delivery system reforms to better align provider incentives to improve care coordination and quality and reduce costs. These reforms include medical homes, voluntary pilot projects to test bundled Medicare payments and voluntary programs where qualifying providers – including hospitals – can form accountable care organizations and share in Medicare cost savings. In addition, the ACA creates a C...

I applaud the government’s interest and fervor for improving health care delivery in the United States. However, any mention of substantive health care reform must include several key inside-out elements. Otherwise, government spending will merely be symptomatic care, rather than addressing the root causes of increasing health care expenditures. Health care coverage has simply become too cheap ...

The Work Group’s recommendations led to formation of the Commission on Health Care Facilities in the 21 Century, whose principal charge is to “right-size” the acute and long term care delivery systems. The Commission’s mandate is to shape a health care delivery system that meets community needs, rather than simply preserve existing institutions. The Commission also envisions new acute and long ...

We address the Home Health Care Delivery Problem (HHCDP), which is concerned with staff scheduling in the home health care industry. The goal is to schedule health care providers to serve patients at their homes that maximizes the total collected preference scores from visited patients subject to several constraints, such as workload of the health care providers, time budget for each provider a...

Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow studies of the cost-effectiveness of a single ...

• To understand the basic nature of the US health care system • To outline the key functional components of a health care delivery system • To get a basic overview of health care reform and the Affordable Care Act • To discuss the primary characteristics of the US health care system • To emphasize why it is important for health care practitioners and managers to understand the intricacies of th...

Aday et al. (1) have defined access as those dimensions that describe the potential and actual, or realized, entry of a given population into the health care delivery system. Access to health care depends on many factors, such as race, culture, geographic location, financial and insurance status. For numerous reasons, equal access for all citizens to health care services in the United States ha...

BACKGROUND Access to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documen...

As health care delivery organizations react to the changes brought about by public and private sector reform initiatives, RNs can anticipate that, in addition to intended outcomes, there will be unpredictable pressures and unintended consequences arising from reform. Biennial national surveys of RNs conducted over the past decade have explored various changes in the nursing workforce, quality o...