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Long-Term Care - Essay Example

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LTC210-Introduction to Long Term Care Administration-Unit 3 Aedric Frechelle Name of the University 1. Explain why the long-term care field is now experiencing much more competition than was the case in the past. According to the Global Burden of Disease Study 2010 (GBD 2010), which was published on December 13, 2012, even though the life expectancy has increased for men and women worldwide by more than ten years, they spend more years living with injury and illness (Wang et al., 2012)…
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Download file to see previous pages In this particular scenario, as the demand for services by the population increases, and when the reimbursement is available, the providers for services will also increase. For a long time, Medicare and Medicaid were the most significant buyers of long-term care services. However, with the introduction of Managed Care Organizations (MCO), the pressure and the competition has increased. MCOs have the option to choose which providers they will do business with since many of them do not cover long-term care. This directly increases the amount of providers looking to provide the services, resulting in opening up the opportunity for competition between the providers (Pratt, 2010, p. 215). Our system allows competition due to a firm belief that the customer will benefit from competition as better quality will be offered in order to gain more customers. Since the customers are also better informed due to higher education and ability to compare services, their expectations are higher and they give their ‘businesses’ to only those health care organizations that meet their needs. The health care facilities are also susceptible to pressure from payers and regulatory agencies to provide quality and cost-effective services. The providers that follow the requirements will be given incentives on top of their reimbursements. These institutions are the most favorable to increase their customer base, to have a solid financial relationship with managed care organizations (MCO), and with the Federal and State agencies. 2. Explain, using examples, the differences between licensure and accreditation. The health care industry is highly regulated. It is natural for them to be so as they deal with life and death situations. It is not like other industries where mistakes can be rectified or losses can be repaid. With the health care industry, the mistakes cost lives and hence, they must be prevented at any cost. For that purpose we have two types of external controls. One deals with governmental regulations, licensing of facilities and individuals (public), and the other deals with voluntary accreditation and certifications (private) (Study Notes, p. 6). One of the most important differences between public and private agencies is that “public agencies have a dual purpose—to control both quality and costs—while the private organizations have a single purpose—to measure, evaluate, and ensure the quality of care” (Pratt, 2010, p. 258). Another difference is that the “government programs seek to ensure a minimum level of quality or competency, while the private organization set standards that measure and ensure more of an optimum level” (Pratt, 2010, p.p. 258-259). Licensure is provided by the State and it is basically a “permission to a qualified individual or entity to perform certain specified activities that would be illegal without a license” (Pozgar, 2006, p.273). For example, in the health care industry we find practitioners like Registered Nurses (RN), Licensed Practical Nurses (LPN), Physicians (MD), Registered Dietician (RD), Licensed Physical Therapist (PT), and many others who, in order to practice their profession, need a license from the State. The exam for ...Download file to see next pagesRead More
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