its efforts and also to include several steps and actions when required (Huot, et al., 2019). The options for handling the risk mitigation are based on the evaluated mixture of the probability of arising and the seriousness of the identified risk. The options for handling the risk mitigation have the following things:-
i. Accept – to concede the actuality of a particular identified risk and to make an intentional decision to acquire it without involving in special actions to control it. It is required to have the approval of the program leader or the project leader.
ii. Avoid – adjusting the constants and requirements of the program in order to remove and lessen the risk. Such type of adjusting can be served by having changes in the scheduling, funding and technical necessities (Gordon, & Catalini, (2018)).
iii. Control – To implement those actions which will minimize the likelihood and impact of the overall identified risk.
iv. Transfer – To redistribute the institutional responsibility, liability, answerability to the stakeholder who is ready to accept the risk.
v. Monitor – To monitor the conditions of surrounding for changes that will affect the environment and the overall impact of the risk.
All these options need a proper development of a plan that must be implemented and monitored with full potential (Parse, (2019)). Basic ways of reducing the risk and mitigation include the following –
i. Exceptional examination and testing of censorious structure goods.
ii. To step up and escalate the tactical and administration feedback of the engineering method.
iii. To consider the mitigating censorious design necessities.
iv. To start the development of parallel fallback.
v. To test the reviews and feedback.
The transition can or cannot need to have transferred to a new clinic. It includes appropriate planning, transferring and integrating into adult or patient-centered healthcare (Sun, et al., 2021). The aims and objectives to have a Health Care transition are:-
To enhance and improve the capability of youngsters with or without any special Health Care necessities in order to manage their own healthcare and to effectively utilize the health care services.
To make sure that a well-organized process in the healthcare practices must be implemented in order to facilitate the preparation of the transition process of the adult patient-centered health care.
The six core elements of Health Care transition determine the basic component of a well-structured transition process. It also involves a customizable sample apparatus for each and every core element (Sousa, et al., 2020). These six core elements of healthcare transition are modified into the forms of practices that are facilitated to the health care transition. These elements are then represented in the three different packages.
1. Policy or guide – this element of Health Care transition includes the policy or guidelines that must be developed and discussed. It also shares the transition process within the patient and healthcare executives.
2. Tracking and monitoring – this tracking and monitoring element includes the track of overall progress in the form of a flow sheet registry.
3. Readiness – this element helps assess self-care skills. It also provides an opportunity to offer education regarding the identified requirements.
4. Planning – this element includes developing an HCT plan by having an appropriate medical summary.
5. Transfer of the care – this element of transition includes the transfer of health care which is child focused into health care which is adult focused. It also includes the practices that are involved in adult-centered healthcare.
6. Completion of the transition – this element talks about the confirmation of the completion of transfer process. It also brings out the consumer’s feedback and reviews.
Transition management is referred to the ongoing support which is given to the patient and to their families over the passage of time as they steer relationships and care among more than the single caregiver (Gordon, W. J., & Catalini, C. (2018)). To improve the transition of care, the best practices that are implemented in the management plan are:- to give appropriate management of medication, to conduct the proper planning of transition, to give education to the patient and family, to overlook and monitor the information transfer, to ensure that proper follow up care has been implemented, to facilitate an active engagement of health care provider, to reveal and indicate the shared accountability within the healthcare organization and providers.
Timeliness is very important in health care system. Right care at the right time is helpful in reducing mortality rates. Time-based management necessitates the development of innovative and exciting tools and abilities, such as prioritization, well-designed planning, work delegation, proper coordination, and the formation of healthcare teams with extra individuals and personnel management (Yin, Ngiam, & Teo, (2020)). In the proposed healthcare system telemedicine services will be offered. It will help in quick answering of the patient’s queries and will provide immediate assistance. By implementing telehealth services not only timeliness is improved but also the health outcomes. Now a day’s electronic scheduling is preferred by younger patients so it will be considered to get a positive impact on the patient health outcomes.
References
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Bogoviz, A. V., Elykomov, V. A., Osipov, V. S., Kelina, K. G., & Kripakova, L. A. (2019). Barriers and perspectives of formation of the e-healthcare system in modern Russia. In Ubiquitous Computing and the Internet of Things: Prerequisites for the Development of ICT (pp. 917-923). Springer, Cham. 10.1007/978-3-030-13397-9_94
Carè, R., & Ferraro, G. (2019). Funding innovative healthcare programs through Social Impact Bonds: Issues and challenges. https://hdl.handle.net/11584/263556
Garrick, R., Sullivan, J. J., Doran, M., & Keenan, J. (2019). The Role of the Hospital in the Healthcare System. In The Modern Hospital (pp. 47-60). Springer, Cham. DOI: 10.1007/978-3-030-01394-3_6
Gordon, W. J., & Catalini, C. (2018). Blockchain technology for healthcare: facilitating the transition to patient-driven interoperability. Computational and structural biotechnology journal, 16, 224-230. https://doi.org/10.1016/j.csbj.2018.06.003
Gottlieb, L., Fichtenberg, C., Alderwick, H., & Adler, N. (2019). Social determinants of health: what’s a healthcare system to do?. Journal of Healthcare Management, 64(4), 243-257. doi: 10.1097/JHM-D-18-00160
Huot, S., Ho, H., Ko, A., Lam, S., Tactay, P., MacLachlan, J., &Raanaas, R. K. (2019). Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals. International Journal of Circumpolar Health, 78(1), 1571385. https://doi.org/10.1080/22423982.2019.1571385
Parse, R. R. (2019). Healthcare Venues in Transition: A Paradigm Shift?. Nursing Science Quarterly, 32(3), 169-170. https://doi.org/10.1177/0894318419826313
Rawlinson, C., Lesage, S., Gilles, I., &Peytremann?Bridevaux, I. (2022). Healthcare stakeholders’ perspective on barriers to integrated care in Switzerland: Results from the open?ended question of a nationwide survey. Journal of Evaluation in Clinical Practice, 28(1), 129-134. https://doi.org/10.1111/jep.13605
Singh, R. P., Hom, G. L., Abramoff, M. D., Campbell, J. P., & Chiang, M. F. (2020). Current challenges and barriers to real-world artificial intelligence adoption for the healthcare system, provider, and the patient. Translational Vision Science & Technology, 9(2), 45-45.https://doi.org/10.1167/tvst.9.2.45
Sousa, M. J., Dal Mas, F., Garcia-Perez, A., &Cobianchi, L. (2020). Knowledge in transition in healthcare. European Journal of Investigation in Health, Psychology and Education, 10(3), 733-748.10.3390/ejihpe10030054
Stoicea, N., Costa, A., Periel, L., Uribe, A., Weaver, T., & Bergese, S. D. (2019). Current perspectives on the opioid crisis in the US healthcare system: a comprehensive literature review. Medicine, 98(20).10.1097/MD.0000000000015425
Sun, E. C., Mariano, E. R., Narouze, S., Gabriel, R. A., Elsharkawy, H., Gulur, P., … & Clark, J. D. (2021). Making a business plan for starting a transitional pain service within the US healthcare system. Regional Anesthesia & Pain Medicine, 46(8), 727-731. https://doi.org/10.1093/jamia/ocz005
Xyrichis, A., Iliopoulou, K., Mackintosh, N. J., Bench, S., Terblanche, M., Philippou, J., & Sandall, J. (2021). Healthcare stakeholders’ perceptions and experiences of factors affecting the implementation of critical care telemedicine (CCT): qualitative evidence synthesis. Cochrane Database of Systematic Reviews, (2). https://doi.org/10.1002/14651858.CD012876.pub2
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