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Health Share of Oregon: A Community-Oriented Approach to Accountable Care (Case Study Sample)


Case Study – Health Share of Oregon: A Community-Oriented Approach to Accountable Care
for Medicaid Beneficiaries


Case Study- Health Share of Oregon
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Case Study- Health Share of Oregon
The aspect of evaluating the feasibility of healthcare policies tends to assume a multi-disciplinary approach (Klein et al., 2014). In a way that the interaction between represented interests, institutions as well as the ideas presents in the policies are critically assessed. Policy analysis is vital both retrospectively and prospectively. In both cases, past mistakes feature with great interest in planning for future implementations. In most cases, healthcare analysis is aimed are correcting the perceived errors but at the same time availing possible measures that can be deployed to avoid the mistakes in future. This paper explores a speculative framework assumed by Health Share of Oregon in facilitating adequate health care for Medicaid beneficiaries (Marcoux et al., 2012).
What are Accountable Care Organizations (ACOs)?
Ideally, Accountable Care Organizations (ACOs) are firms that are jointly held responsible for attaining deliberate quality in the healthcare sector (Tu et al., 2016). Initially put in place by policy experts as well as researchers who were interested in a substantial reduction of the healthcare cost. It can be noted that the whole idea is patient-centered. In the process of improving the quality of care; the rate of spending for the same also matters for a defined patient population. Furthermore, ACOs can be described as schemes dedicated to high standards and competence, regarding the mandate to oblige report as well as evaluate values of practitioners on behalf of patients (Stern, 2015).
Nevertheless, imposing of these features comes as an advantage to the patients and the health facilities as well (Tu et al., 2016). One of the fundamental achievements includes nurturing a better clinical amalgamation across healthcare backgrounds. Policies are set to check on the clinician's operations and their general relationship with patients. However, in most cases, they fail to implement the established standards while addressing patients. Additionally, patients are always neglected and treated inappropriately, especially in scenarios where conditions are chronic, but there is lack of funds to settle bills. It is the role of ACOs to increase transparency and avail relevant information regarding the policies, costs as well as the expectations of efficient health care (Marcoux et al., 2012).
According to Stern, (2015), Medicare Payment Advisory Commission recognizes ACOs as a potential tool that facilitates the transformation of traditional health care to a modern health care system. In the process of restructuring healthcare physicians are held accountable for the annual spending for a given patient population. Under the recommendations of the agency, reimbursement would be under a combination of free-for-service expenditure that is made to cater for the medical bills. The financial incentives are geared towards reducing the total costs at the same time facilitating quality services to the patients. Therefore, the success of the structure depends on adoption of reliable standards together with a practical payment methodology to eliminate uncontrolled practices (Klein et al., 2014)
What makes Oregon unique in its approach to Coordinated Care Organization?
Apparently, Oregon has instituted a variety of initiatives. These wide ranges of actions help its member states improve the quality and harmonization of care for the needy. It is a unique aspect that facilitates the effectiveness of its overall goal (Stern, 2015). It can be noted that it is centered on meeting strict financial targets and quality care as well; therefore structuring a wide range of initiatives facilitates an improved manner in which care is transitioned through proper management. At the same time addressing focusing its efforts on addressing the socioeconomic barriers that could hold back its development. For instance, in the manifestation of its initiatives $3.4 million is facilitated by the member states to restructure care. On the other hand, $17.3 million of the grand from the members' countries is collected to facilitated innovations in healthcare in the affected regions (Tu et al., 2016).
Besides, Oregon has put in place a thorough transition team to facilitate its activities. Unlike other organizations, it stands out as a unique accountable organization with a well-stipulated squad (Marcoux et al., 2012). The notion of the reliability of the management team lies behind the aid of the Health Commons grant. A body that oversees the provision of short-term proper mental health management to patients admitted to the psychiatric hospital. Additionally, the team incorporates mobile crisis support to patients at the hospital and those in the outpatient care as well. The group tends to be competent in its activities that help in goal achievements. The program in every member state facilitates a mutual relationship of the community-based services that are centered on salvaging patients (Stern, 2015).
Why are states experimenting with different models of integrated care?
Currently, it can be understood that the increase in diseases demands an efficient and quality healthcare system (Klein et al., 2014). As a result, states are in search of suitable models that can be deployed to achieve better healthcare schemes. These models that can be integrated to improve services in healthcare; through standardizing administrative processes. In identifying a model that has an added benefit in sustaining quality in health care; monitoring of the performance in all the networks is vital. As well, it can also help reduce how services are deployed with much ease and service intensity. Regarding the same notion discussions are in progress to find means of facilitating mechanisms that can help solve patients health issues rapidly with fewer costs but at the same time availing services that are acceptable and in line with the healthcare policies (Tu et al., 2016).
Furthermore, assessment is integral regarding investing in grand programs that are reliable and agitate rapid improvements in the adequate health care (Rosenbaum & Burke, 2011). It can be agreed upon that estimating the effectiveness of a project will ultimately result in the collapse of the same. It is therefore essential that empirical analysis is conducted to determine a more reliable scheme to deploy. Besides, the mediation is centered at civilizing care at the same time reducing the costs felt by the high-risk beneficiaries. According to the expectations of several states...
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