Assuntos
Definição da Elegibilidade/organização & administração , Medicaid/organização & administração , Medicare/organização & administração , Administração de Caso , Serviços Contratados , Gerenciamento Clínico , Necessidades e Demandas de Serviços de Saúde , Humanos , Modelos Organizacionais , Estados UnidosRESUMO
Banner Health consists of 19 hospitals, 6 long-term care centers and a number of family health clinics, home care programs, and home medical equipment providers in 9 Western and Midwestern states. Banner Health has developed an integrated organization-wide effort called Care Management to simultaneously address quality and safety, reduce patient errors, and measure and report performance, outcomes, and patient satisfaction, while controlling costs through utilization management, care coordination, and performance improvement. Eleven functional areas were identified and more than 36 cross-functional and cross-facility work groups have been created. These work groups use a deliberate process in which knowledge is created, reviewed, synthesized, distributed, taught, and implemented within the system. Key lessons after the first 2 years of this effort are as follows: information sharing and collegial support can be established within newly merged organizations; there must be continued enhancement of both the accuracy and timeliness of data; the ability of health care professionals to understand and use sophisticated statistical tools has increased; a variety of methods should be used to distribute the knowledge products; and the strategy to have functional teams and work groups develop systemwide policies and toolkits but leave implementation to facility employees has worked relatively well.
Assuntos
Sistemas Multi-Institucionais/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/métodos , Comportamento do Consumidor , Eficiência Organizacional , Humanos , Sistemas Multi-Institucionais/normas , Estudos de Casos Organizacionais , Garantia da Qualidade dos Cuidados de Saúde/normas , Estados UnidosRESUMO
Strategic health authorities can learn a lot about strategic vision from Arizona's healthcare cost containment system. The Arizona commissioners have greater power than primary care trusts to push through new and more effective models of community care. Commissioner/provider relations can be fraught as health plans hold out for big discounts.
Assuntos
Planejamento em Saúde Comunitária/organização & administração , Medicaid/organização & administração , Medicare/organização & administração , Atenção Primária à Saúde/organização & administração , Planos Governamentais de Saúde/organização & administração , Arizona , Planejamento em Saúde Comunitária/economia , Controle de Custos , Atenção Primária à Saúde/economia , Planos Governamentais de Saúde/economia , Medicina Estatal/organização & administração , Estados UnidosRESUMO
Managed care organizations face distrust from public policy-makers, the media, and other public stakeholders. To succeed, the managed care industry must work to restore trust in their approach to healthcare delivery. A variety of strategies are presented as ways to mitigate the public's distrust of the managed care industry.
Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Comportamento do Consumidor , Programas de Assistência Gerenciada/organização & administração , Opinião Pública , Confiança , Competência Clínica , Confidencialidade , Humanos , Disseminação de Informação , Programas de Assistência Gerenciada/normas , Objetivos Organizacionais , Relações Públicas , Garantia da Qualidade dos Cuidados de Saúde , Estados UnidosRESUMO
Physicians have lost their trust in managed care plans because of perceived deficits in competency, concern, choice, confidentiality, and communications. To succeed in a market-driven healthcare system, managed care plans must work to restore that trust. A variety of strategies are proposed to address physician concerns related to these 5 domains of trust. Although no single strategy will restore trust, a combination can improve the relationship with these important stakeholders.
Assuntos
Atitude do Pessoal de Saúde , Programas de Assistência Gerenciada/normas , Médicos/psicologia , Confiança , Comunicação , Confidencialidade , Humanos , Autonomia Profissional , Competência Profissional , Estados UnidosRESUMO
Managed care organizations face distrust from patients, many of whom believe the organizations disregard their interests. To succeed in a market-driven healthcare system, managed care plans must work to restore that trust. A variety of strategies are presented to restore patient trust. The next 2 articles of this 3-part series will examine trust-building strategies targeted at physicians and public stakeholders.
