MASON HSCI 678 - Management of the US Health Services System

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Management of the US Health Services SystemManagement in Roemer ModelPlanningComprehensive Health Planning ActHealth Planning & Resources Development Act 1974Failure of Health Planning ActAdministrationLegislationRegulationSpecific RegulationsSummaryIntro to US Health SystemManagement of the US Health Services SystemChapter 5 Dr. Tracey Lynn KoehlmoosAdjunct ProfessorManagement in Roemer Model•Planning•Administration•Legislation•Regulation•We will discuss each of these issues within the PUBLIC sectorPlanning•In US NO central planning authority•Projects, programs, organizations: PLANS•Historical Planning Initiatives–Comprehensive Health Planning Act 1966–National Health Planning and Resource Development Act 1974Comprehensive Health Planning Act•Designed to involve community and consumers in health service planning•Part of Great Society era•Federal dictate of State-wide programs CHP-A, CHP-b•Failure–No assurance of resources to meet needs–Consumers & Providers: unequal knowledge unwillingness to compromise–Failed to control expansion of the systemHealth Planning & Resources Development Act 1974•Grew out of concern for skyrocketing costs•Established three levels of state orgs:–Statewide Health Coordinating Council–State Health Planning and Development Agency–Health Systems Agencies•Certificates of Need (CON): largest long-term contribution!–All projects/changes costing >150K–No CON = No Medicare fundingFailure of Health Planning Act•Repealed in 1986•CON: Providers resented the Review process•Frustration led to litigation•No new national health planning programAdministration•“Decision making” capacity•Dimensions include–Organization of programs–Staffing and budgeting–Supervision toward achieving goals–Procurement of supplies and material–Coordination of activites–Evaluation of effortsLegislation•Six types that govern healthcare system:–Authorizing legislation: enables programs–Facilitates Resource Production: either people or facilities–Social financing of health services–Quality Surveillance–Prohibition of injurious behavior–Protection of individual rightsRegulation•Gov’t regulation in a free-market economy•Regulation required to implement legislation: Code of Federal Regulations•There is a lag-time between enactment of legislation and the establishment of regulations and implementation of programsSpecific Regulations•Licensure:–National Standards in State-wide procedures–Physicians, Nurses, Hospitals–Controls Entry into market place•Certification: More often programs or specialties•Accreditation: usually voluntary–JCAHO, NCQA–CEPHSummary•Roemer Model: four parts to Management–Planning–Regulation–Legislation–Administration•No central planning authority exists in US•Regulation cause of most


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MASON HSCI 678 - Management of the US Health Services System

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