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What Is Health Care

    In todays time, health care has become about all aspects, services, and devices that go into taking care of you. The larger landscape of health care includes all of the goods, services, and payment mechanisms to attain and sustain ones health. Healthcare is concerned, directly and indirectly, with providing healthcare services to individuals.

    These services may take place in various working environments, including hospitals, clinics, dentist offices, office-based surgical centers, birthing centers, urgent care, home health, and assisted living facilities. Depending on a patients situation, the care may range from supervised nursing to specialty health services, such as lab workups. Depending on the nature of their medical condition, patients may be referred for secondary or tertiary care.

    Depending on the organization and policies of a nations health care system, patients may need to visit their primary care provider to obtain a referral before accessing secondary care. In countries operating with mixed-market health systems, some physicians confine their practices to primary care, requiring patients to first visit a primary care provider. In other countries, patients refer themselves to medical specialists for secondary care less frequently, because a prior referral by another doctor, whether primary care physician or other specialty, is considered essential, whether the financing is through a private insurance plan or national health insurance. Yet, the reality is that the vast majority of providers (and insurance companies) do not keep records on both outcomes or costs for the medical conditions of individual patients.

    Overuse of care, or providing care with lower value or without value, has been consistently identified as contributing to higher costs in the U.S. health care system.1-3 Overuse of care is physically, psychologically, and financially detrimental for patients.4-6 Some interventions aimed at encouraging high-value care and restricting low-value care are implemented at the national level, such as the national insurance benefit determinations in the Medicare program7 or bundled payment models.8-10 Other interventions are delivered at the local level, in the practice unit, and are implemented via practice change initiatives.

    For example, the landmark Affordable Care Act increased funding to Federally Qualified Health Centers, which deliver primary and preventive care to more than 27 million low-income patients, regardless of ability to pay. If initiatives undertaken by the Center for Medicare & Medicaid Innovation are certified by federal actuaries to increase quality at the same cost–or to preserve quality while reducing healthcare costs–the U.S. secretary of Health and Human Services has authority to expand those initiatives, without Congressional approval, across its CHIP and Medicaid programs. By providing a wide array of services that help Texans stay healthy, Texas health care providers are not just making sure that those eligible are receiving direct services, they are helping improve overall health outcomes for all Texans. Aging and Disability Resource Centers help Texans find personal care, nursing, in-home assistance, and other long-term services.

    They also include services from professionals in residences and in community settings to support self-care, home health, long-term care, assisted living, substance use disorders, and other types of health care and social services. Most services are provided through providers called managed care organizations. Medical and paramedical services provided to patients formally admitted for diagnosis, treatment, or another type of medical care, with intent of having patients leave on the same day.

    All persons who have completed the Basic Nursing Education Program and are competent and registered or licensed to deliver responsible, competent services to promote health, prevent disease, treat illness, and restore rehabilitation, and are physically working within the State. A licensed medical professional, licensed medical professional, licensed professional, or professional, as used in this Handbook, is defined as a person licensed or otherwise authorized by the State to provide medical services; or any individual who, without authority, purports to be such licensed or authorized. We define a primary care medical home as one based on the Patient-Centered Medical Home X Principles of Collaboration, and has adopted five core functions from the Comprehensive Primary Care Plus (CPC+) Initiative, which established a health practice providing comprehensive care and partnership between patients and their primary care physicians and other members of a health care team, and a payment system that acknowledges the integrated work of providing primary care, and that establishes a payment system that acknowledges the integrated work of providing primary care.

    A pluralistic approach to health care system financing, organization, and delivery is designed to obtain accessible health care coverage involving competition on quality, cost, and services. In the field of health care, an overall objective for providers, and indeed all other stakeholders, should be the improvement in the value of health care for patients, with value defined as health outcomes achieved that are important to patients compared with the costs to obtain these outcomes. Transparency–An increased investment in primary care and in medical homes allows health plans not only to lower costs of treating high-risk patients, but also to improve quality of care.xi This increased investment must be supported by an aggressive push for pricing transparency across health services. As noted by the Commonwealth Fund, designing a system that provides health coverage to all individuals would have profound implications for its ability to achieve sustained, systemic improvements in access to care, equity, quality of care, efficiency, and cost control.

    We need to replace the current piecemeal system, where each local provider offers the entire spectrum of services, with one where services for specific health conditions are concentrated within the delivery organizations and at locations that are well-placed for the highest-value care. By providing in-community and through-community care, PHC addresses not just the individual and family health needs, but the larger issues of public health and needs for defined populations.

    At the Geisinger Health System, for instance, in Pennsylvania, caring for patients with chronic conditions like diabetes and heart disease involves not just physicians and other physicians, but also pharmacists, who are principally responsible for monitoring and adjusting medications. Ambulatory-care services are provided in a variety of settings, ranging from doctors offices to stand-alone outpatient surgery facilities or cardiac catheterization centers. Nursing care can include wound dressings, ostomy care, IV treatment, administration of medications, monitoring the patients overall health, pain management, and other support services. Health systems balance fiscal interests in making decisions regarding strategic consolidations or new service lines, follow state and federal regulations, and strive to provide high-quality care and achieve positive patient outcomes.

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