Include the following in your assessment:
Select two or three health care delivery systems to examine.
Provide a description and relevant details of the selected delivery systems.
Summarize the mission or philosophy statement for each of the health care delivery systems you selected.
Formulate your own mission or philosophy statement, with rationale as to why you chose these elements to include.
"To cultivate health equity and human flourishing by delivering autonomously coordinated, culturally-informed care that places prevention and lifelong wellness above episodic treatment."
"Cultivate health equity and human flourishing": This is the ultimate ethical and societal goal. Health equity acknowledges that healthcare access must be fair, addressing social determinants of health. Human flourishing (Eudaimonia) elevates the mission beyond mere absence of disease to promoting an individual's highest potential in life, aligning with the holistic nature of allied health care.
"Delivering autonomously coordinated, culturally-informed care": This addresses structural and quality issues.
Autonomously Coordinated: This blends the efficiency of the ACO model with the professionalism of the PPO. It implies providers have the necessary authority and integrated technology (EHRs) to coordinate care without unnecessary bureaucratic gatekeeping.
Culturally-Informed: This ensures sensitivity and respect, recognizing that effective care must align with the patient's language, beliefs, and family structures, preventing alienation and improving adherence.
"Places prevention and lifelong wellness above episodic treatment": This is the financial and operational philosophy. It directly rejects the FFS model by emphasizing high-value, proactive care (like physical therapy and nutrition counseling) intended to prevent expensive hospitalizations, thereby driving down overall costs in the long run.
| Feature | Description and Relevant Details | Mission/Philosophy |
| Description | A type of managed care system where members pay a fixed premium and receive care from providers within the HMO's network. The system uses a Primary Care Physician (PCP) as a gatekeeper; referrals are required to see specialists, and out-of-network care is rarely covered (except emergencies). | Philosophy: To provide integrated, cost-efficient care primarily through preventative services and utilization control, emphasizing wellness and keeping costs low by maintaining a closed network. |
| Details | Characterized by the lowest monthly premiums and deductibles but the highest restrictions on patient choice. Providers often receive a fixed monthly payment per patient (capitation). |
| Feature | Description and Relevant Details | Mission/Philosophy |
| Description | A network of providers that contract with an insurer to deliver care at a discounted rate. PPOs offer greater flexibility than HMOs; patients do not need a PCP referral to see specialists and can seek care outside the network but must pay a higher percentage of the cost (co-insurance or co-pays). | Philosophy: To balance patient choice and provider autonomy with cost savings achieved through negotiated service rates. The focus is on offering broad access while leveraging volume discounts. |
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