Framework for Analysis – A method to help analyze the evolving healthcare delivery system using different perspectives

A framework for analysis of systems based practice analyzes evolving health care delivery systems from all of the following perspectives:

  1. Consumers;
  2. Patients;
  3. Providers;
  4. Payors;
  5. Health Plans; and
  6. Laws and Public Policies encompassing any and all of the above perspectives.

Framework for Analysis

Consumers – actual or potential recipients of healthcare.

Patients – persons subject to the medical care rendered by the providers and the terms for health care coverage available under the health care insurance policy.

Providers – all of the different types of health care providers rendering medical care to the patients, including physicians, hospitals, pharmacies, etc., encompassing the entire continuum of care to patients.

Payors – for example, governmental programs such as Medicare and Medicaid; Employer Groups such as companies/businesses/other entities that pay for the health care benefits.; and individuals purchasing health care benefits.

Health Plans – companies offering healthcare insurance type of coverage products, such as Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), other Managed Care Organizations (“MCO’s”), and insurance companies.

Laws and Public Policies encompassing all of the above perspectives – laws and/or public policies currently enacted or pending or do not currently exist but should be considered that affects any of the above perspectives.

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