What do the New Health Care Structures Means for Health Care Ethics?Philip Boyle, STL, Ph.D
VP, Mission & Ethics
My plan
New Structures• Continuum and hand-offs (LTC, home health,
PACE, hospice)• CINs & ACOs• Partnerships• Physicians
Common mechanisms• Facilitation• Education• Policies
Moral Problems
New Structures
• Continuum & hand-offs• LTC• Home health & hospice• PACE Programs
• CINs & ACOs
• Partners- Walmart, CVS, Walgreens
• Physicians
Clinically Integrated Networks
A mechanism for addressing population health management ; infrastructure
A contractual agreement between insurance provider and a network of health care providers
• Health Systems• Employed Physicians• Independent Physicians
Members share the risk in caring for an assigned group of patients (covered lives) across the continuum of care
Addresses Triple Aim: 1) improving quality/satisfaction of care experience, 2) improving health of populations, 3) reducing per capita health costs
Methods to address
• Facilitation• How to access?• Who possesses competencies?
• Education• Problems specific to setting• Delivery methods: Web & virtual ECs
• Policy• Specific policy: e.g., smoker & oxygen
Content
• Allocation & appropriate care
• Population health
• Consumerism
• Conflicts of interest
• Cooperation
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