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The paper covers the leadership and management traits and theories necessary for managing a multidisciplinary and multicultural health care organization to promote organizational effectiveness.


The need for health services is a basic need in every sphere of the earth. Delivery of quality services in health care has always remained a main objective of many healthcare organizations. There are many existing organizations that deliver health care. The quality of health care varies from one organization to another. The existing ethnic and racial disparities hinder quality service delivery. Implantation of sound management practices is one of the strategies that the management can apply in order to ensure quality service delivery.

 The health care providers always try to balance the quality of services and the financial outcomes of the services. The leaders of healthcare organizations play a major role in establishing the overall success of the organizations. They are responsible for the financial and medical outcomes.

In order for the healthcare leaders and care givers to achieve the desired results, they must have a thorough understanding of organizational effectiveness determinants. The determinants include the quality of leadership, finance, strategy and the operations of the organization. The leaders require a superior delivery system in the healthcare business. Leaders in the healthcare business require having a sound knowledge on healthcare options. They should plan strategically and their vision should always be in line with the patients well being. The leaders need to explore the available medical options in order to establish a cost effective payment scheme which delivers quality health care services. The leaders should factor in the well being of the stake holders as their main responsibility. Both the patient and the caregivers should be satisfied with the terms and conditions of the contract. Caregivers and attendants are the closest to the patients and thus their welfare should not be overlooked. They should be included in important decision making process and planning. Their contribution towards the success of the healthcare organizations is paramount.

Patients are the clients in the healthcare business. Every organization should uphold ethical and lawful considerations when handling patients. The patients deserve to be treated with respect and care. The leaders should always ensure that the patient- caregiver relationship is good. The healthcare organizations face many challenges in the process of service delivery. They include language barrier in the multi cultural society, high poverty levels of patients that prevents them from purchasing the recommended medications, insurance systems and care delivery.

Problem statement

Effective management of healthcare in the face of multicultural and multidisciplinary health care helps to enhance the overall success of the healthcare organization.

Literature review

Strategic planning, performance improvement, and information systems in the quality health care delivery.

Strategic planning is a critical element that should be present in every planning of an organization. It is the responsibility of the leaders to involve the other stakeholders in planning as this will affect their performance. The leaders should also provide managerial support to the staff and health care givers in order to motivate them. This helps to ensure the overall success of the medical schemes. In relation to the support structures, relevant information systems should be put into place in order to enhance the effectiveness of the systems. The managerial structures should be in line with the organizational goals and objectives.

Effective management of information systems will ensure that there is unity of command and every stakeholder is responsible and accountable.

The Financial characteristics of health care delivery, managing costs, revenues, and human resources.

There are many options that are available in healthcare. The choice of a healthcare scheme may depend on the nature of sickness and the level of care given to patients.  A variety of different options of hospital payment systems is available to a patient who is the beneficiary. The beneficiaries enjoy a wide range of services. Payments setting depend on the level of care that is suitable for a patient. For example, a routine and continuous homecare, inpatient general or specialized care charges are different.

Payments systems

Different options of payments systems are available. The choice that is taken depends on factors like nature of sickness, geographical location and the level of care to be accorded to the patient. Factors such as geographical location of patients, severity of illness and, care cost must be put in consideration when designing the system. Payment systems have an effect on the cost and, behaviour of the service provider. Payment systems include the Fee-for –service per diem DRG-based.

The preference of the system influence is by the nature of care that is fitting to a patient. There are conditions to fulfil for a patient to be eligible for Medicare. Some of them include a certificate from a doctor who shows the nature of illness, and certifies that a terminal illness exists. The following are some of the options that are available for healthcare. They include advantages and disadvantages of each method both to the patient and the health care providers.

Fee-for-service per Diem the DRG –based system

The payment charges   per day even in times when few or no patient   the care giver still receives payments. However, the payment is constant and, no addition payments in case the care giver exceeds the number of patient to attend. It is de motivating since at times, the care giver does a lot of work. It is a slow method in terms of incorporating new medical technology.

Capitation Medicare Payment Advisory commission

In cases where the profit made from the patients is high, the hospitals have less pressure when it comes to containing the costs. In some cases, the hospitals are under pressure of containing the cost if the profit made from the patient is lower.

Capitation Medicare

There is continuous care to the patient and payments have a predetermined fee. The patient pays only once for the services that the policy stipulates. Other extra costs due to negligence of the provider are the liability of the hospice. Since, the predetermination of the fee hinders the delivery of the appropriate services due to rise of the cost unless the patient makes additional payments.  The patient may be under treated by the care giver.

It encourages the shifting of costs from Medicare to service provider. The care giver assumes total responsibility to ensure that no omission occurs as this could eventually increase the cost. For example, provision of necessary vaccines like pneumonia and, measles in order to avoid opportunistic illness that Medicare is not liable to make payment for the treatment since the care giver did not fulfil the conditions. Every patient gets a vaccine immediately after joining the insurance.

The DRG-based payment system

The conditions are flexible and, where the situation demands arrangements for a transfer to a hospice that offers advanced facilities for the patient condition commences. This reduces the patient’s costs and helps the provider in service delivery. However, some medical cases are costly due to their extreme nature. Medicare has to make extra payments for these cases.

  The ethical and legal concepts

Organizations dealing with healthcare giving have the responsibility of protecting the patient interests. The services given should comply with the health and safety requirements. Only certified and authorized caregivers should be allowed to handle patients. Ethical considerations should be practiced by the care givers when handling the patients. The health care providers should ensure that respect and dignified treatment is accorded to every patient. The fee charged for the healthcare services should be fair and just. The ethical considerations and also the laws that govern the field of health care should be strictly followed.

The leaders and managers should also be extra careful in ensuring that the stipulated laws and ethics that govern the safety of patients are always upheld. Illegal and unlawful medical actions that jeopardize the health safety of the patients should be prohibited. Such unethical or unlawful acts that are not in accordance with the medical practices are punishable by law. It is morally wrong for the health care organization not to deliver quality services. The service providers are entrusted with the task of protecting human lives. Patients are delicate and thus should be handled with outmost care, empathy and respect.



Leaders in health care can formulate strategies that will help reduce disparities in care errors that relates to language barriers and literacy levels. According to the Medicine Institute report (IOM), ethnic and racial minorities receive lower quality services in healthcare in comparison with the majority groups. This is done regardless of the minority financial status or payment scheme. The IOM identifies the presence of many disparities in the healthcare system. The disparities are based on ethnicity, race, socio economic status and gender.

An analysis of Medicare shows an improvement in the quality of services. There are many options available in the scheme depending on the needs of the patients. Over the years, significant disparities have been present in the provision of effective control and treatment where chronic illnesses persist. Some settings like home based health care has improved the quality of services since it provides the patient with well organized and timely services. This has helped to reduce the disparities that exist in the healthcare organizations.

However, performance assessment and the existing quality programs have unintentionally, led to an increase in ethnic and racial disparities.

Leaders need to provide quality materials interpreted in multiple languages. This helps in provision of effective care in the face of a diverse population. The quality of the available translated materials was not credible. It had issues that were related to language translations. These could cause serious problems that could place the patient health and safety at risk. Poor quality in translated materials also can cause confusion, increase costs and increase the time taken to translate the directions to the patients

According to the Medicare Learning Network Payment System Fact Sheet Series, Hospital Outpatient Prospective Payment System mainly covers patients who are not in restriction to stay at the hospital.  The adjustment of drugs Price is always in consideration of the costs in order to prevent the incurring of losses. Medicare makes additional payments to hospitals depending on the geographical location and the complexity of the services that are on provision. The revision on payments of some services occurs annually and, not quarterly. This may not be convenient as many economical changes rise and, requires some immediate changes.

The adjustments on payments depend on the geographical location and, in case of a transfer from one facility to another. Medicare has a fixed payment system that forces providers to reduce their inpatient cost by transfer of services which may be costly to them.

The basic Medicare outpatient hospital services system provides a wide range of services at the hospital to the beneficiary. The predetermination of payment enables the patient to pay according to the nature of services. This may be expensive in case the patient has multiple illnesses that requires making of separate payments. This may limit the care giver in terms of the treatment that the patient receives.


Leaders and caregivers should attend educational programs that are designed for non clinical and clinical executives. These programs are important in every organization that is involved in healthcare delivery. The programs help to educate leaders in order to make them more efficient. The programs offer knowledge on how to enhance healthcare services, reduce costs and improve the outcomes for all the stakeholders.

Leaders should emphasize on the quality of healthcare that is provided in their organizations. Emphasizing on costs at the expense of quality of services can lead to serious problems in the healthcare business.

Payment Reform Options: Episode Payment is a Good Place to Start. Each case receives a different treatment in terms of payments. This ensures that the patient gets all the effective treatment and, the care provider has necessary requirements of high quality service delivery. The provider is not at pressure in terms of payments and, there is motivation.

Healthcare Payment Reform and Provider Reimbursement: health care givers should consider the Strategies by the Oregon Health Fund Board. The Board’s main responsibility is to develop a reform plan that is accessible, coordinated, motivation on efficiency and, cost effective care to patients thus ensuring the system sustainability. The plan caters for proper resource utilization and the provision of high quality services. It also works towards the implementation of plans that ensure a uniform performance in terms of quality and, satisfaction.

There is a need to strengthening of patient and care giver relationship that facilitates the partnership. Many factors like care cost, geographical location and, severity of illness need to be taken into consideration in order to design an effective system. The system has to be fair, efficient, sustainable and, transparent to all parties. This helps in creating an equitable and, an appropriate system.


Sound management practices of health care are a vital element in ensuring the overall success of the organization. The current systems are not particularly appropriate in health care provision and, service provider welfare. However, the system is constantly under review and, the necessary amendments are underway. This will enhance sustainability and prevent the collapse of the care systems.

There is a need for the leaders in healthcare to understand and also address the various barriers that the minority patients face. The minority patients are in smaller primary facility which provides minimal care to patients. Leaders should try to reach out to such groups in order to ensure that they get access to quality healthcare services. This will help to improve the care given to the minority groups. The leaders also need to identify the necessary resources that they can use in improving the multicultural care. This will help to reduce the disparities that exist at the level of the physicians. Focus on the minority groups helps the disadvantaged people in the society. This acts as an ethical consideration on the part of the organizations socio- corporate responsibility.

Leaders should come up with programs that emphasize on improvements on quality of services. This includes addressing the language barriers, cultural differences and the health matters.


Agency for Healthcare Research and Quality, Department of Health and Human Services. 2010. National healthcare disparities report 2009. Rock Ville, MD: AHRQ.

Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. annual report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Insurance Trust Funds. Washington, DC: Boards of Trustees

Chassin, M. R., J. M. Loeb, S. P. Schmaltz, et al. 2010. Accountability measures—Using measurement to promote quality improvement. New England Journal of Medicine 363, no. 7 (August 12)

Medicare Payment Advisory Commission. 2010c. Report to the Congress: Medicare payment policy. Washington, DC: Med PAC.

 Schneider et al, Racial Disparities in the quality of care in Medicare managed care, Journal of the American Medical Association, March 2002, 287(10) 1288-1294.

National Healthcare Disparities Report. December 2006. Agency for Healthcare Research and Quality, Rockville, MD.



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