Management challenges in the United States Medicare healthcare system

Health Systems Management and Electronic Health Records

Healthcare is an essential factor or tool in relation to the American society. The society of America has no national socialized healthcare system. In this research paper, the focus will be on the Medicare healthcare system in the context of the United States. The paper will focus on illustration of the concepts of the Medicare healthcare system, various management challenges, problems, and opportunities in relation to the organizational impact of the policies governing the system.

Healthcare is an essential factor or tool in relation to the American society. The society of America has no national socialized healthcare system. This forces the citizens to adopt and integrate various ways of paying for their healthcare needs. In the context of the United States, various systems provide healthcare services to the rich and less fortunate society members. In this research paper, the focus will be on the Medicare healthcare system in the context of the United States. The paper will focus on illustration of the concepts of the Medicare healthcare system, various management challenges, problems, and opportunities in relation to the organizational impact of the policies governing the system.

Medicare Health System

The United States lacks the aspect of the universal healthcare thus the need for incorporation of various healthcare systems for the provision of vital services for the growth and development of the economy in relation to the health sector. Medicare healthcare system is integrated within the health sector of the United States with the aim of providing essential services to the special populations (Carpenter, 2011). Medicare health system is in place to offer services to the citizens who are 65 and above years old. This indicates that, for the qualification of the healthcare system under Medicare, one has to attain the age of 65 and above. Exceptions are also essential for the disabled citizens below 65 and collect social security disability insurance benefits. These individuals obtain healthcare services in relation to the concept of Medicare (Harle et al., 2013).

Medicare is designed to offer services in the context of ambulance transportation, limited hospital stays, x-ray services, and chemotherapy. In the United States, department of health and human services has the responsibility of providing diverse programs towards enhancement of the health and well-being of the citizens. This indicates that the management of the programs of Medicare is under the influence of the health and human services department. Medicare healthcare system reflects one of the largest healthcare insurers facilitating the well-being of the society members. This is evidence in the massive expenditure in excess of most of the cabinet departments. For instance, in the context of 2011, Medicare managed approximately 800 million claims paying about $200 billion in the process. In addition to this notion, health and human services department is the largest federal grant-making agency. This is evident through the massive portion of grants annually at about 60,000 grants per year.

Lack of Reliable and Comprehensive Data Accessibility

In the process of fulfilling the responsibilities and management issues in relation to the health sector, health and human services face various challenges (Fung et al., 2011). These challenges are in the form of management and operational issues thus hindering the pursuit of goals and objectives by the relevant organizations. One of the paramount problems or challenges hindering effective and efficient management of the healthcare system in the form of Medicare is lack of reliable and comprehensive data and data systems. Reliable and comprehensive data and data systems are essential in the management of the programs and evaluation of the impacts of the program in relation to the citizens or societal welfare. Health and human services department lack access to essential data in the management of the health insurance programs, grant-making activities, and regulation functions and obligations.

Development and maintenance of the system facilitating accessibility of the data are also challenging concept in relation to this data issue affecting the management of the Medicare systems. This is because health and human services programs are under the influence of local and state governments thus conflict of interest in the accessibility of the information or data. Lack of these data accessibility systems limits the ability of the health and human services to oversee the health systems effectively and efficiently. Another aspect of this problem is the illustration of the technical issues relating to the computer capabilities in 2000 thus enhancing complexity of the data accessibility issue by the health and human services department. This management issue contributes towards the interruption of the payment and other relevant services by Medicare healthcare systems within the United States.

Reason for Selection of the Issue

The main reason behind the selection of this issue is its necessity in the provision of quality services and products to consumers. Information is vital for the enhancement of the quality of services to consumers in relation to the implementation of the healthcare systems within the United States. It is also vital for the organization to integrate the concepts of the data accessibility and systems to manage programs and services focusing on the stated healthcare system. Health and human services department is in need of this vital information or data for the improvement of quality services to consumers. Lack of accessibility to reliable and comprehensive data is also one of the main reasons behind poor performance within the healthcare system or sector. In order to enhance the services of the healthcare sector, it is essential to adopt and integrate relevant systems to avail the comprehensive and reliable data or information concerning the healthcare system. Identification, management, and minimization of this problem will enhance the effectiveness and efficiency of the concept of Medicare in the realization of the goals and objectives.

Impact of the issue of Medicare policies

Lack of reliable and comprehensive data will influence the concept of policies in relation to the Medicare program or healthcare system within the context of the United States. One of the policies affected by lack of reliable and comprehensive data in relation to inadequate accessibility to the information relates to the therapy students. According to the policies of the Medicare program, therapy students participating in the field experience must be under "line of sight" level of supervision thus under the influence of the professional therapist. Accessibility of information will enhance the interaction of the students and beneficiaries in relation to this policy. This is essential in the maximization of effective and efficient provision of services to consumers or society members thus vital for the achievement of the goals of societal welfare. Reliable and comprehensive accessibility to information are essential tracking the information about students within the professional field (Carpenter, 2011).

Another policy of Medicare health system under the influence of reliable and comprehensive accessibility of data is the aspect of services or coverage to the old-age population. Accessibility of information will enable the organization to manage effectively and efficiently through identification of the individuals who qualify for the program. Accessibility of information will also enable the organization to identify problems facing the implementation of the program thus the opportunity to implement necessary changes in the improvement of services (Carpenter, 2011).

Implications in the development of future policies

Information is one of the critical factors towards the achievement of quality and efficient management of the healthcare systems. This is essential for the development and implementation of the concepts of the healthcare system thus essential in the management of the healthcare programs. Lack of accessibility to reliable and comprehensive data is vital for the adoption of information and factors for the improvement of Medicare services for societal welfare. Implementation of information will guide the development of policies focusing on the expansion of the aspect of Medicare and improvement of services. Lack of accessibility to the valuable data will hinder the achievement of the goals and objectives of Medicare programs in addressing the societal needs.

Solving the Problem

Strategic management of the health and human issues department should focus on the implementation of various measures towards minimization or elimination of the issue from hindering the achievement of the targets of the Medicare program (Gengler, 2011). One of the efficient methods in the minimization or elimination of the lack of accessibility to reliable and comprehensive data is the implementation of Quality and Safety Education in Nursing (QSEN). Implementation of this concept in the working practices or operations of Medicare programs within the healthcare facilities will enable the realization of effective and efficient management of the aspects of the health system. Quality and Safety Education in Nursing (QSEN) focuses on the incorporation of various factors towards the improvement of the service delivery to consumers or less fortunate society members. One of the essential components of this program is focusing operations of the project on the patients.

Teamwork and collaboration will also enhance the accessibility of information (Sullivan, 2010). This is because relevant practitioners in the management of the Medicare program or healthcare system will execute their roles and functions effectively. Incorporation of evidence-based practice also enhances the accessibility of information for the organization to maximize in the realization of the targets and goals in service delivery to the consumers (Headrick et al., 2012). Other components of the Quality and Safety Education in Nursing (QSEN) include quality improvement, efficiency enhancement, and informatics concepts in the realization of the goals and objectives of the management of Medicare program in the context of the United States (Lenburg et al., 2011).

Conclusion

Medicare is one of the effective medical or healthcare systems within the context of the United States (Carpenter, 2011). It operates towards the provision of vital healthcare services to the less fortunate society members in the form of individuals above 65 years of age (Carpenter, 2011). In the implementation of its concepts, Medicare associates with some problems such as lack of accessibility to the reliable and comprehensive data. This hinders the achievement of the goals and objectives of the aspects of Medicare in enhancing the health conditions of the citizens of the United States. Implementation of the Quality and Safety Education in Nursing (QSEN) will contribute towards enhancing the accessibility of information thus improvement of the concept of Medicare (Miltner et al., 2012).