#1. Historical Developments in Healthcare Delivery
The U.S. healthcare delivery system is often described as a kaleidoscope, puzzle, or patchwork quilt to emphasize that healthcare delivery in this country involves multiple, loosely coordinated components and does not function through one integrated system (Shi & Singh, 2017). The organization of this “system” has a significant impact on the delivery of services. As a healthcare administrator, it is important to understand how the healthcare industry has been shaped over time and the various factors that influence healthcare delivery today.
To prepare for this discussion, the Instructor will assign each student one legislative act from the list below:
• 1935 Social Security Act
• 1946 Hill-Burton Act
• 1965 Social Security Amendments (Medicare/Medicaid)
• 1973 Health Maintenance Organization Act
• 1974 Employee Retirement Income Security Act (ERISA)
• 1986 Emergency Medical Treatment and Active Labor Act (EMTALA)
• 1986 Consolidated Omnibus Budget Reconciliation Act (COBRA)
• 1986 Health Care Quality Improvement Act
• 1989 Ethics in Patient Referrals Act (Stark Law)
• 1990 Patient Self Determination Act
• 1996 Health Insurance Portability and Accountability Act (HIPAA)
• 2005 Patient Safety and Quality Improvement Act
• 2006 Medicare Part D Drug Benefit
• 2008 Genetic Information Nondiscrimination Act
• 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act
• 2010 Patient Protection and Affordable Care Act (PPACA)
• 2013 HIPAA Omnibus Rule
• 2015 Medicare Access and CHIP Reauthorization Act (MACRA)
Research the assigned legislative act using peer-reviewed, government and/or legislative resources.
Post a single 3- or 4-paragraph response that addresses the following prompts:
• Analyze the historical events or circumstances that created a need for the legislative act you have selected
• Describe the legislative act and analyze how it has influenced the U.S. healthcare system
• Evaluate positive and/or negative consequences that arose following implementation of the act you have chosen
• Consider discussing how the legislation impacts your profession/organization
• Discuss any other relevant information you feel necessary about the act.
Support your posting and subsequent responses to your colleagues’ postings by identifying and explaining key points and/or examples presented in the Learning Resources and other government and/or legislative sources.
By the due date cited on the syllabus, respond to at least two of your colleagues’ postings that address legislative acts that differ from yours. Analyze and compare the historical events and consequences you and your colleague describe, explaining how this enhances your understanding of the historical background of healthcare delivery and/or posing questions for further investigation. Be sure that each of your responses is 2 or 3 paragraphs in length. Review the Discussion Rubric for more information about how your work will be evaluated by the Instructor.
Please make sure to adhere to APA 7th edition formatting guidelines.
• Shi, L., & Singh, D. A. (2017). Essentials of the U.S. health care system (4th ed.). Jones and Bartlett Publishers.
#2. Access to Care in the United States
A person’s health may be greatly impacted by his or her access to timely, appropriate care. Davis & Ballreich (2014) write that the United States ranks last out of 11 high-income countries on measures of financial access as well as the availability of healthcare services on nights and weekends. Literature suggests that access to care varies greatly among urban and rural residents. For the 51 million Americans living in rural settings, barriers to access such as lack of providers, decreased access to digital health as a result of poor broadband internet connectivity, insufficient transportation, increased financial burdens, and a scarcity of healthcare services available, contribute to higher rates of chronic disease and poorer outcomes (Douthit, Kiv, Dwolatsky, & Biswas, 2015).
For this discussion board assignment, focus on one access to care barrier in the United States. Imagine your audience is a group of healthcare professionals who are attending a professional conference and coming to hear your presentation on access to care. here.
Use the following to serve as a guide as you work on your presentation:
• Which access-to-care barrier in the U.S. healthcare delivery system are you discussing?
• Analyze recent statistics surrounding the access-to-care barrier you selected. In the past 5-10 years, has access-to-care related to that barrier improved? If it has improved, what are some methods that have been used?
• What can be done to reduce the burden imposed by the barrier you are discussing?
• As an administrator, could you take action at the local level to reduce the burden, how?
Be sure that each of your responses is 2 or 3 paragraphs in length.
• American College of Healthcare Executives (2016). Access to affordable healthcare.
• Kullgren, J. T., McLaughlin, C. G., Mitra, N., & Armstrong, K. (2012). Nonfinancial barriers and access to care for U.S. adults. Health Services Research, 47(1 Pt 2), 462-85.
• Rural Health Info. (2017) Healthcare access in rural communities. https://www.ruralhealthinfo.org/topics/healthcare-access
• Henry J. Kaiser Family Foundation. (2011). Timeline: History of health reform in the U.S.
• Hoke, K., & Hexem, Sarah. (2016). Expanding access to care: Scope of practice laws. Journal of Law Medicine & Ethics, 45, 33-36. https://doi-org.prx-usa.lirn.net/10.1177/1073110517703316
• Obama, B. (2016). United States health care reform progress to date and next steps. JAMA, 316(5), 525–532.
• Orgera, K., & Artiga, S. (2018, August 8). Disparities in health and health care: Five key questions and answers. Henry J. Kaiser Family Foundation.
• U.S. Department of Health & Human Services. (2015). Key features of the Affordable Care Act by year.
• David, K., & Ballreich, J. (2014). Equitable access to care – how the United States ranks internationally. The New England Journal of Medicine, 371, 1567-1570. https://doi.org/10.1056/NEJMp1406707
• Douthit, N., Kiv, S., Dwolatsky, T., & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public Health, 129(6), 611-620. https://doi.org/10.1016/j.puhe.2015.04.001. For more information on Historical Developments in Healthcare Delivery check out: https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/evolution-us-healthcare-system
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