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Health Systems - Coggle Diagram
Health Systems
What is the structure of a typical hospital
Physicians and Hospital
hospital grands admitting privileges and MD admits some patients
Outpatient services
emergency room
outpatient surgery
diagnostic testing
inpatient services(overnights)
surgery
labor and delivery
intensive care
med/surg units
clinical support services
non-clinical support services
Changes in insurance
BEFORE
Medicare had DRGs payment system
medicare estimates costs of each type of procedure
gov pays hospital 90% of estimated cost- hospitals loose money
payment stays the same no matter staffing or services required
AFTER
Value Based Reimbursement
pay for performance
bundled payments- MD and hospital split payments
Accountable care organizations
insurers share cost sharing with health systems
What is an ACO?
network of doctors and hospitals who coordinate a patients care to remove unncessary spendinng
How are they paid?
paid bonus for efficient care
How does it work?
Medicare forcasts costs
if quality and cost targets are met ; ACO recieves 50% of the savings
Is it efficient?
eh- reduced medicare spending by 4.9%
typs of hospitals
nnon-profit
spend 36B in uncompensated care
for profit dedicate more to charitty than nnon profitt
profit
What have been the trends in medical spending?
more percentage of spending happening outside of the traditional hospital