Managed healthcare offers a selection of techniques that facilitate the uncalled for cost of healthcare through the different mechanisms and monetary incentives such as lesser costly select forms, programs that are to evaluate the medical stipulation of some services are such, control the cost of admission and the long stays in the hospitals, helps increase beneficiary cost sharing, lower the cost of outpatient surgery, and lower the cost of healthcare. Managed healthcare in modern world is in favor of the insurance carriers.

This has resulted to a situation where the insurance provider is blocked by insurance carriers; likewise the patients have been pushed to a point where they cannot access the services of a doctor whom they prefer, unless the doctor is in league with the insurance carriers. These trends have seen many healthcare professionals quitting the industry due to unnecessary frustrations. More so, many doctors involved in this scheme, are imperatively doing so for the sake of survival. However, there distinctive merits attributed to managed care plans, some of these advantages include, decisions concerning health care are generally determined by the HMO, and the patient has contact to a broad variety of reliable professionals, much of the paperwork is decimated, price of managed care is typically minimal than protection plans for seniors and for other persons, HMOs generally offer certain  services as a sheltered advantage that may not generally be a part of other types of health plans, such as immunizations, annual physicals and well-child visits(Nzau,2007).

Some services may be presented which indemnity plans do not offer, such as eye exams, eyeglasses, dental care or other services, to mention just but a few. On another hand, the provider’s benefits in that, they get a stable flow of guaranteed patients in particular if they concur to take on a colossal corporation and offer all the care to the workforce. However, the providers are disadvantaged in that they are capped on how much they will be paid for medical services. If not managed in the approved manner, they may wind up losing money as a result of a mismanaged care plan.

A patient benefit from an insurance plan is that a compensation plan reimburses you for your medical expenses in spite of who provides the service; although in some cases your reimbursement amount may be limited. Under managed care, if you divert from the permitted arrangement list without consent you will not be reimbursed for services. A patient disadvantage to indemnity policy is the cost. Without someone running the finances, the healthcare personnel is free to charge what they desire for services rendered,basically,this burden is pegged on the patient in higher insurance charges.

In principal, a provider has a higher hand in traditional, he is free to set the price depending on what he considers to be fair, and more than often the price is always high. However, Mulutu (2000) noted, this strategy has been noted to work against the providers, this has been established by the fact most patients have a tendency of avoiding costly service providers.  This has considerably affected the volume of patients seeking services in this managed care schemes, hence making it impossible to compete with other service providers with subsidized fees.     As a caregiver, let me acknowledge that, the managed care plans are just the way to go. This means I have to adjust on my finances, in order to provide the quality services as agreed with insurance companies.

Much emphasis is given to the Patient-Centric approach in order to resolve multifaceted problems faced by healthcare today. But the pertinent question is whether this approach is the only way to solve the existing healthcare problems? Patient-Centric systems such as EHRs (Electronic Health Records), EMRs (Electronic Medical Records), and Hospital Management Systems are extremely beneficial for the customer (i.e. patient) and may be for the administration, but do they make a healthcare facility more efficient and productive? The care is delivered by the healthcare professionals such as nurses, specialists, residents. What systems are available to gauge their professional competencies and performances? Surprisingly, not much headway has been made in this vital segment of the health care system.

Dr-SIR is a knowledge-based, hospital efficiency measurement software system, which generates powerful reports and analysis for healthcare administrators and stakeholders in the following areas:

        • Accurate efficiency measurement

        • Cost reduction

        • Resource planning

        • Performance evaluations

It is an Internet accessed technology and requires no interface with a hospital’s MIS. All data provided to Dr-SIR in off loaded files are non-patient specific.

Dr-SIR evaluates over 3500 work flow activities that can exist in a hospital system.  The system can analyze work flow efficiency on a macro (system wide) and micro (specific physician, shift).  Dr-SIR generates a myriad of analysis and optimal work flow models via reports that you can access via the Internet in a menu format.  Dr-SIR’s standard measures (work units) and benchmarking are recognized as most aligned with the 2008 Health and Human Resource (AHRQ) study on measuring hospital efficiency.

In Dr-SIR, we define efficiency as an attribute of performance that is measured by examining the relationship between a specific product of the healthcare system (also called an output) and the resources used to create that product (also called inputs). Under our definition, a provider in the health care system (e.g., hospital, physician) would be efficient if it was able to maximize output for a given set of inputs or to minimize inputs used to produce a given output.

Efficiency =   Actual Work Generated

Work Generation Capacity

Efficiency Measurement (EM) is able to undertake a full scope “capability due diligence” of healthcare institutions using international quality and performance benchmarks.

EM provides the means to take any activity or participant within a framework and translate its functions onto a leveled platform to enable measurement of the adequacy of output in terms of efficiency and capacity. Therefore, for every activity that is passed through this system, there would be an ideal output and actual output both stated in the common denominated units of measurement. It is this basic concept which forms the cornerstone of this system.

The most effective way to measure the efficiency of any service is by establishing a basis by which different services can be quantified into a common, or unified measurable unit of output. This baseline becomes a benchmark of efficiency to be achieved by medical professionals, departments or entire hospitals.

Dr-SIR’s efficiency measures count the amounts of different inputs used to produce an output (patient treatment) and help to answer questions about whether the output could be produced faster, with fewer people, less time from medical professionals, or fewer supplies.

In economic terms, the focus is on whether the output is produced with the minimum resources and cost.

Dr-SIR will help to achieve work flow standardization as all treatments, operatives and diagnostic activities in a hospital setup have been standardized and quantified on a unified scale in terms of time frame, acceptable rate of complications or misdiagnosis, etc.

The DR-SIR efficiency measurement system helps to increase work output and decrease cost per unit. The system identifies the deficiencies and reasons for the positive or negative variances for decision makers. Accordingly, administrators will be able to forecast and take preventive measures to better manage the healthcare system. Thus a complete Decision Support System is available to healthcare decision-makers that allows for the quantification of professional efforts and thus ensures the accountability and efficiency standards which are so instrumental to ensure healthcare quality in patient treatment.

NEW YORK, NY–(Marketwire – October 27, 2009) – Allied Healthcare International Inc. (NASDAQ: AHCI) (AIM: AHI) (http://www.alliedhealthcare.com), a leading provider of flexible healthcare staffing services in the United Kingdom, has implemented a three-year contract with the London Borough of Islington Council in the United Kingdom.

Under the Islington contract, Allied has the opportunity to deliver up to two thousand five hundred hours of home care services a week (130,000 hours a year) as one of two providers for the South region of Islington, a borough in North London with a population of 175,000. This award, which was secured in March 2009 and is Allied’s first contract with Islington, has now completed its implementation stage with the opening of a new branch, London North.

Sandy Young, Chief Executive Officer of Allied, commented: “Our stated objective of materially increasing our presence across London Boroughs is yielding excellent results as this win comes on the back of recent long-term contract wins in Waltham Forest and Redbridge. I look forward to updating our shareholders on further results of this successful strategy.”

For more news and information on Allied Healthcare International Inc., please visithttp://www.IRGnews.com/coi/AHCI where you can find the CEO’s video, a fact sheet on the company, investor presentations, and more.

ABOUT ALLIED HEALTHCARE INTERNATIONAL INC.

Allied Healthcare International Inc. (http://www.alliedhealthcare.com) is a leading provider of flexible healthcare staffing services in the United Kingdom. Allied operates a community-based network of 111 branches with the capacity to provide carers (known as home health aides in the U.S.), nurses, and specialized medical personnel to locations covering approximately 90% of the U.K. population. Allied meets the needs of private patients, community care, nursing and care homes, and hospitals.

FORWARD-LOOKING STATEMENTS

Certain statements contained in this news release may be forward-looking statements. These forward-looking statements are based on current expectations and projections about future events. Actual results could differ materially from those discussed in, or implied by, these forward-looking statements. Factors that could cause actual results to differ from those implied by the forward-looking statements include: general economic and market conditions; Allied’s ability to continue to recruit and retain flexible healthcare staff; Allied’s ability to enter into contracts with local government social services departments, NHS Trusts, hospitals and other healthcare facility clients on terms attractive to Allied; the general level of patient occupancy at our clients’ hospitals and healthcare facilities; dependence on the proper functioning of Allied’s information systems; the effect of existing or future government regulation of the healthcare industry, and Allied’s ability to comply with these regulations; the impact of medical malpractice and other claims asserted against Allied; the effect of regulatory change that may apply to Allied and that may increase costs and reduce revenues and profitability; Allied’s ability to use net operating loss carry forwards to offset net income; the effect that fluctuations in foreign currency exchange rates may have on our dollar-denominated results of operations; and the impairment of goodwill, of which Allied has a substantial amount on the balance sheet, may have the effect of decreasing earnings or increasing losses. Other factors that could cause actual results to differ from those implied by the forward-looking statements in this press release include those described in Allied’s most recently filed SEC documents, such as its most recent annual report on Form 10-K, all quarterly reports on Form 10-Q and any current reports on Form 8-K filed since the date of the last Form 10-K. Allied undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise.

APPLICATION OF THE FOUR QUADRANT HEALTHCARE MODEL TO VARIOUS POPULATIONS -

The examples used in the diagram of the Four Quadrant Integration model are for adult populations; the same template can be used to create models that are specific for children and adolescents, or older adults, reflecting the unique issues of serving those populations (for example, the role of schools and school based services in serving children). Older adults, particularly, have been shown to utilize primary care settings for psychosocial, non-organic somatic complaints and to be underrepresented in specialty behavioral health populations — research suggests they are willing to receive behavioral health services in a primary care setting and that targeted interventions can make a difference in depression symptoms. Ethnic, language and racial groups also have unique issues in receiving language and culturally appropriate behavioral health services. Primary care based behavioral health services can improve access for these populations and lead to appropriate engagement with behavioral health specialty services as needed. For example, the Bridge Program in metropolitan New York has been successful in reaching the Asian-American community via their primary care settings.

There are also differences between rural and urban environments and among regional markets in terms of the resources available and ease or difficulty of access to services. The Four Quadrant Integration model provides a template for considering the resources locally available and developing alternative methods of coordination (for example, telemedicine) that may be required when specialty care (either physical or behavioral health) is delivered in another community.

The Four Quadrant Clinical Integration model is not diagnosis specific; it looks at degree of clinical complexity and risk/level of functioning. Further, the evidence-base is at different levels of development in each of the Quadrants. The model is intended to provide a conceptual construct for how to integrate services. Diagnosis specific guidelines should be used to provide detailed guidance for the scope of the primary care provider, the primary care based behavioral health provider, and the specialty behavioral health provider.

THE FOUR QUADRANT MODEL AND EVIDENCE-BASED PRACTICES IN HEALTHCARE AND BEHAVIORAL HEALTH -

In the healthcare system, there are numerous evidence-based practice guidelines that are diagnosis/condition specific. The National Guideline Clearinghouse (NGC) is a public resource for evidence-based clinical practice guidelines. NGC is sponsored by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, in partnership with the American Medical Association and the American Association of Health Plans. There are over 1000 disease/condition guidelines that can be accessed through their website (www.guideline.gov).

The Chronic Care Model (CCM) (http://www.improvingchroniccare.org/change/index.html) was developed under the Improving Chronic Illness Care Program. The CCM is in use in a variety of healthcare settings, providing a structured approach for clinical improvement.

The CCM has been used to develop specific approaches for serving patients with diabetes, cardiovascular disease, asthma and depression in a project sponsored by the Bureau of Primary Health Care (BPHC) with the Institute for Healthcare Improvement (IHI), a not-for-profit organization driving the improvement of health by advancing the quality and value of health care. The Health Disparities Collaboratives (http://www.healthdisparities.net/) are a multi-year national initiative to implement models of patient care and change management in order to transform the system of care for underserved populations.

The organizing principles for each of Health Disparities Manuals follows the key elements of the CCM; many of the components apply to each disease entity (e.g., diabetes, asthma, depression), while specific tasks and tools are unique to the specific disease entity. The key change concepts found in the Depression Collaborative manual include:

Organization of Health Care/Leadership -

>   Make sure senior leaders and staff visibly support and promote the effort to improve chronic care
>   Make improving chronic care a part of the organization’s vision, mission, goals, performance improvement, and business plan
>   Make sure senior leaders actively support the improvement effort by removing barriers and  providing necessary resources
>   Assign day-to-day leadership for continued clinical improvement
>   Integrate collaborative models into the quality improvement program

Decision Support -

>   Embed evidence-based guidelines in the care delivery system
>   Establish linkages with key specialists to assure that primary care providers have access to expert support
>   Provide skill oriented interactive training programs for all staff in support of chronic illness improvement
>   Educate patients about guidelines

Delivery System Design -

>   Identify depressed patients during visits for other purposes
>   Use the registry to proactively review care and plan visits
>   Assign roles, duties and tasks for planned visits to a multidisciplinary care team. Use cross training to expand staff capability
>   Use planned visits in individual and group settings
>   Make designated staff responsible for follow-up by various methods, including outreach workers, telephone calls and home visits

Clinical Information System –

>   Establish a registry
>   Develop processes for use of the registry, including designating personnel to enter data, assure data integrity, and maintain the registry
>   Use the registry to generate reminders and care planning tools for individual patients
>   Use the registry to provide feedback to care team and leaders

Self- Management -

>   Use depression self management tools that are based on evidence of effectiveness
>   Set and document self management goals collaboratively with patients
>   Train providers and other key staff on how to help patients with self management goals
>   Follow up and monitor self management goals
>   Use group visits to support self management

Community -

>   Establish links with organizations to develop support programs and policies
>   Link to community resources for defrayed medication costs, education and materials
>   Encourage participation in community education classes and support groups
>   Raise community awareness through networking, outreach and education
>   Provide a list of community resources to patients, families and staff

EVIDENCE-BASED PRACTICES IN THE BEHAVIORAL HEALTH SYSTEM -

The Chronic Care Model (CCM) has also been adapted by The National Program Office for Depression in Primary Care (http://www.wpic.pitt.edu/dppc/), to develop a clinical framework for all partnering organizations to follow. Its Flexible Blueprint was developed after a review of published interventions used to treat depression, interviews with a variety of primary care physicians, mental health specialists and other experts in the field, and selected site visits to view elements of the Chronic Care Model in action.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is supporting the Implementing Evidence Based Practices Project. This project is focused on people who have severe mental illness; these people are most frequently served in the public mental health system (http://www.mentalhealthpractices.org/).

There are six areas that have been researched. Toolkits have been developed based on the multi-state demonstrations that have been underway. The six areas are described below, based on the website materials:

Illness Management and Recovery –

This is a program of weekly sessions where specially trained MH practitioners help people develop personal strategies for coping with mental illness and moving forward in their lives. The program emphasizes helping people set and pursue personal goals and become better able to realize their vision of recovery.

Medication Management Approaches In Psychiatry (Medmap) –

This focuses on using medication in a systematic and effective way, providing guidelines and steps for decision-making based on current evidence and outcomes, monitoring and recording information about medication results, and involving consumers in the decision-making process.

Assertive Community Treatment (ACT) -

This program is for people who experience the most severe symptoms of mental illness. The goal is to help people stay out of the hospital and develop skills for living in the community. Services are provided by a team of practitioners, are available whenever and wherever needed, 24-hours a day, and are provided for as long as they are wanted and needed.

Family Psychoeducation –

This involves a strong partnership between consumers, families and supporters, and practitioners. People work toward recovery by developing better skills for overcoming everyday problems and illness-related issues, developing social support, and improving communication with treatment providers.

Supported Employment –

This is a well-defined approach to helping people with mental illness find and keep competitive employment. These programs are for anyone who expresses the desire to work. The programs are staffed by employment specialists who work with the treatment team to integrate services. They help people look for jobs soon after entering the program, and provide support as long as consumers want the assistance.

Integrated Dual Disorders Treatment -

This treatment approach is for people who have mental illness and addiction disorders, offering mental health and substance abuse services together, in one setting, at the same time. A wide variety of services are offered in a stage-wise fashion because some services are important early in treatment, while others are important later on.

The EBPs described above are intended for use in the public mental health system, serving people with severe mental illness; they are not diagnosis specific. The American Association of Community Psychiatrists (http://www.wpic.pitt.edu/aacp/default.htm) has released guidelines, such as Guidelines for Recovery Oriented Services that also address this target population rather than a diagnosis specific population.

The American Psychiatric Association has developed diagnosis specific practice guidelines (http://www.psych.org/) that are applicable in a wide variety of settings, as have other professional groups. The following list of behavioral healthcare guidelines and protocols is from the National Guideline Clearinghouse:

>   Adjustment Disorders
>   Anxiety Disorders
>   Delirium, Dementia, Amnestic, Cognitive Disorders
>   Dissociative Disorders
>   Eating Disorders
>   Factitious Disorders
>   Impulse Control Disorders
>   Mental Disorders Diagnosed in Childhood
>   Mood Disorders
>   Neurotic Disorders
>   Personality Disorders
>   Schizophrenia and Disorders with Psychotic Features
>   Sexual and Gender Disorders
>   Sleep Disorders
>   Somatoform Disorders
>   Substance-Related Disorders

EVIDENCE-BASED PRACTICES FOR ALL POPULATIONS -

There are evidence-based practices in clinical preventive services that should be utilized with all populations, whether or not they are receiving services related to a particular diagnosis or condition. This is an area for improvement in services to persons with severe mental illness, who historically have had difficult accessing healthcare services for acute or chronic medical conditions, not to mention clinical screening and prevention services.

The U.S. Preventive Services Task Force (USPSTF) (http://www.ahcpr.gov/clinic/uspstfix.htm) was convened by the U.S. Public Health Service to rigorously evaluate clinical research in order to assess the merits of preventive measures, including screening tests, counseling, immunizations, and chemoprevention. The USPSTF consists of 15 experts from the specialties of family medicine, pediatrics, internal medicine, obstetrics and gynecology, geriatrics, preventive medicine, public health, behavioral medicine, and nursing. The recommended clinical prevention services are organized into the following clinical categories:

>   Cancer
>   Heart and Vascular Diseases
>   Injury and Violence-Related Disorders
>   Infectious Diseases
>   Mental Disorders and Substance Abuse
>   Metabolic, Nutritional, and Endocrine Disorders
>   Musculoskeletal Disorders
>   Obstetric Disorders
>   Pediatric Disorders
>   Vision and Hearing Disorders

The original Task Force’s efforts culminated in the 1989 Guide to Clinical Preventive Services. A second edition of the Guide was published in 1996. In November 1998, the Agency for Healthcare Research and Quality (then the Agency for Health Care Policy and Research) convened the current USPSTF to update existing Task Force assessments and recommendations and to address new topics.

CONCLUSION –

The Institute of Medicine’s Improving the Quality of Healthcare for Mental and Substance-Use Conditions states: “A large body of research and other published work on organizational change, for example, consistently calls attention to five predominantly human resource management practices (and one other organizational practice) that are key to successful change implementation (1) ongoing communication about the desired change with those who are to effect it; (2) training in the new practice; (3) worker involvement in designing the change process; (4) sustained attention to progress in making the change; (5) use of mechanisms for measurement, feedback, and redesign; and (6) functioning as a learning organization. All of these practices require the exercise of effective leadership.”

Aarkstore announce a new report  “Clinical Decision Support in Healthcare – One step closer to the Omniscient Clinician (Strategic Focus)” through its vast collection of market research report.

Introduction

As healthcare organizations implement electronic health records, they are becoming increasingly aware of the ways clinical decision support tools will help them improve quality of care, comply with clinical standards and take part in pay for performance initiatives. However, CDS includes a vast range of solutions, many of which are difficult to implement.

Scope

Identifies the key factors driving adoption of CDS Pinpoints common pitfalls in CDS implementation Provides a framework for future CDS solutions

Highlights

The culture of medicine is resistant to CDS CDS tools of the future will be patient-centric and focus on diagnosis Clinical intelligence will change the way medicine is practiced

Reasons to Purchase

Understand where CDS is today and where it will be in 5 years Align product messaging with what will resonate best with healthcare organizations Identify strategies that will increase CDS adoption.

Overview 1
Catalyst 1
Summary 1
Key Messages 2
The culture of medicine is resistant to CDS 2
CDS tools of the future will be patient-centric and focus on diagnosis 2
Clinical intelligence will change the way medicine is practiced 2
Implementation of CDS is difficult and requires an understanding of common pitfalls 3
Table of Contents 4
Table of figures 5
Market Opportunity 6
The next step after EHRs: CDS 6
CDS addresses top of mind healthcare pain points 7
CDS improves care by providing clinicians with the right information at the right time for the right patient 8
Faced with cost pressures, healthcare organizations are looking to CDS to improve efficiencies 9
CDS solutions will have the reporting capabilities needed to take advantage of P4P initiatives 10
The inhibitors to CDS adoption are not easily overcome 10
The culture of medicine shows great resistance to CDS 11
‘Can’t put the cart before the horse’ – without EHRs, the full value of CDS is not realized 12
The upfront costs of implementing CDS are steep for most healthcare organizations 12
Technology Evolution 14
CDS today is varied, though CDS tomorrow will cover an even broader range of solutions 14
The modern healthcare system needs new ways to access traditional reference materials 14
Many healthcare organizations would benefit from outsourcing the development of clinical standards 15
Data mining will allow providers to truly practice evidence-based medicine 15
Tools of the future will be patient-centric and focus on diagnosis 16
Healthcare is picking low hanging fruit now, but will use more advanced tools in the future 17
Applying business intelligence tools to clinical data will create clinical intelligence 18
Customer Impact: Effectively Implementing CDS 21
Despite the fact that it is a well-known pitfall, hospitals are still plagued with alert fatigue 21
The quality of patient data will determine the quality of CI results 21
Interoperability is not just a technology issue 23
Go to Market 24
Recommendations 24
CDS vendors should establish relationships with leading EHR vendors to promote interoperability 24
The vendor and medical communities must come together to create and abide by set standards 24
Technology vendors need to encourage, not follow, their clients by educating the market 25
Vendors must be acutely aware of how they position their products in the market 25
CDS solutions need to continue to mature through input from end users 25
APPENDIX 26
Definitions 26
Methodology 26
Further reading 27
Ask the analyst 27
Consulting 27
Disclaimer 27

List of Figures
Figure 1: The various types of CDS will be implemented in stages 7
Figure 2: The adoption of CDS solutions will increase over time 17
Figure 3: Effectively implementing CDS is often difficult 22

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http://www.aarkstore.com/reports/Clinical-Decision-Support-in-Healthcare-One-step-closer-to-the-Omniscient-Clinician-Strategic-Focus–17034.html
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Special offer till 31th Dec 2009

When considering the family budget and being a good parent, providing quality healthcare at a reasonable price is right up there with the mortgage payment, car payments and college tuition. Consumer driven healthcare is a movement in the United States. Consumer Driven Healthcare relies on a free-market approach to control costs through consumer choice, with employees assuming greater ownership for their healthcare decisions and related finances. Consumer driven healthcare is about changing employee behavior. Consumer driven healthcare is just talk and will fail unless we want to walk the walk. In simple words, the hope for consumer driven healthcare comes from the simple notion that putting responsibility for expenses and decisions back into the hands of the consumer will result in more rational utilization of resources. So while the healthcare debate heats up in Washington, across the state capitals, in corporate boardrooms, on the campaign trail and on TV, some of us folks are trying to make sense of “consumer driven healthcare”.

Consumer-Driven Healthcare also referred to as “CDH”, is a type of health plan that gives members more choice and flexibility in making health benefits decisions and more control over their health benefits dollars. Consumer-driven care will change the way your hospital does business. Consumers will increasingly take on the responsibility of managing their own health benefits, in many cases through individually held health savings accounts that will give them greater freedom to determine when and how they spend their healthcare dollars. Consumer-driven healthcare is defined as a system where consumers, not the employer or insurance provider, determine how and where to spend their healthcare dollars. However, consumer-driven healthcare (CDH) can result in savings and greater flexibility for consumers of all kinds. The merits of various types of consumer-driven programs are being hotly debated, but the reality is that CDHC simultaneously creates both a consumer “movement” as their financial responsibility and involvement in their care choices increase, and a consumer experience.

If healthcare were consumer-driven, “maintenance” prescriptions (medications you need over long periods of time) wouldn’t require complicated pre-authorization forms from your doctor, which are usually rejected the first time around. If healthcare were consumer-driven, basic allergy medications like Zyrtec wouldn’t be so hard to come by, and wouldn’t cost $25 a bottle out-of-pocket. If healthcare were consumer-driven, patients wouldn’t be forced to choose between complex HMO, PPO, and POS plan options that leave a loophole for various “medical groups” to decline responsibility for specific doctor’s office visits or treatments (sticking the befuddled patient with the full bill). “Consumers have choice in every area of their lives, except healthcare,” he stated. Nearly 85 percent of consumers responding to a new survey said that they believed hospitals and doctors should be required to disclose their prices.

Opponents argue that CDH is really just cost shifting from employers to employees and that rather than spending more responsibly, consumers in these types of plans will be more inclined to avoid necessary care.

Consider these options for maximizing your health care discounts: Ask your doctor’s office if they provide a discount for paying cash. Start today and put these easy steps into practice to become a champion of consumerism and proactive consumer of health care. A survey of more than 70 leading health care insurers (representing more than 100 million insured individuals) found that over the next 12 months health care costs are projected to increase by 10. However, consumer-driven healthcare (CDH) can result in savings and greater flexibility for consumers of all kinds. Learn how CDHC will change the way health care is financed and delivered. Understand how CDHC will affect health plans, healthcare providers and pharmaceutical companies.

Shop-Till-You-Drop the debate rages on about how to reform healthcare in America… Meanwhile, what can we do to become more successful consumers? We consumers may not be in the healthcare driver’s seat yet, but we can at least become more vocal back-seat drivers. ” The consumer experience combines the individual’s sense of empowerment, because he has direct input into decisions about his healthcare, with the knowledge and tools he needs to make those decisions.

In my opinion the ultimate goal of CDHC should be to put control of you health decisions back into the hands of the consumer and their healthcare provider of choice, (in other words you and your doctor) not into the hands of the insurance companies and the employer. To get the biggest bang from your buck look at getting a

1. Discount Health Plan,

2. Health Savings Account

3. High Deductible Health Plan

The Discount Health Plan saves you money on the day to day health care expenses. The Health Savings Plan is a savings account where you deposit money for future large medical or other expenses. The High Deductible Insurance Plan will kick in to cover the hospital expenses when something really serious happens such as heart attack, stroke, cancer etc. But and this is a big but, YOU ARE RESPONSIBLE FOR PAYING THE DEDUCTIBLE and that could be up to $5 or $10 thousand dollars or more depending on your plan. This is why you will need the discount plan and the savings plan. If your cash flow is low and you have a really good Discount Health Plan which includes a Patient Advocacy program at no additional cost this is a good start. The Patient Advocacy program will negotiate with the hospital and GREATLY reduce or eliminate your hospital bill when you have one. You can find a really excellent plan for less then $60 a month for an entire household. When you can afford to add the other one or two do so if you desire. You may want to read my other article Healthcare and the Family Budget – What is a Health Savings Account and Do You Need It?

The climbing cost of healthcare has been among the top issues in this year’s elections, and it should be on your list of concerns too, because within the healthcare industry lies an immensely untapped potential for financing that is in dire need of your cash flow expertise. Allow me to explain the situation and then show you where you fit into the healthcare financial equation.

According to the Agency for Healthcare Research and Quality’s Web site, the United States spends a larger portion of its gross domestic product (GDP) on healthcare (nearly one-seventh) than any other major industrialized country, and it has been one of the fastest growing areas within the federal budget for the past several years. In other words, a large portion of all U.S. economic expenditures (14 percent or $1.2 trillion) is spent on providing healthcare to Americans. On the surface, this appears to be a good thing because if more money is budgeted for healthcare, then more people can benefit from it. Yet there’s an underlying irony – an increasing number of healthcare providers continue to operate in the red. In fact, according to the American Hospital Association, one-third of America’s 5,000-plus hospitals are actually losing money, while another one-third is barely breaking even.

So who’s to blame for this financial crisis? Most would assume that healthcare institutions are the ones to blame. It is easy to jump to the conclusion that the institutions are abusing the system and that they are not using their allotted sums appropriately. However, in reality there are a number of culprits on the playing field, and only one of them is healthcare institutions. An aging population, an increasing number of uninsured Americans and slow-paying government aid programs all play a part in cramping the budgets of hospitals, physicians, employers and consumers.

Over the past 50 years, our nation’s population has aged significantly. The Baby Boomers are quickly approaching their 65th birthdays, which will place them in the oldest adult segment of the American population. (In fact, the U.S. Census Bureau projects that over 20 percent of the American population will be included in the oldest segment by 2050). According to The 2003 Chartbook on Trends in the Health of Americans, the surge in elderly adults will place tremendous stress on America’s healthcare system during the 21st century, because additional services will be necessary to treat and manage their chronic and acute health conditions. Not to mention there will be over 40 million retired elderly adults depending solely on Medicare to cover their medical bills next year, a problem that I will delve into later in the article.

In addition to the ‘baby boom’ generation getting older, our younger generation has received the short end of the stick when it comes to healthcare coverage. Medicaid usage and the percent of uninsured Americans has been on the rise since 1984. The 2003 Chartbook on Trends in the Health of Americans reported that in 2001, adults aged 18-24 were most likely to lack health insurance coverage (16 percent went without for the year) and those 55-64 were least likely. In addition, the Denver Post reported that the number of uninsured young adults aged 25-34 “jumped dramatically” during 2003, from 9.8 million to 10.3 million. Rising health insurance premiums and overall poverty rates have both contributed to the 45 million Americans who went uninsured last year, as reported by The New York Times.

For example, expensive healthcare premiums make it harder for employers to afford coverage for their employees, creating an uninsured working class. According to the Washington Post, the proportion of the working class who received health insurance through their employers fell to 60.4 percent in 2003, (down from 61.3 percent in 2002,) the lowest level in a decade. Within that uninsured working class, 20.6 million people were full-time employees. Add in the fact that emergency rooms are obligated to care for any patient that comes through their doors, regardless of whether they have insurance or not, and what do you get? Answer: Millions of uninsured people who visit the emergency room to receive medical attention and who also rely on the hospital to foot the bill.

To make matters worse, the U.S Census Bureau reports that poverty rates have been steadily increasing over the past few years (12.3 percent in 2002, translating to 34.6 million people, see figure 1), forcing a majority of the less fortunate population to either go uninsured or rely on Medicaid to pay their medical bills. Neither option is a promising solution to the healthcare cash crunch equation because the facilities cannot count on being recompensed directly and adequately for their obligated medical actions.
Hence, the increase in uninsured Americans and those who rely solely on Medicaid and Medicare has had a tremendous affect on the United States’ healthcare institutions.

Title XIX of the Social Security Act, commonly known as the Medicaid program, is the largest source of funding for medical and health-related services for America’s poorest people. However, since its launch in 1965, Medicaid’s costs have rapidly increased, paying an average of $3,935 per person to healthcare vendors in 2000, as reported by The Official U.S. Government Site for People with Medicare (www.medicare.gov). On the other hand, the Medicare program was created in 1965 under title XVIII of the Social Security Act. Designed to provide basic hospital and medical coverage for adults aged 65 and above who are no longer working and therefore are unable to pay for healthcare, Medicare’s costs has also increased rapidly, and it currently covers 41 million Americans.

Although Medicaid and Medicare programs can be beneficial for underprivileged and elderly Americans in need of healthcare, American medical institutions and their vendors don’t fare quite as well in this cash crunch equation due to sluggish and inadequate payments from the above federal programs.

Because each state has its own unique way of filing for government healthcare coverage and because of capped expense amounts, federal insurance plans like Medicaid and Medicare make their payments slowly, sometimes taking months to deliver funds and in many cases, the government-mandated payments don’t cover the actual cost of providing care. Accordingly, healthcare institutions such as hospitals and nursing homes take a longer time to pay their own invoices. As a result of their inadequate financial resources, these hospitals and nursing homes suffer from dwindling human and technological resources. So in an effort to save money, facilities are forced to make cuts in staffing and special treatment programs, pass on costly technological advances and start outsourcing more general positions, which creates a whole new world of vendors who sell to hospitals and nursing homes. (Think: janitorial services, cafeteria workers, temporary nurse staffing agencies, medical staffing and medical transcriptionists, to name a few.)

Healthcare institutions need money to help patients, increase technology and pay their vendors. But because it sometimes takes months for hospitals and nursing homes to be paid for their services, they are forced to take additional months to pay their own vendors for their services. In the meantime, those vendors suffer because they can’t make payroll or pay taxes. So they reach out to healthcare factoring consultants to help them find a way to stabilize their cash flow.

The Internet is a wealthy source of information and if you’re
looking for healthcare information, the Internet can be a
resourceful vehicle for you to find reliable and trustworthy
guides and advice on healthcare products and supplies. It all
depends on how you find the information and who is dispensing
the healthcare information.

If used properly, the Internet allows us to find healthcare
information quickly and easily. Many website owners provide free
healthcare information on a wide range of topics like diseases,
health conditions, therapies, medical products and symptoms of
diseases, etc. Lists of healthcare providers and healthcare
institutions can also be found online, if you go to the right
website.

Some people contend that the healthcare information provided by
website owners is not reliable. This is true, to a certain
extent. The healthcare information found online can NEVER be
relied upon fully and the healthcare information printed out
from websites cannot replace professional advice that your
doctor or healthcare practitioner can give you. But the
healthcare information found online can be used as a basis for
your visits to your doctor. For instance, browsing through the
healthcare information online prior to your visit to the doctor,
you’re better prepared with information and questions that you
might want to ask your doctor during the visit.

It’s either very difficult to verify, or almost impossible to
verify the source of the healthcare information or advice
available online. This is where reliability is in question. But
most professional healthcare advice websites will give you the
source of the advice, and with this, you can easily verify the
source of the healthcare information.

One thing is for sure, consumers have to be extra careful about
buying pharmaceutical products or medicines online. In fact, the
act is dangerous enough for certain governments to consider
making buying medication and healthcare supplies online illegal,
unless you’ve got the ‘green light’ from your doctor and can
prove that your doctor’s permission or prescription allows it.
Even then, there’s a huge question mark hanging over our heads.

The fastest way to finding healthcare information online is
through a search engine, of course. But the problem is that
there’s no guarantee that the information you can find through
the website is reliable or professional enough. You can ask your
doctor or pharmacist for URLs of websites that they often visit.
As medical practitioners, they won’t recommend healthcare
websites if they don’t trust the information that is in the
healthcare portal.

If your doctor is not Internet savvy and has no healthcare
portal to recommend, you should ask around among your friends,
relatives or colleagues to see if they can recommend a good
healthcare portal.

Once you’re there, a good healthcare portal should have a list
of their panel doctors listed. This way, you’ll know that
whatever healthcare information that they disperse in the
website is approved by a professional healthcare provider.

Dakota Caudilla, journalist, and website builder Dakota Caudilla
lives in Texas. He is the owner and co-editor of
http://www.wise-healthcare.com on which you will find a longer,
more detailed version of this article.