Delivery System Disscussion 2

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Health Medical

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Assignment: What was the intended purpose of the “gatekeeper” system? Based on what you’ve read, do you believe it has achieved its purpose? Why or why not? If not, what could be changed that would result in it meeting its intended goal? Be sure to read and comment upon a few of your fellow students' remarks on this subject. Expectations: 1 page, 3 cited sources required reading

Required Reading

Affordable Care Act; findings from Mayo Clinic provide new insights into Affordable Care Act (expected and unexpected consequences of the Affordable Care Act: The impact on patients and surgeons—pro and con arguments). (2016). Managed Care Weekly Digest, 63.

Berenson, R. A., Burton, R. A., & McGrath, M. (2016). Do Accountable Care Organizations (ACOs) help or hinder primary care physicians' ability to deliver high-quality care? Healthcare, 4(3), 155-159.

Hoffman, S. (2015). Managed care, the legal system, and checklist medicine. Brown University Child & Adolescent Behavior Letter, 31(6), 8.

Managed care; researchers at American College of Physicians Report new data on managed care (preconsultation exchange in the United States: Use, awareness, and attitudes). (2015). Insurance Weekly News, 171.

National Committee for Quality Assurance (NCQA); NCQA health insurance plan ratings—valuable tool for consumers. (2015, November 1). Health Insurance Law Weekly, p. 31.

Owen, R., Heller, T., & Bowers, A. (2016). Health services appraisal and the transition to Medicaid Managed Care from fee for service. Disability and Health Journal, 9(2). 239-247

Sonderling, H. (2015, September 16). ValueWalk: Could managed care companies help offset rising healthcare costs? [Web log post]. Newstex Global Business Blogs. Chatham: Newstex.

Waitzkin, H., & Hellander, I. (2016). Obamacare: The neoliberal model comes home to roost in the United States—if we let it. Monthly Review, 68(1), 1-18.

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Explanation & Answer

Attached.

Delivery System

1

Delivery System
A gatekeeper in the healthcare system is a primary care professional, mainly a physician
or a nurse who makes the first contact with a patient upon entry into the healthcare system and
controls them through the system. The gatekeeper directs the patient to hospital care, a specialist
or laboratory. Gatekeepers also make decisions or approve special services. The gatekeeper
system intended to provide better quality healthcare services at reduced costs. The system
reduces the costs by eliminating unnecessary services. It aimed at managing healthcare services
and controlling referrals given ...


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