Compare And Contrast Healthcare And Ambulatory Care

Personal beliefs, is just that, personal beliefs and does not have an effect on whether the government will provide healthcare to patients for free. The fact of the matter is, health care in America is not free, neither cheap and generally the quality of care ranges from poor to basic but it is required in order to sustain a healthy lifestyle. If survival is contingent upon basic health care, then why is there a price? There is a price because healthcare is a business, and in order for a business to generate a continuous flow of funds, patients much be charge, which should not be a problem. However, when insurance and pharmaceutical companies are inflating their prices, the impoverished and even the lower middle-class suffer tremendously.
Life is not fair, which is comprehended as the unspoken rule, but what is right is right and what is wrong is wrong, and healthcare in the United States is wrong. Things must change, and recently have been changing especially when certain concepts as Patient Centered Medical Home (PCMHs), Ambulatory Care, Community Care, etc. as introduce into healthcare. These specific models have many differences, and similarities, with certain payment systems, and choosing one over the other maybe somewhat of a challenging choice.
Impoverished individuals who were born into a family with a lack of wealth, usually struggles to get by on a daily basis, and paying a pricy health insurance is unreasonable and quite difficult. The icing on the cake is that America quality care in health care is usually subpar to mediocre, which is not expected, but occurs because of the demanding patient load. Two models that are interesting healthcare models which are very unique and distinctive are the Patient Centered Medical Homes (PCMHs) and Ambulatory Care. Patient-Centered Medical Homes (PCMHs) are “delivery models whereby patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand” (ACP, 2017). Whereas Ambulatory Care Plans are “ambulatory treatments refers to care being provided outside the hospital. The patients come for treatment and are not admitted as inpatients to a hospital” (Torrey, 2017).
PCMHs and Ambulatory care are very similar in a few ways. For example, the primary focus of a PCMH is based on efficient quality care and safety of patient. PCMHs utilizes the entire healthcare team to not only assist the patient but to also benefit the physician as well. PCMHs pushes patients and their clinicians to work thoroughly together to guarantee that treatment is more inclusive, synchronized, and dependable. “PCMH fosters an environment of transparent reporting on progress toward measurable outcomes that potentially result in certain medical home incentives” (Adamson, 2011). PCMH requires the patient clinical team to have full understanding of the patient’s treatment plan, along with their encounters. Such a maneuver typically results in more modernized and suitable care, decrease costs and most significant, easier conclusions.
Ambulatory care utilizes physician capabilities to convey health information successfully and highlights Patient-Centered Care (PCCs) as a resolution in order to deliver passionate support which is an imperative role in healthcare encounters.
“Each patient-physician interaction comprises experiences that shape patients' opinions about their physicians” (Keating, 2002). Ambulatory care is a small part in quality patient care, but nevertheless, it is a part. Both models are quite similar because centering care primarily around the patient needs, describe empathy and the main purpose of health care. However, the differences are minimal at best. Since ambulatory care practices are recognized as outpatient care, not all health care related services can be performed even though surgical and urgent care centers are provided for ambulatory
care.
Whereas, PCMHs offers all services and provides all needs for every patient. Needs that Ambulatory care models may not offer or utilize. Additionally, this model specifically goes above and beyond by treating patients at their home regarding specific circumstances, which is not only unique but considerate. PCMH healthcare team provides services such as: out-of-home care assistance, specialty care, reserved public services, informative services, and pediatric affiliations. This particular method allows the patient to be linked to a care manager, who in turns connects with the clinical team on behalf of the patient with certain health proposals in order to prepare a more proficient and all-inclusive treatment method.
Ambulatory care methods of payment usually includes salary, capitation, fee for service (FFS), pay for performance (P4P), and mixed systems.
Salary is paid to clinicians for working certain hours on an annual basis. This specific payment method does not have any monetary enticements to enhance quality care, but depending on clinicians performances, determines if their salary will or will not be increased. Another ambulatory care payment method is FFS. In an FFS, physicians are normally compensated based on precise items supplied. Usually FFS is the conventional approach by which most patients and third parties utilize to pay
providers.
“FFS provides economic incentives for the healthcare professionals to provide more services regardless of their necessity, so cost escalation might be the biggest problem under this payment method” (Beibei, 2017). Additionally, capitation payment is a distinctive payment choice. Capitation payment consist the physician being compensated on a predestined rate in advance in order to specify a usual amount of services for each patient that is registered with that doctor for a certain amount of time. The benefit of this specific payment method, truly benefits the provider. For instance, capitation methods presents incentives for physicians by allowing providers to manage cost by reducing participations and diminishing patient time visits, and concentrating on inexpensive health promotion.
Patient Centered Medical Home payments consists of monthly bundled care fee payments, visit-based fee-for-service or FFS, and a performance-based system. Bundle fee definitely needs to be address since it is a good method of payment. Bundle care coordination fee is a type of payment that’s intended to pay numerous physicians and clinicians for organizing the entire amount of services needed for a particular, distinct type of care. This specific method is a genius technique because it does not put financial risks on providers. Regardless of the low financial risk, there are a few issues that arise. One major problem is supervising costs for a patient’s treatment which maybe uncontrollable and may lead to certain problematic incidents. For example, when a provider have a variety of patients with more than one illness or disease, the treatment for the illness normally is costly.
The provider cannot and is not able to decrease the price of the treatment, which makes this uncontrolled event, hard to explain to a patient. Although ambulatory care is a great model, PCMH rises to the occasion in every way. PCMHs model was built in a way, that it incorporated the providers, the nurses, the information technologists, the human resource managers, the pharmacists, the clinical laboratory technologists, basically the entire medical team, in order to treat the patient with the utmost care. By involving every clinical member that was a part of the healthcare team in treating the patient, the patient walks away with the notion and perception of great service and personal needs being met. PCMHs compensates the providers in different ways, but also provide certain incentives to inform the physicians of how great of a job they’re doing.
PCMHs is the future of health care, because quality care and safety should always be the priority and PCMH demonstrates great quality care by the accolades and tributes it consistently receives. The differences between PCMH and Ambulatory Care is minimal but the similarities are many which demonstrates the movement towards patient safety as the key factor in these specific models. PCMH is definitely the model to look out for. It is genuinely geared towards the patient and improving clinical teams on a daily basis.