American Well: The DTC Decision Harvard Case Solution & Analysis

American Well: The DTC Decision Case Solution

1.     Provide a brief overview of US Health Care – including the key players, health care system performance, the ACA, retail clinics, and telehealth.

The U.S health care system comprises of major players in the market which include patients, providers, payors, and firms supplying health care products and services. In addition to this, other major players of the market included IT industry, venture capitals, government and non-profit research institutions. These are the forces that played significant role in driving the major health care innovations and changes.

Key Players in the US Health Care

America was considered as the major healthcare service provider. It provides a platform to many healthcare services and hosts a large number of hospitals and other medical facilities. There are almost 5500 hospitals, 15500 nursing facilities, and 4000 rural health clinics in US. In addition to this, there were huge number of pharmacies and other health care entities were established in U.S that provided care. Furthermore, according to an estimate, about 895,000 physicians were practicing in U.S, which include a large number of primary care physicians and specialist. At the time of need, primary care physicians act as a main source of contact as they referred the patents with health insurance to the specialists.

American government gives health care services to every third person from the population through health insurance programs. The poor and disabled population of America is receiving healthcare insurance programs through Medicaid,they are accounted for only 16% of the whole population. Furthermore, people over 65 years that receive healthcare facilities through Medicare account for 15% of the population.In addition,only 2% in United States receive medical services through other public programs. In addition to this, majority of the U.S population’s healthcare services were covered by the private insurance companies through their employers.

It is considered that, it was difficult for the individuals to buy the insurance plan since it was expensive. Moreover, it was also difficult for individual applicants to acquire the insurance coverage. Therefore, many people in the population were lacking the insurance and proper healthcare services.

Other Key Players

Health Care System Performance:

The healthcare system performance of U.S was not considered as efficient. The health expenditures of U.S population were increasing and accounted for $2.8 trillion in 2012, which was considered as high. Furthermore, the chronic illnesses among the U.S population were accounted the major amount in the healthcare budget. Due to which, the healthcare performance of U.S was considerably low than many other developed countries.In United States, the physicians were getting paid for their services in the form of medical reimbursement which contributed in the low performance and low quality of care.

Moreover, many physicians started private practices to take more patients in order to overcome the problems regarding their practices, low reimbursement rates, overhead cost expenses, and other administrative burdens. This increased the shortage of physicians in the regional level. Therefore, this condition posed challenges for the government to fulfill the shortage by acquiring agreat number of PCPs.

The Affordable Care Act (ACA):

In order to overcome the above mentioned problems and to improve the performance of U.S healthcare sector, the Affordable Care Act was passed by the U.S. Senate in March 2010. The ACCA act has facilitated the U.S. population in many aspects, as it expanded the health insurance coverage by enabling Americans to buy insurance plans, providing financial support to the low-income group of people to afford the quality healthcare services, enabling individuals and small businesses to buy coverage, penalty for the large firms for not giving the medical insurance to their employees, and prohibiting insurers from rejecting coverage for the individuals. ACA has formed accountable care organizations in order to provide the financial and medical care in the most efficient manner, which has reduced the cost for local patients through categorizing value adding and non-value adding activities................

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