Developing Organizational Policies and Practices

Running Head: PERTINENT HEALTHCARE ISSUE 1

PERTINENT HEALTHCARE ISSUE 2

Analysis of Pertinent Healthcare Issue

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Impact of increasing cost in a health organization

Introduction

The cost of receiving healthcare service is becoming a serious national healthcare concern. It has been established that the United States spend more on healthcare, in relation to the national income than any other industrialized nation. However, achieving minimum cost means having to make certain hard compromises which have never been easy. For example, low expenditure on research and development, limitation in terms of the choices of health coverage or healthcare providers and having to wait for long before using new technologies. The health system has gone through a series of transformational changes that has seen the cost of healthcare provision sky-rocket. The most affected are among the 41 million uninsured Americans who are unable to cater for the cost of insurance as well as the underinsured whose coverage program cannot cater for their overall health needs. The major catalyst behind the rising cost of healthcare has been; the rising number of aging population that take great benefit from the technologies created for lengthening life span, lifestyle choices like adoption of sedentary lifestyle and unhealthy eating habits resulting to obesity and cardiovascular disorders among others.

Cost impact on health organization.

Increasing cost has impacted the national health organization/system in so many ways. The impacts are not only experienced by the patients but the providers, employers, payers (insurance bodies) and even other employees within the health organization. Firstly, an array of transformational changes has been made i.e. payment transformation where a shift has been made from volume-based (fee-for service payment) which has high cost implications to value-based models and also the development of primary care in attempt to counter increasing cost. The turnover of healthcare providers has also faced a fair share of cost impact. The providers burdened by the feeling of denying patients services due to inability to cater for cost or lack of insurance loses meaning of services and morale to continue with the service. Consequently, advancement in training and education improve the providers’ patient service and more enhanced application of Evidence-Based practice appears costly and unaffiliated hence promoting low morale. Morbidity and mortality cases has been on the rise. Advanced technology used in diagnosis/treatment of serious medical conditions has become expensive and some of them are not covered by the insurance (core payments) hence late interventions taken after serious damage. The is also an indication of lowered patient engagement as far healthcare decision making is concerned since patients with financial challenge have limited options and are sometimes forced to comply with the physician decision deliver low price medical services.

How increase of cost has been addressed from two other articles

The vital element of addressing the cost of healthcare that has been recommended for application include;

(a) The use of payment reforms to create incentives and promote delivery reform where the cost and quality responsibility is taken by the accountable care organization or provider for a defined population under shared savings through the global budget provision

(b) Decrease of waste through minimizing the delivery of services that are considered to be indeterminate while ensuring that the clinical decisions made are capable of providing maximum benefit to the patients

(c) Improving price transparency which has enabled Medicare patients to compare procedure prices across various hospitals. This has led to identification of price variations and standardization.

(d) Thinking of and managing different groups of patients differently. The importance of identifying and treating different groups as described by Diane Rowland has been applied by certain facilities where she explain that; the costliest 10 percent of Medicaid beneficiaries are different from the costliest 10 percent of Medicare beneficiaries.

(e) Engaging and listening to the patients’ needs and involving them in their healthcare decision making while including screening them for financial harm and identifying potential cost-related non-adherence.

(f) Promotion of Evidence-Based Practice in which case the approved treatment condition must show evidence of effectiveness. Medicare has established that they can spend better while using a coverage with evidence development (CED).

Most of the above strategies addressed in the articles have been applied in the overall national health system to mitigate cost. The strategies have restore patients’ belief in health system and removed the possible corrupt impression that might be wrongly associated with the health organization. Patient care has significantly improved, provider-patient relations increased thereby promoting healthcare providers’ job satisfaction, meaning, and morale. One aspect that has led to a negative impact is price transparency which some patient shift private or public health facilities that offer minimum cost for similar procedures.

References

Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses' work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005

Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531

Michael c., H. A. (2012). High and Rising Costs of Health Care in the U.S. The Challenge: Changing the Trajectory. Alliance for Health Reform. Mathews AW. Lifting the veil on pricing for health care. Wall Street Journal. October 28, 2009. http://online.wsj.com/news/articles/ SB10001424052748704222704574499623333862720 ?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj. com%2Farticle%2FSB10001424052748704222704574499623333862720.html.> Accessed May 12, 2014.