Question

1.  

Discuss the Principles of Management Framework: its components, application, and utility for understanding the US healthcare system.

Answer 1

Key components of Healthcare management system:

According to WHO, the key components are

* Improving the health status of the individual, families and the communities.

* Defending the population against life or health threatening factors.

* Protecting the people against the financial consequences of ill health.

* Providing equitable access to people-centred care.

The Other components include

- Universal coverage.

- inclusive leadership.

- health in all policies.

- a flexible and innovative value based payment system.

- a culture of Care Management with organisationwide buy-in.

- effective teams in which care managers commingle with Healthcare providers.

- customised care that identifies patient needs and removes the barriers in care.

- trusting relationships from top to down.

Application of components:

1. Innovation to develop the evidence base for action.

2. Technical package of Limited number of high priority, evidence based interventions get together will have a great impact.

3. Effective performance management special through rigorous, real time monitoring, evaluation and program improvement.

4. Partnerships and coalitions with public and private sector organisations.

5. Communication of accurate and timely information two Healthcare community, decision makers and the public to effect behaviour change and engage civil society.

6. Political commitment to obtain resources and support for effective actions.

Utility for understanding the US Healthcare management

Understanding of Healthcare system is essential

* to prevent and avoid Healthcare fraud.

* To know about the basics of Child Health Insurance program (CHIP), what it covers, costs​ and if the child is qualified or not.

* provides information on Complementary Alternative Medicines (CAM), regarding making decisions, selecting provider and financial issues.

* to know about Health Insurance Information.

* in explaining the health insurance market places, the different coverage and plans options, affordability and how to enroll.

* To gain knowledge about public and private health coverage options.

* to get tips about how to request medical records.

* help to get smart about insurance.

* guide in selecting health plan.

* to prevent medical identity theft.

* to statistical data of health.

* helps to understand palliative care.

* guides to identify the eligibility for Insurance.

* Serving as a consumer guide in health sector.

* in understanding medical research and tests.

* helps to know the predetermined set of fees made by health plans.

* knowing about health care provider network.

* helps the Healthcare provider in communicating family, friends and relatives.

* explains regulation about expanding dependant coverage for adult children upto the age of 26.

* Getting information on where to obtain birth, death, marriage and divorce records.