Health Care Ecosystem
Healthcare organization (HCO) | A formal legal entity creates, supports, and coordinates professional teams(caregiving teams clinical support team,logistic support team and strategic support team) that deliver care to its community. |
Any real HCO is highly dynamic in three senses: The HCO constantly responds to the changing array of patients and their changing needs. This makes most HCOs a 24/7/365 operation. The HCO evolves as medicine and management change, reflecting both the latest scientifically proven treatments and new developments in management practices and information technology. The HCO adjusts to the changes in its community's needs.
As the population grows, shrinks, and changes in age and ethnic diversity, the epidemiology of disease changes and the HCO must respond. One function of the strategic activities is to manage these changes
.An important way to understand organizations is as devices to negotiate solutions.
Exhibit 1.2: General Model of Stakeholder-Organization Interaction
Image from book
Most payment organizations mandate two outside audits of HCO performance—accreditation by The Joint Commission or its osteopathic counterpart the American Osteopathic Association and audit by a public accounting firm of the HCO's choice. Some insurance plans are accredited by the National Commission on Quality Assurance (NCQA), which also accredits ambulatory care and disease management.
| Government regulatory agencies | Agencies with established authority over healthcare activities; licensing agencies and rate-regulating commissions are examples |
| Certificate of need (CON) | Certificates or approvals for new services and construction or renovation of hospitals or related facilities; issued by many states |
| Quality improvement organizations (QIOs) | External agencies that review the quality of care and use of insurance benefits by individual physicians and patients
Any real HCO is highly dynamic in three senses: The HCO constantly responds to the changing array of patients and their changing needs. This makes most HCOs a 24/7/365 operation. The HCO evolves as medicine and management change, reflecting both the latest scientifically proven treatments and new developments in management practices and information technology. The HCO adjusts to the changes in its community's needs.
As the population grows, shrinks, and changes in age and ethnic diversity, the epidemiology of disease changes and the HCO must respond. One function of the strategic activities is to manage these changes
.An important way to understand organizations is as devices to negotiate solutions.
Exhibit 1.2: General Model of Stakeholder-Organization Interaction
Image from book
Most payment organizations mandate two outside audits of HCO performance—accreditation by The Joint Commission or its osteopathic counterpart the American Osteopathic Association and audit by a public accounting firm of the HCO's choice. Some insurance plans are accredited by the National Commission on Quality Assurance (NCQA), which also accredits ambulatory care and disease management.
| Government regulatory agencies | Agencies with established authority over healthcare activities; licensing agencies and rate-regulating commissions are examples |
| Certificate of need (CON) | Certificates or approvals for new services and construction or renovation of hospitals or related facilities; issued by many states |
| Quality improvement organizations (QIOs) | External agencies that review the quality of care and use of insurance benefits by individual physicians and patients