Health Care Delivery System in America

Discuss the interaction of the major components of the U.S. healthcare system on (1) Access to Healthcare (physically and financially), (2) Healthcare Expenditure, and (3) Quality of Care. Answer the questions from the perspective of two internal factors and one external factor:
Internal factors:
Financing:
• Public health insurance programs such as Medicare, Medicaid, State Children’s Health Insurance Program, and TriCare.
• Employer provided health insurance.
• Commercial health insurance.
• Out-of-pocket payments.
Payment:
• Payment mechanisms used by public and private health insurance programs, including but not limited to fee-for-service, capitation, per diem, global budget, pay for performance, shared savings, gain sharing, bundled payments.
Delivery:
• Healthcare delivery institutions such as hospitals, ambulatory care clinics (e.g., community health clinics, and physician offices), pharmacies, and rehabilitation centers.
Resources:
• Healthcare human resources, including all types of healthcare professionals (physicians, nurses, therapists, pharmacists, technicians, and so on) as well as management and administrative personnel.
• Health IT infrastructure.
• Medical equipment.
Regulation:
• Federal and state legislation that regulates all agents in the healthcare system (e.g., Patient Protection and Accountable Care Act [PPACA], Health Insurance Portability and Accountability Act [HIPAA], Consolidated Omnibus Budget Reconciliation Act [COBRA], and Employee Retirement Income Security Act [ERISA]).

External factors:
• Economic development.
• Political climate.
• Population characteristics such as demographic composition and health outcomes.
• Social and cultural values.
• Technological development
Define strategic planning in a healthcare organization.
Identify the barriers an organization will encounter during the process.
Make suggestions on how to overcome these barriers.

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