Assignment Sample on 7069SOH Healthcare Organisations
Population based funding model
“Primary Healthcare” (PHC) are groups that provide healthcare facilities to Australian citizens. Hybrid organisations were observed to incorporate both public and private sector practices (Liaw et al. 2017). PHC in Australia is fragmented and performed by community healthcare centres and allied healthcare personnel. Preventive healthcare activities such as “health promotion”, chronic disease management and treatment of diseases are some of the activities performed by the PHC. To perform these activities the funding is received from different levels of government and other sources. Medicare and Australia’s national public health scheme were the federal funding for PHC (Plueckhahn et al. 2017). The overall funding could be segmented into two models and “Population-based funding” is one of the two variants in practice.
A “population-based” model focuses on block funding to fulfil the healthcare needs of Australian population. The payments are made by citizens in a periodic manner and in lump sum amount to the assessors. However this model is not primarily practiced in Australia as many Aboriginal healthcare facilities are funded by this structure. The components of the Medicare provided to communities include the “Medical Benefits Scheme” (Scott et al. 2020). The scheme primarily covers the funding needed for visiting general practitioners and some prescribed pharmaceutical drugs through the “Pharmaceutical Benefits Scheme”. In addition to the Federal funding, both state and territory initiatives promote PHC services like Community and Preventive health services. Private “health and workers insurers” and non-government sources of funding further nourish the PHC services. Accordingly the healthcare initiative is capable of paying expenses for the healthcare services of Australian communities. The population based funding model is a tool that divides the health board funding according to the needs of targeted population. It is also a mechanism for compensating District boards that serve rural communities and deprived areas of Australia.
The model is particularly appreciated as funding are aligned according to the clinical outcomes. Such a kind of model can reduce the cost allocated for individual patients or any group of patients (Raman et al. 2018). As a specific medical outcome is decided at the beginning of the initiative and costs are aligned according to it. The process is monitored to prevent any scope of unneeded interventions and an overall efficiency in the service is maintained. Saving the capital by utilisation of such a healthcare model could preserve the capital to serve a larger community in future. The model further highlights the aspect that non-physicians could also provide care to communities. The employees are constantly involved in a funded practice and the experience is necessary to cater patients. An opportunity to reduce the cost structure is further generated through this model.
A number of challenges arose while developing healthcare services based on this model. The funders possess direct control over the capital of PHC and could lead to under provision of services to reduce workload, operational costs. The model primarily focuses on a cost effective approach towards healthcare and pays very little attention to needs of patients. Another issue with this model is that it involves an excessive number of referrals to secondary providers. Accordingly the model was restricted to community health care services and “Inala Primary Care” is an example of such a facility.
Patient-focused funding (fee for service)
Patient-focused funding was developed on an activity based model that utilises incentives and support mechanisms. The primary focus of this model is to improve quality and efficiency of PHC healthcare services catered to Australian citizens (Alison et al. 2017). Most of the healthcare facilities utilise this model of funding and involves billing the funder, patient for every service that is provided. Payment for the service would depend on the cost of delivering a particular kind of healthcare. “Service-incentive payment”, “practice incentive payment” and management of chronic diseases are some of the services catered through Patient-focused funding.
The primary funding model for PHC emphasises on volume rather than catering a comprehensive healthcare service to patients. As a result it is often identified as a poor model for delivering health outcomes efficiently and improving the quality of service. Financial incentives serve as a main source of funding for improvements in PHC practices. Little improvement in terms of healthcare service quality is observed while utilising this model. However the model implements a “fee for service” policy and patients get to pay for healthcare services they require. Incentives further help to reduce the cost of performing the healthcare services on Australian patients.
It was already discussed that “financial incentives” serve as primary funding for incorporating changes. These incentives are incorporated in payment systems and develop a funding structure for healthcare facilities. Patients get access to a relatively better quality of healthcare and productivity once they are able to pay for their services. It is evident that a difference in quality of healthcare service is attained. Patients with better sources of funding can get access to premium quality service and the amount of incentives being paid by the funders is relatively low. Healthcare being provided by this model can be fragmented as quality of service would primarily depend on the fee (Lorio et al. 2019). Visiting hours for the patients under the influence of such a model could be reduced as a sense of professionalism is maintained in these facilities. Another issue with this model is that it focuses on delivering rewards instead of improving the overall quality of service. Majority of the PHC facilities utilise this model through “MBS” and “out-of-pocket expenses”.
Stakeholder engagement is promoted through a Patient-focused funding model. It eventually promotes a cost effective approach towards healthcare services. The cost of operations is reduced as fewer process delays are observed due to this model. Staff and material resources are less wasted as inventory management is improved through this approach. Patients are only concerned about the type and cost of healthcare service they need. Additional expenses are not charged and customers possess the authority to review a billing for any discrepancies. The burden on PHC services to pay high incentives for patients is reduced by incorporating this model. Besides that the educational efforts of patients are maximised as they gain full awareness regarding the disease and its cure.
References
Plueckhahn, T. M., Kinner, S. A., Sutherland, G., & Butler, T. G. (2017). Are some more equal than others? Challenging the basis for prisoners’ exclusion from Medicare. Medical Journal of Australia, 203(9), 359-361.Retrieved on 19 June 2021, from:https://core.ac.uk/download/pdf/159508523.pdf
Nissen, L., & Kyle, G. (2010). Non-medical prescribing in Australia. Australian Prescriber: an independent review, 33(6), 166-167.Retrieved on 21 June 2021, from:https://onlinelibrary.wiley.com/doi/pdfdirect/10.5694/mja2.50544
Raman, S. R., Man, K. K., Bahmanyar, S., Berard, A., Bilder, S., Boukhris, T., … & Wong, I. C. (2018). Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases. The Lancet Psychiatry, 5(10), 824-835.Retrieved on 19 June 2021, from:https://discovery.ucl.ac./id/eprint/10058682/3/Raman_Man_ADHD_medication_20180713.pdf
Alison, J. A., McKeough, Z. J., Johnston, K., McNamara, R. J., Spencer, L. M., Jenkins, S. C., … & Lung Foundation Australia and the Thoracic Society of Australia and New Zealand. (2017). Australian and N ew Z ealand P ulmonary R ehabilitation G uidelines. Respirology, 22(4), 800-819.Retrieved on 20 June 2021, from:https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/resp.13025
Iorio, A., Stonebraker, J. S., Chambost, H., Makris, M., Coffin, D., Herr, C., & Germini, F. (2019). Establishing the prevalence and prevalence at birth of hemophilia in males: a meta-analytic approach using national registries. Annals of internal medicine, 171(8), 540-546.Retrieved on 20 June 2021, rom:https://www.researchgate.net/profile/Jeff_Stonebraker/publication/33572537
Know more about UniqueSubmission’s other writing services:
