Hospice Outline

While debate continues on both the success and the future of managed care, one cannot deny the increased emphasis on cost containment. The results of managed care and the continuing evolution of the American health care system are both quantitative and qualitative. They range from a reduction in hospital admissions and stays to an increase in ambulatory care, out-patient surgeries, and home care from an emphasis on prevention and better decisions by consumers about health-related behaviors to the sometimes limited choices by consumers in selecting practitioners and in utilizing benefits from increasing limitations in coverage with higher deductibles and co-pays to the reality of a still significant portion of the population among the disenfranchised or uninsured and from quality of care and treatment to issues and concerns around trust. Four of these areas will be addressed in greater detail below. The Institute for the Future in Health and Health Care 2010 described three tiers of coverage in todays evolving health care system and projected how individuals and families may experience this changing system based on which tier of health coverage describes their particular situation (2000). Their observations are summarized below Tier 1 The securely enfranchised. The first group represents 38 percent of the population. It consists of empowered consumers with considerable discretionary income, who are well educated and use technology, including the Internet,, to get information about their health. Usually they are able to make choices in their plans and coverages. They are able to educate themselves about health behaviors as well as health care issues and concerns. They are likely to engage in shared decision making with physicians and other allied health professionals. Because access and benefit/ coverage security are not issues for them, and because they are more likely to be politically active, their tier will be the most likely to influence changes in legislation