What are the roles and responsilities in healthcare delivery?

Healthcare

and Allied Healthcare

Professionals

Healthcare

professionals who manage a patient's

care might include physicians, nurses, physician assistants and nurse practitioners. Allied health professionals are those who support the direct caregivers or perform a specialized service. This might include nurse assistants, x-ray

technicians, phlebotomists

(lab technicians) and so on. Healthcare

and allied healthcare

professionals are responsible for the "hands on" delivery of care. The have a responsibility to provide quality care which includes the development of standards consistent with their professional accrediting agency's requirements. For example, for a particular diagnosis or suspected diagnosis, certain examinations should be done, certain tests should be ordered until that particular problem is confirmed or ruled out. The patient should be involved as much as possible in terms of gathering information and giving instructions on self care and follow-up

after a diagnosis is made.

Healthcare

Organizations

Healthcare

Organizations would include hospitals and all their departments and satellite facilities, clinics, organized doctor's offices, outpatient surgical centers, urgent care centers and so on. These organizations are responsible for supporting the caregivers by ensuring they have the equipment and staffing required to deliver quality care. The managers of these organizations should ensure proper credentialing procedures are carried out (i.e.

verifying qualifications of the various healthcare

and allied healthcare

professionals) and they should ensure all facilities comply with state and federal licensure

requirements. These organizations are also responsible for working with patients financially either through a commercial insurance company, government insurance (Medicare or Medicaid) or working with patients who are private pay.

Insurance Companies

Although insurance companies do not provide direct care, they pay for the care. However, there are some HMO's

like Kaiser Permanente

that actually employ their own healthcare

professionals (including physicians),

and have fully staffed ancillary departments such as radiology and laboratory. Government insurance programs and commercial insurance companies affect the delivery of healthcare

because of their restrictions what will be paid and how much will be paid . If an insurance company will not pay for a particular procedure, test, or medication, the physician may be reluctant to order it. If a patient has poor insurance coverage, they may be hesitant to seek care even when they need it. Although there has been much debate over the role of insurance companies in patient care, as it stands now, they are an integral part of healthcare

delivery system in the United States.