1. Trends in Health Care Where are we going?????

2. Cost containment  Reasons for High Health Care Costs

3. Cost Containment  Cost Containment means trying to control the rising cost of health care and maximizing every dollar spentmeans trying to control the rising cost of health care and maximizing every dollar spent

4. Cost Containment  Reasons for High Health Care Costs  Technological advances heart, lung, kidney, and liver transplantsheart, lung, kidney, and liver transplants artificial heartsartificial hearts Computers & equipment to examine internal body partsComputers & equipment to examine internal body parts

6. Cost containment  Reasons for High Health Care Costs  Technological advances

7. Cost containment  Reasons for High Health Care Costs  Aging population people are surviving illnesses that used to be fatal, and are then requiring expensive and life long care…people are surviving illnesses that used to be fatal, and are then requiring expensive and life long care… increased use of pharmaceutical agents, more chronic diseases, need frequent health care servicesincreased use of pharmaceutical agents, more chronic diseases, need frequent health care services

9. Cost containment  Reasons for High Health Care Costs  Health-related lawsuits Malpractice insurance is expensive!Malpractice insurance is expensive! Doctors order diagnostic tests even though they might not be necessaryDoctors order diagnostic tests even though they might not be necessary Doctors make every effort to avoid lawsuits by practicing “defensive” medicineDoctors make every effort to avoid lawsuits by practicing “defensive” medicine

10. Methods of cost containment  Diagnostic related groups (DRG) Payment is for the disease, not the treatmentPayment is for the disease, not the treatment Attempts by Congress to control costs for Medicare and MedicaidAttempts by Congress to control costs for Medicare and Medicaid Payment is based on diagnosisPayment is based on diagnosis Certain amount paid for each disease conditionCertain amount paid for each disease condition Agencies providing care for less can KEEP the extra moneyAgencies providing care for less can KEEP the extra money Agencies accept loss if care costs more than payment allowed.Agencies accept loss if care costs more than payment allowed.

11. Methods of cost containment  Combination of services Health care agencies share servicesHealth care agencies share services Care can be provided to a larger number of people at a decrease in cost per personCare can be provided to a larger number of people at a decrease in cost per person Example??Example??  Lab Corp

12. Methods of cost containment  Out Patient Services Patients receive care without being admitted to hospitals or other care facilitiesPatients receive care without being admitted to hospitals or other care facilities Hospital care is EXPENSIVEHospital care is EXPENSIVE Reducing the length of stay or decreasing the need for hospital admission lowers the cost.Reducing the length of stay or decreasing the need for hospital admission lowers the cost. Example: Open heart surgery patients used to spend several weeks in the hospital and now stay on average 5-7 daysExample: Open heart surgery patients used to spend several weeks in the hospital and now stay on average 5-7 days Less expensive home care or transfer to a skilled care facility is used for those who require additional assistanceLess expensive home care or transfer to a skilled care facility is used for those who require additional assistance Examples of outpatient services are surgery, x-rays, diagnostic testsExamples of outpatient services are surgery, x-rays, diagnostic tests

13. Methods of cost containment  Mass/Bulk Purchasing Buying equipment and supplies in larger quantities at reduced prices- Ex: Sam’s ClubBuying equipment and supplies in larger quantities at reduced prices- Ex: Sam’s Club Combine purchases of different departments in an agencyCombine purchases of different departments in an agency Combine purchases of several different agenciesCombine purchases of several different agencies Major health care system purchasing medical supplies for hundreds or thousands of health care agencies can obtain much lower prices than an individual agencyMajor health care system purchasing medical supplies for hundreds or thousands of health care agencies can obtain much lower prices than an individual agency Computerized inventory can be used to determine when supplies are needed and to prevent overstock and waste.Computerized inventory can be used to determine when supplies are needed and to prevent overstock and waste.

14. Methods of cost containment  Early intervention and preventive services Providing care before acute or chronic illness occursProviding care before acute or chronic illness occurs Preventing illness is ALWAYS cheaper than treating illnessPreventing illness is ALWAYS cheaper than treating illness Methods to prevent illness includeMethods to prevent illness include  Patient education  Immunizations  Regular physical examinations to detect problems early  Easy access for all individuals to preventive health care services  People with limited access to health services and restricted finances use expensive emergency rooms and acute care facilities much more frequently  Providing early intervention and care to these individuals is much more cost effective.

15. Methods of cost containment  Energy Conservation Monitoring the use of energy to control costs and conserve resourcesMonitoring the use of energy to control costs and conserve resources Major expenses for every health care industry/agency are electricity, water, and/or gasMajor expenses for every health care industry/agency are electricity, water, and/or gas Most large health care facilities perform energy audits to determine how resources are being used and to calculate ways to conserve energyMost large health care facilities perform energy audits to determine how resources are being used and to calculate ways to conserve energy Methods used include designing and building new energy efficient facilities, constantly monitoring and maintaining heating/cooling systems, using insulation and thermopane windows to prevent hot/cool air loss, repairing plumbing fixtures immediately to stop water loss, replacing energy consuming light bulbs with fluorescent or energy efficient bulbs, installing infrared sensors to turn water faucets on and off, and using alternative forms of energy such as solar power.Methods used include designing and building new energy efficient facilities, constantly monitoring and maintaining heating/cooling systems, using insulation and thermopane windows to prevent hot/cool air loss, repairing plumbing fixtures immediately to stop water loss, replacing energy consuming light bulbs with fluorescent or energy efficient bulbs, installing infrared sensors to turn water faucets on and off, and using alternative forms of energy such as solar power. Recycling is a form of energy conservation and most health care facilities recycle many different materials.Recycling is a form of energy conservation and most health care facilities recycle many different materials.

16. Home Health Care  Rapidly growing Field due to shorter hospital stays DRG’s result in shorter hospital stays so patients need care at homeDRG’s result in shorter hospital stays so patients need care at home Home Health Care is less expensive to provide and can include:Home Health Care is less expensive to provide and can include:  Nursing care  Physical and occupational therapy  Respiratory therapy  Social services  Nutritional and food services  Homemaking services  Hospice-care for the terminally ill

17. Geriatric care “ Care of the elderly ” 1. Types of facilities 1.Long Term Care 2.Extended Care Facility 3.Geriatric Care 4.Adult Daycare 2. Omnibus Budget Reconciliation Act (OBRA) 1.Requires certification for Health Care Providers caring for Elderly 2.Pt/Residents Bill of Rights

18. Telemedicine  Uses video, audio, and computer systems to provide medical and or health care services  New technology allows interactive services between health care providers even though they are in different locations EMT’s providing care to a heart attack victim use technology to transmit medical data such as an EKG to the emergency room physician who can monitor the data and direct the care of the patient.EMT’s providing care to a heart attack victim use technology to transmit medical data such as an EKG to the emergency room physician who can monitor the data and direct the care of the patient. Surgeons using a computer can guide a remote- controlled (robotic) arm to perform surgery on a patient miles awaySurgeons using a computer can guide a remote- controlled (robotic) arm to perform surgery on a patient miles away A surgeon can direct the work of another surgeon by watching the procedure on video beamed by a satellite system.A surgeon can direct the work of another surgeon by watching the procedure on video beamed by a satellite system.

19. Telemedicine  As consumers become more computer literate, more health care services will be provided electronically.  Telemedicine machines, operating over telephone lines, are “user friendly”, compact, and less expensive than when they were developed.  People with chronic illnesses or disabilities can receive care in the comfort of their homes: Decreases the need for trips to medical care facilitiesDecreases the need for trips to medical care facilities Can test blood sugar levels, oxygen levels, blood pressure measurements, and other vital signs, transmitting results to nurse or physician.Can test blood sugar levels, oxygen levels, blood pressure measurements, and other vital signs, transmitting results to nurse or physician. Can use online courses to learn to manage illnessCan use online courses to learn to manage illness Can schedule an “appointment” and talk “face to face” with health care provider using video conferencingCan schedule an “appointment” and talk “face to face” with health care provider using video conferencing Electronic reminders to take medicine or perform diagnostic testsElectronic reminders to take medicine or perform diagnostic tests Receive answers to health related questionsReceive answers to health related questions Provides access to specialists thousands of miles away.Provides access to specialists thousands of miles away.

20. Wellness “ The state of being of optimal health”  Physical wellness  Emotional wellness  Social wellness  Mental and intellectual wellness  Spiritual Wellness  Holistic Health  People are more aware of the need to maintain health and prevent disease.  Improves quality of life  Saves MONEY  Recognize the importance of:  Exercise, good nutrition, weight control, and healthy living habits!  Development of wellness centers, weight loss centers, health food stores, nutrition services, stress reduction counseling, and habit cessation management

21. Alternative and Complementary Methods of Health Care  Most common Heath care system in the US is the “Western” system  Current trend in US is an increasing use of the following: Alternative –methods of treatment used in place of biomedical therapiesAlternative –methods of treatment used in place of biomedical therapies Complementary- methods of treatment used along with conventional medicineComplementary- methods of treatment used along with conventional medicine Holistic Care-Caring for the whole personHolistic Care-Caring for the whole person

22. Alternative and Complementary Methods of Health Care  Ayurvedic practitioners Developed in IndiaDeveloped in India Looks at body type (Dosha)Looks at body type (Dosha)

23. Alternative and Complementary Methods of Health Care  Chinese Medicine Practitioners Believe in holistic careBelieve in holistic care Chi or energy flow effects wellnessChi or energy flow effects wellness

24. Alternative and Complementary Methods of Health Care  Chiropractors Believe that the spine and nerves must be in alignment for the body to function properlyBelieve that the spine and nerves must be in alignment for the body to function properly

25. Alternative and Complementary Methods of Health Care  Homeopaths Believe that the body can heal itself though the immune systemBelieve that the body can heal itself though the immune system

26. Alternative and Complementary Methods of Health Care  Hypnotists Believe that in a trance like state the body can promote healing and changes in behaviorBelieve that in a trance like state the body can promote healing and changes in behavior

27. Alternative and Complementary Methods of Health Care   Naturopaths Believe in using only “natural” therapies, like fasting, special diets, herbs, etc NC LIVE Video CollectionNC LIVE Video CollectionNC LIVE Video CollectionNC LIVE Video Collection http://media.nclive.or g/authvid.phtml?vid= 71&ctime=16http://media.nclive.or g/authvid.phtml?vid= 71&ctime=16http://media.nclive.or g/authvid.phtml?vid= 71&ctime=16http://media.nclive.or g/authvid.phtml?vid= 71&ctime=16