Write a 1,250-1,500-word essay about delivery models in health care. Include the following in your essay:
Address the triple aim as it relates to population health management and delivery models.
Discuss current trends in health care delivery models.
Describe how quality and safety impact delivery models in health care.
Include at least three peer-reviewed/academic references in your essay, including the HealthyPeople website.
Prepare this assignment according to the guidelines found in the APA Style Guide
Health Care Delivery Models
Student’s Name
Institutional Affiliations
Health Care Delivery Models
The United States health system operates under a network of clinicians, clinics, hospitals, public and private insurers, and purchasers who interact with one another to ensure that individuals and populations enjoy optimal health. These networks are designed in a manner that guides the provision of care that improves patient and population outcomes while at the same time minimizing hospital costs (Steier & Moxham, 2020). Health systems utilize numerous models of health care delivery as they strive to achieve their goals and objectives. Despite the diverse mix of health care delivery models, it is important to note that nurses serve as the ‘back-borne’ of various models of health care delivery utilized by health systems. Precisely, nurses have a crucial role in providing care that meets the desired safety and quality standards (Columbia School of Nursing, 2022). The application of models in the delivery of health care contributes greatly to the realization of Healthy People 2030 goals and objectives (Office of Disease Prevention and Health Promotion, 2022). The purpose of this assignment is to discuss delivery models in health care by addressing the relationship between Triple Aim and its relationship with health management and delivery models, current trends in health care delivery models, and the impact of quality and safety on delivery models in health care.
The Triple Aim and its Relationship with Health Management and Delivery Models
Today’s nurses should have an adequate understanding of the Triple Aim framework and its relationship with health management and delivery models. The Institute for Healthcare Improvement (IHI) developed the Triple Aim which acts as a framework that guides healthcare systems to optimize performance (Shenoy, 2021). The Triple Aim concept holds that health systems are able to optimize performance when they design their processes to effectively capture three domains namely care, cost, and health. Precisely, health systems should always strive to improve patients’ experiences of the care that they provide to them, reduce per capita cost of health care, and improve population health (Institute for Healthcare Improvement, 2022). Health systems that make these three considerations are able to meet their goals while at the same time meeting patient and population needs.
The Triple Aim is linked with health management in that effective health management encompasses aspects of health, care, and cost which the Triple Aim advocates for. The United States spends approximately 15% of its gross domestic product to sustain its health system which is considered to be the costliest globally (Institute for Healthcare Improvement, 2022). The country’s health system should adopt a new design that incorporates the Triple Aim framework in order to minimize costs. Notably, even those health systems that spend less on health care service delivery than the United States are faced with the challenge of deriving greater value from the resources that they allocate to health care delivery. Additionally, patients with acute and chronic conditions expect to receive that will improve their health and promote satisfaction (Shenoy, 2021; Institute for Healthcare Improvement, 2022). The advantages associated with the Triple Aim framework are the primary influences for its integration by health systems.
The relationship between the Triple Aim framework and health care delivery models is understood from the perspective that health systems select delivery models in order to improve performance in the three domains of the Triple Aim namely care, health, and cost. For instance, in most health care settings that do not adopt the Triple Aim, it is difficult to find an organization that is accountable in the three areas defined in the framework. Therefore, modern health care delivery models such as Accountable Care Organizations (ACOs) and patient-centered medical homes are designed to create a system that can ensure accountability and address the three dimensions highlighted in the Triple Aim. In ACOs, healthcare providers have a joint responsibility to provide quality and safe care that will improve patient experience and enhance satisfaction, improve population health, and minimize costs.
The Triple Aim framework influences health systems to adopt delivery models that encourage a systematic approach to change implementation. Such changes should aim to improve community health determinants such as health care access, quality, health insurance or costs, communicable and non-communicable diseases, and addressing health disparities (Institute for Healthcare Improvement, 2022). Therefore, implementing such reforms will enhance the contribution of various health systems to the realization of Healthy People 2030 objectives. For example, one of the goals of Healthy People 2030 is to improve health care. The specific objective aligned with this goal is to “increase the proportion of children and adolescents who receive care in a medical home (Office of Disease Prevention and Health Promotion, 2022).” Another goal that Healthy People intends to achieve by 2030 is to increase access to comprehensive, high-quality health care services. One of the objectives that will result in the achievement of this goal is to “increase the proportion of people with health insurance (Office of Disease Prevention and Health Promotion, 2022).” These objectives aim to address social determinants of health by seeking to improve population health and increase access to quality and affordable care that will eventually generate positive patient experiences and minimize costs as highlighted in the Triple Aim.
Current Trends in Health Care Delivery Models
Health care delivery models have transformed from the traditional forms to new frameworks that are currently utilized by contemporary health systems. There are a number of historical health care delivery models some of which are rarely used in contemporary healthcare settings. These models include primary nursing, team nursing, and progressive patient care models (Jennings, 2021). In team nursing, members of a team under the supervision of a team leader provide care to patients with different types of illnesses. Primary nursing involves individualized care provided by a registered nurse to a small group of patients admitted to a hospital. Under the progressive patient care model, care coordination is done on the basis of illness severity where a hospital can be divided into the intensive care unit, self-care, units, and intermediate care units (Jennings, 2021). Primary nursing, team nursing, and progressive patient care models are still utilized to a lesser extent today because they are currently integrated with other models of care delivery to help improve patient outcomes and achieve organizational goals. As Prentice et al. (2021) explain, healthcare organizations should understand that there is no “one size fits all” approach when choosing the health care delivery model to use as most health systems utilize hybrid models provided that they will result in the delivery of care that improves patient outcomes and minimize costs.
There has been wide adoption of new health care delivery models in the recent past. These new models are clearly defined in the Patient Protection and Affordable Care Act of 2020 and they emphasize the quality of care, healthcare costs, patient safety, and patient outcomes. (American Nurses Association, n.d.). These models include nurse-managed health clinics, patient-centered medical homes, and accountable care organizations. Accountable Care Organizations (ACOs) is a model of health care delivery where primary healthcare providers/clinicians, specialists, and hospitals have a joint responsibility for providing quality, safe, and cost-effective health care to patients. All members of the network are accountable for their actions towards patients and populations. In medical homes, patients have a central primary care provider who coordinates the care that they receive. Conversely, nurse-managed health clinics are care delivery models whereby clinics that are managed by advanced practice nurses provide comprehensive healthcare service to underserved communities (American Nurses Association, n.d.). These modern health care delivery models are gaining tremendous application in the United States today.
How Quality and Safety Impact Delivery Models in Health Care
Quality and safety have a direct effect on health care delivery models. Precisely, a number of healthcare models require providers to provide high-quality and safe care to be able to obtain reimbursement from insurance companies (American Nurses Association, n.d.). Such care should be able to generate positive patient experiences and enhance satisfaction. In such cases, insurance companies use Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores to determine whether certain health care procedures will be reimbursed or not (Centers for Medicare and Medicaid Services, 2021). For example, ACOs must meet certain quality standards and budgetary targets to be able to receive reimbursements. In this respect, organizations operating under various health care delivery models must maintain high levels of safety and quality to be able to achieve their goals.
Conclusion
There are numerous health care delivery models utilized by today’s healthcare systems. Current models such as ACOs aim to achieve similar objectives as the Triple Aim Framework by ensuring that healthcare organizations provide care that improves patients’ experiences, reduces per capita cost of health care, and improves population health. These goals are also aligned with the Healthy People 2030 goals and objectives. Quality and safety are crucial aspects of health care delivery in the various models utilized by health care systems.
References
American Nurses Association. (n.d.). New care delivery models in health system reform: Opportunities for nurses and their patients. https://www.nursingworld.org/~4af0e8/globalassets/docs/ana/ethics/new-delivery-models—final—haney—6-9-10-1532.pdf
Centers for Medicare & Medicaid Services. (2021). HCAHPS: Patients’ perspectives of care survey. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS
Columbia School of Nursing. (2022). Models of health care delivery. https://www.nursing.columbia.edu/research/research-areas-focus/models-health-care-delivery
Institute for Healthcare Improvement. (2022). The IHI Triple Aim. http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx
Jennings, B. M. (2021). Care models. Rockville (MD): Agency for Healthcare Research and Quality (US. https://www.ncbi.nlm.nih.gov/books/NBK2635/
Prentice, D., Moore, J., & Desai, Y. (2021). Nursing care delivery models and outcomes: A literature review. Nursing Forum, 56(4):971-979. doi: 10.1111/nuf.12640.
Shenoy A. (2021). Patient safety from the perspective of quality management frameworks: a review. Patient Safety in Surgery, 15(1), 12. https://doi.org/10.1186/s13037-021-00286-6
Steier, J., & Moxham, J. (2020). The load and capacity model of healthcare delivery: considerations for the crisis management of the COVID-19 pandemic. Journal of Thoracic Disease, 12(6), 3022–3030. https://doi.org/10.21037/jtd-2020-054
Office of Disease Prevention and Health Promotion (ODPHP). (2022). Healthy People 2030: Building a healthier future for all. https://health.gov/healthypeople