Healthcare Delivery Case Study

Healthcare Delivery
The state insurance options include both Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). In 2015, the total enrollment in Colorado’s forty-four HMOs was 839,754 (Kaiser Family Foundation, 2016). In December 2015, the total enrollment for Medicaid and CHP+ combined was 1,315,144 (Kaiser Family Foundation, 2016). The CHP+ focuses on providing quality care in preventative services, acute services, and services for chronic illness (Kempe, Beaty, Englund, Roark, Hester, & Steiner 2000). The PPACA mandate requires that all individuals be enrolled in some type of insurance plan or face penalties. Despite expanding access to healthcare insurance, access is now inadequate because healthcare resources
The act was enacted in response to the asymmetry of the services offered in the rural and urban areas in Colorado (Lampe, Atherly, VanRaemdonck, Matthews & Marshall). This act allowed all residents in Colorado equal access to healthcare services. Since Colorado’s geography includes both rural and urban areas, it is necessary to provide this type of access. Only 13% of Colorado’s residents reported having difficulties accessing primary care services (Kaiser Family Foundation, 2016). This is significant because that it describes the lack of a medical home for some individuals. Twenty-four percent of individuals indicated that they did not have a designated primary care provider (Kaiser Family Foundation, 2016). It is necessary for individuals to have access to a primary care physician because it is of the emphasis on a primary care physician being the gatekeeper in the United States. This is noteworthy because the United States has a lower percentage of individuals not having access to a primary care physician at 22% (Kaiser Family Foundation, 2016). Colorado is attempting to resolve the issue of accessibility, while controlling the costs associated with healthcare
In 2011, there was structural change in Colorado’s Clinica Family Health Services organization to promote better health outcomes and cost-effective measures. The organization began restructuring its operations by highlighting the need for greater patient access, continuity of care, and provider teamwork to improve efficiency in the delivery of care (Feder, 2011). The focus of both the United States and Colorado is on preventative services, which cost less than specialty services to provide. By providing better access to care, Colorado expects to help residents control their conditions and reduce the need for expensive, and potentially avoidable,