The health care system in the US is rapidly changing, which makes it necessary for all entities involved to be aware of the factors influencing the health system change, and their impact. This section examines the evolving and imperfect market as one of the drivers of change, and its impact in the future of patients, providers, payers, and insurers.
A few decades ago, the amount spent on servicing insurance payments was influenced by technology, demographics, physician and hospital supply and the decision making process. However, there are new influencers in this age that include the role of price rivalry, purchasing power of buyers, drive for market share, and new role of employers among others.
Studies show that the future will involve price-driven purchasing by employers or providers to dominate the health care system. One of the implications is proper information for employers, which will provide a better platform for purchasing health care. The other implication involves pragmatism, which may result in new purchasing arrangements for employers (Zelman, 1996).
On the side of the payers and insurers, the health plan market will continue to impact the future considerably. This can be seen from the enormous market for Medicare, which is a vital component for managed care.
Changes in the payers will include services for private health plans, and wider networks, leading to rivalry among Medicare enrollees. This is also likely to lead to new legislation on consumer protection. Additionally, competition among health plans will lead to enhanced measures and disease management technologies; hence, improved health status (Etheredge, Jones, & Lewin, 1996).
As for the patients or consumers, the primary influences will involve the rapid changes in Medicare enrollees who get into managed care plans. These plans increase the savings of consumers by up to $1000, compared with traditional Medicare.
The new plans also have better benefits and less paperwork than previous plans. The process will also be attractive to consumers due to better assistance activities from both the public and private health care faculties. There will also be enhanced information for patients regarding health plans, providers and treatments, which will assist in moving the broader consumer market along (Etheredge, Jones, & Lewin, 1996).
Emergency medical care varies from other forms of medical care since the practitioners have minimal interaction with the patients, which implies that they have no pre-existing relationships with them.
They have limited knowledge on the patients, and usually rely on electronic medical records to familiarize themselves with the patient’s medical history. This section examines the concept of co-ordination among various entities in disaster and emergency preparedness (Serafini, 1995).
One of the elements of co-ordination involves co-opetition, which is a term coined from the cooperation of competitors in order to attain a common aim. Under such circumstances, shared success can be in the form of distributing the non-profitable elements of the business in order to maximize on gains.
These coalitions enhance preparedness, response, recovery and mitigation activities in support of National Response framework, and Emergency support (KPMG Peat Marwick, 1995).
Efficiency of the system requires commitment and coordination among all stakeholders including multiple levels of government, medical and public health communities, local and regional EMS resources, and citizens. The process also promotes redundancy and communication of interoperable systems between hospitals, Emergency medical services (EMS) and public health agencies.
Other areas that are impacted include pre-hospital care systems, inpatient care systems, and specialty care programs. The basic precept of emergency care holds that an “efficient and effective health care delivery system that provides equitable access to efficient routine and emergent care will be better able to support a successful surge response to major public health and medical incidents” (ASPR, 2009).
ASPR. (2009). Emergency Care Coordinating Center: Strategic Plan FY 2012. Journal of Disaster Medicine and Public Health Preparedness, 2-11.
Etheredge, L., Jones, S. B., & Lewin, L. (1996). What is driving health system change? Health Affairs, 15(4), 93-104.
KPMG Peat Marwick. (1995). Health Benefits in 1995. Washington: KPMG Peat Marwick.
Serafini, M. (1995). The Unkindest Cut. National Journal, 19(21), 8.
Zelman, W. (1996). The Changing Health Care Market, place, Private Ventures, Public Interests. San Francisco: Jossey-Bass.