Healthcare
Discuss the role played by managed care and its impact on long-term care reimbursement.
As the population ages, cutbacks in long-term care reimbursement are inevitable in the way of public reimbursement. Therefore, nursing home administrators or other long-term care facilities will have to find innovative ways to increase revenue streams to their facilities to make up for these losses. They will then have to rely more upon private resources instead as other organizations are tapped for cost sharing schemes (Singh, 2010, 161) .
Managed care organizations (MCOs) are private insurance organizations that can also contract with Medicaid or Medicare to deliver to beneficiaries that are covered by these programs.
These organizations are contracted to provide systems on the basis of a prepayment-based system called capitation. Under this system, the MCO must provide all of a basket of services to enrolled beneficiaries for a fixed monthly payment fee that is agreed to in advance. The capitation system provides the parameters within which the facility must deliver their services. If the cost of services exceeds the capitation reimbursement, the facility will loose money. The system is designed to restrict inappropriate expenditures on services and to control the sky-rocketing costs of service delivery (ibid).
Discuss the concept of quality improvement and how it applies to the present long-term care system or facility.
Continuous Quality Improvement (CQI) is the current rage in long-term care facility management. Care facility is growing more and more complex and therefore the management tools themselves will also logically continue to grow in complexity. For this reason, all of the staff needs to be brought on board and trained adequately so as to understand what the level of care is expected within the financial and quality parameters. CQI must be seen as an approach to quality management that is built upon traditional quality assurance methods. This is done by emphasizing organizations and systems as a whole rather than focusing on individual;s only. CQI is a management philosophy that cost containment on the once hand and customer service on the other hand to deliver service withing budget. CQI applies a the scientific method applied to everyday tasks to meet the above criteria ("Continuous quality improvement," 2011) .
Discuss the legal and ethical implication of end of life issues in the facility.
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