Disc 6 U.S

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Luis

The healthcare sector in the United States (U.S) is at a critical point, whereby the excessive costs of health services are no longer tolerable and substandard outcomes cannot be justified. In 2016 alone, the US spent almost twice as much as any other high-income country did on health care (Papanicolas et al., 2018). Despite this high expenditure, the country performed poorly in most population health indicators. Further analysis of the social spending and health care use revealed minor differences with other high-income nations offering no explanation for the high expenditure. The only observable difference was in pharmaceuticals and administrative costs. According to data by the Centers for Medicare and Medicaid Services (2020), Medicare is predicted to undergo a growth rate of 7.6% per annum resulting from increased enrolment. In contrast, the proportion of the insured population is predicted to decline from 90.6% to 89.4% by 2028.The expected changes will increase healthcare expenditure, making it the biggest contributor to national debt. These rising costs have not only affected the federal government as state governments are also struggling with these inflated costs of health care.  

Galvin (2018) proposes the Triple Aim, an initiative that has the potential to reduce the per capita expenditure on health care costs while boosting patients’ experience and enhancing populations' health. While it sounds favorable, it has been difficult to implement it, with experts proposing that it is easier said than done. Regardless, the framework proposed by Dr. Don Berwick has been borrowed from medical systems to improve patient experience and supply better services at lower costs. Other measures that could be implemented to uphold the triple aim include:  

Foundational elements 

This category includes prioritizing governance, where the hospital management prioritizes transparent and effective leadership. This policy applies to all leaders in the different ranks. The other initiative is to encourage cultures of continuous improvement. In this principle, healthcare workers are encouraged to commit to real-time learning and dedication to their work.  

Infrastructure fundamentals 

Initiatives in this category include implementing the best IT practices and infrastructures in health care. The other one is best use of resources such as health personnel, space, and amenities. Lastly is evidence protocol which is an element that encourages efficient and consistent care of patients.  

Care Delivery Priorities 

This initiative stresses the essence of integrated care, which is offering care in the right setting, by the right teams, using shared decisions and collaboration to supply affordable tailored services.  

Reliability and feedback 

This category relies on collaborated safety, which aims to reduce injury and re-infection, known to increase hospital stays and costs. The other strategy is internal transparency, an element that ensures there is workable evidence of progress, result, and costs. 

Generally, integrating the recommendations into the American healthcare system will create a lasting sustainable effect that will improve the quality of service while reducing individual costs and national expenditure on healthcare. 

  

References 

Centers for Medicare and Medicaid Services. (2020). National Health Expenditure Projections 2019–28. CMS. https://www.cms.gov/files/document/national-health-expenditure-projections-2019-28.pdf 

Cosgrove, D., Fisher, M., Gabow, P., Gottlieb, G., Halvorson, G., James, B., ... & Toussaint, J. (2012). A CEO checklist for high-value health care. NAM Perspectives. http://movieweb.mmtools.eu/images/dbimages/docs/hospitalgovernanceaanbevelingen2012ceohighvaluechecklist.pdf 

Galvin, G. (2018). Staff Population Health: The North Star of the Triple Aim. U.S News. https://www.usnews.com/news/healthiest-communities/articles/2018-05-25/a-decade-later-triple-aim-health-care-framework-offers-lessons-promise 

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.https://jamanetwork.com/journals/jama/article-abstract/2674671 

Meghan

The US healthcare system is financially irresponsible. The US spends nearly twice as much on healthcare in relation to the other countries, but has the lowest expectancy rate, highest obesity rate, and the highest chronic disease rates. The health care spending gap with other countries appears to be driven by the high prices the US pays for health care services-particularly doctors, pharmaceuticals, and administration (Healthcare Spending in the US, 2018). The US should examine the benefits of regulating the price of care and standardizing the delivery of care. The current trend that will further strain the healthcare system is the older population. As the population ages, so does the cost. As the cost of healthcare continues to rise, the US will see a trend where the uninsured rate will increase. Whatever the future holds for the ACA, healthcare executives should continue to make reducing costs a top priority to maintain a strong financial margin (Hegwer, 2017).

The COVID pandemic has added additional strain to the healthcare systems. Prior to the pandemic, nurses were making 33% of a physician salary. The ratio of nurses to a provider in a hospital system is 3:1. When the pandemic hit, there was a high turnover of nurses due to burnout, retirement, or switching over to become a travel nurse. As of today, travel nurses make more than providers. What impact has that had on hospitals when there is still a ratio of 3:1? How do the physicians feel? At this time, my organization has placed a hiring freeze on the outpatient setting as they continue to battle with monthly financial loss. It is unknown how long the freeze will last but it will certainly impact patient care. Some other ways to save costs would be to transition more providers to telemedicine, move call centers or other admin positions into a remote position, and look at hiring mid-level providers as replacements in lieu of providers. If backfilling vacant positions, such as the front desk, is not feasible I would suggest implementing kiosks.  

The time is now to assess the healthcare plan of the future. The US healthcare system remains in flux as they attempt to look at ways to provide universal care and reduce the costs.

References

Health Care Spending in the United States and Other High-Income Countries. (2018). Medical Benefits, 35(7), 6–8.

Hegwer, L. R. (2017). THE FUTURE OF HEALTHCARE FINANCE. Focusing Your Strategies Amid Uncertainty. Healthcare Executive, 32(3), 10.