Summarize 3 different reimbursement methods that are used by health care providers and organizations

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Proposal for an Ambulatory Care Facility to Meet Evolving Healthcare Needs in the United States

Proposal for an Ambulatory Care Facility to Meet Evolving Healthcare Needs in the United States

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The provision of healthcare in the United States is at the point of transformational change. It has shifted from the traditional inpatient services as customers' expectations change, technologies emerge, and global recession takes effect. This change is driven by the increased use of precautionary services, capturing costs, and patient-friendly technologies, which ambulatory care units handle effectively. This analysis is likely a result of the growing preference for ambulatory care facilities as people shun hospital stays for as long as possible. The proposal of establishing an ambulatory care setting is expounded on, with the justification of choice based on current health care needs, an overview of service delivery, staffing patterns, and advantages.

Facility Type and Rationale

This is because the recommended healthcare facility is an ambulatory care center, where patients obtain necessary treatment without being admitted for an overnight hospital stay. These services can be rendered in one day or within a short period and are cost-effective; patients will not be exposed to the hospitals for many days, improving satisfaction. This facility type has increasingly transformed as provider institutions seek to lessen the expense implications for the health delivery system or the individual patient.

Another flexibility ambulatory care centers offer is that the health system can easily control resources and focus more on serious inpatient issues while dealing with outpatient requirements in a separate hall. In this capacity, providing essential healthcare services such as annual physical exams, mammograms or dental checkups, habit formers or minor surgeries, and diagnostic tests shall accommodate the various patient segments seeking convenient, quality, and cheaper healthcare services. Moreover, as Askin and Moore (2022) have found, ambulatory care facilities also contribute to the diminution of the pressure on patients' and insurers' wallets and emphasize the efficiency of avoiding uncalled-for inpatient care and using preventive care instead. This model complements the new trends in US healthcare policy that have embraced value-based care. This care delivery model emphasizes using available resources to deliver optimum care to the patient at the least cost possible.

Advanced and Basic, Primary, Secondary and Tertiary Healthcare and Services Offered

The proposed ACF will operate from a patient-centered and team-based healthcare delivery system. It will offer early health promotion, screening services, minor procedures such as skin lesion excisions and minor injuries, and specialist referrals. Nine will be spent on screenings, vaccines, and wellness counseling by the national goals of primary and secondary prevention of chronic diseases. Diagnostic services shall be limited to radiology, which involves imaging and other laboratory tests, such as blood tests and screening, that are vital in diagnosing ailments at certain stages in the human body. Outpatient surgery will cover operations that can be done under local anesthesia and do not necessitate hospitalization, for instance, dermatological operations or endoscopic operations.

This facility also had key features: telemedicine, a vital method of offering consultations and follow-ups through computer program interfaces. Apart from improving access for patients in remote or underserved areas, this feature also removes those patients who do not necessarily need to be physically present to benefit from healthcare services. Telemedicine will mean that patients can easily book appointments and wait for shorter periods. In contrast, the capacity for the facility to provide services to more patients is possible without overstretching physical infrastructure. With a comprehensive but narrow specialization of services to be delivered, the facility will address the most frequently encountered healthcare issues in a versatile, client-oriented model of preventive healthcare delivery (Cole et al.,2022).

Staffing Requirement and Demand

In an ideal ambulatory care setting, one has a diverse staff that would help deliver quality healthcare services across the department. The facility will require the services of several medical personnel, such as contractual primary care physicians, nurse practitioners, registered nurses, medical assistants, radiology or laboratory technicians, and the administrative workforce. Both positions are critical to the smooth operation of the practice and ensuring that patients are seen and treated appropriately.

Specialists will primarily conduct outpatient consultations and screening exams; primary care physicians and nurse practitioners will also play key, active roles throughout the screening and diagnosis process. Because of the superior education of NPs, they can practice independently for both acute and chronic conditions with a capacity to supplement the roles of physicians and significantly improve access for patients to care. Registered nursing staff and medical assistants will provide first forms, monitor students' health status, support during some simple procedures, and morbidity surveys. These roles are crucial to patient satisfaction and service delivery since they break down the economic processes and improve quality patient care (Clarke et al.,2017).

Specific employees like radiographers and laboratory officers will take and develop radiology and lab work to get valuable results for diagnosing and managing patients. Radiology technicians will operate X-ray and ultrasound machines, and a laboratory technician will perform and interpret blood tests and perform other basic investigations. Lastly, administrative staff will be responsible for appointment fixing for the patients, billing, and insurance repudiation, which are very important for the center's clinic and the patient. All actors within the clinical workforce will be licensed accordingly to practice in the state to meet the legal requirements.

Health care practitioners in the state where the facility is to be established must possess a degree of Doctor of Medicine (MD) or Doctor of Osteopathy (DO), a completion of residency, and a valid medical license in the state. Practice requirements that must be met include:

Possessing a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP).

Passing the certification examination.

Acquiring an APRN license in the state.

Registered nurses would have at least an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) and are expected to write the NCLEX-RN exam to get a license. This type of credentialing policy assures that all staff members can deliver quality patient care as provided by laws in the region.

Conclusion

The completion of an ambulatory care facility responds to the new characteristics of the US health services delivery system, outpatient services that are accessible, efficient, and focused on the patient's needs by present trends of change. By providing this broad scope of services, focusing on primary prevention, and implementing the telemedicine concept, this facility can adequately respond to the health needs of the populace. Its structural staffing involves manners that can help ensure service delivery is performed by professional staff with valid licenses who are educated and trained to advance the facility's goals in supporting the patients (Yu et al.,2017).

The proposed concept of the ambulatory care center is designed with the dynamic future patient specifications and preferences, technology advancement, and the healthcare industry's policy changes in mind. This facility will enhance general access to adequate healthcare by investing heavily in outpatient sessions and many others that would help promote health and disease prevention, promoting society's health standards.

References

Askin, E. T., & Moore, N. (2022). The health care handbook: a clear and concise guide to the United States health care system. Lippincott Williams & Wilkins.

Clarke, J. L., Bourn, S., Skoufalos, A., Beck, E. H., & Castillo, D. J. (2017). An innovative approach to health care delivery for patients with chronic conditions. Population health management, 20(1), 23-30.

Cole, C. L., Cheriff, A. D., Gossey, J. T., Malhotra, S., & Stein, D. M. (2022). Ambulatory Systems: Electronic Health Records. In Health Informatics (pp. 61-94). Productivity Press.

Yu, S. W., Hill, C., Ricks, M. L., Bennet, J., & Oriol, N. E. (2017). The scope and impact of mobile health clinics in the United States: a literature review. International journal for equity in health, 16, 1-12.

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