Iron Triangle Of Health Care

The Iron triangle for healthcare consists of cost, quality, and access; these three characteristics when balanced create great healthcare. Managed Care Organizations combine the three to offer consumers with care that is appropriate for their individual needs. Our book describes managed care organizations as “the cost management of healthcare services by controlling who the consumer sees and how much the service cost” (Basics of the U.S Healthcare System, Niles). Taking a look at the history prior to the Health Maintenance Organization Act of 1973 (HMO ACT of 1973) the implementation has been significant in balancing cost, and quality control. Before this Act was signed in to law by President Nixon healthcare costs were determined by fee for service. A fee for service or indemnity plan is a plan that allows the provider to determine the cost of service, this fee for service plan caused for healthcare costs to increase rapidly. An example of this would be going to the doctor with neck pain, being told to stretch then receiving a bill for 25,000 dollars. As could be understood the cost of healthcare had became a problem.

Having access to quality healthcare is major part of one’s life however the cost of care has been on the rise over the past decades and continue to rise every day due to many situation such

For the last five years of my life I have worked in the healthcare industry. One of the biggest issues plaguing our nation today has been the ever rising cost of health care. If we don't get costs under control, we risk losing the entire system, as well as potentially crippling our economy. For the sake of our future, we must find a way to lower the cost of health care in this nation.

Impact to Healthcare organizations - These increases in cost raise questions of health care expenses at the hospital level. As higher profits are sought, the cost will become unstable for all, thus causing many to postpone going to the doctor. However, there are many complicated problems associated with our healthcare system. We will focus on main issues that can correct many related problems within the current structure. More importantly, we need to find ways to ensure all Americans have access to health care; and we need to hone in on how we can get the best value for the $2 trillion dollars we spend annually on healthcare.

I will compare the current health care system with the new Patient Protection and Affordable Care Act (ACA) that became law on March 23, 2010.   The current system, which is being phased out between 2011 and 2018 is increasingly inaccessible to many poor and lower-middle-class people. About 47 million Americans lack health insurance, an increase of more than two million people from 2005 (Rover, 2011) the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and the end result is that the United States pays roughly twice as much per

T.R. Reid uses cost, quality, and choice to fully evaluate healthcare systems all around the world. As an American citizen, I have always thought our system was unfair. The poor suffer more than the rich for going to see a doctor for the same reason. In chapter one of The healing of America, T.R. Reid comments on how many Americans have also started to notice that the American healthcare system is not as great as we once thought. Not only is it unfair, but it is also expensive and unsuccessful (9). By looking at all the other countries’ healthcare systems, Reid would then be able to better pinpoint how America can better its health care system by taking portions of those health systems.

In the 21st century, medicine has become very dependent on technology (Kumar, 2011). With that being said technology is one of the most costly concepts in the health care system today. While you need the best technology to provide the best quality of care, unfortunately, this drives up the cost. The cost associated with health care is a major factor in the number of Americans without coverage (Popescu, 2015). The passing the ACA into law was intended to drive down these health care costs.

In healthcare system the highest quality medical care means” the greatest benefit to patients at the lowest possible cost” (Burke & Ryan, 2014, p. 3). “The Agency for Healthcare Research and Quality (AHRQ) defines quality health care as doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results” (NCQA, p. 3) According to American college of physicians, the single most reason for the health care cost is higher healthcare spending. There are several factors involved in the high health care cost such as inappropriate use of technologies, lack of patient centered care, overuse of the reimbursement, excessive price for health care facilities, increased organizational cost, and health accountability are some of the reasons for increased health care cost. In order to decrease the cost, the available health resources be used judiciously and equitably. Understanding these factors and identifying the potential factors of health care costs assists in providing quality and effective services and thus improves the health outcomes (ACP, 2009).

In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary

However, prior to the existence of the ACA, the American healthcare system left a lot to be desired and still today leaves room for improvement. The basic issues underlying efforts to improve the United States (US) health care system remain, as they have for decades, concerns for costs, access, and quality (Sultz, 2006). Even though knowledge, technology, and

Access to care has become a buzz word in the modern healthcare theater. The prevailing thought is that our healthcare system will experience a significant amount strain as an increasing number of individuals seek care with increased number of individuals being covered by third party payers under the affordable care act. Access to care has become a catch-all term used to describe the inability for an individual or population to seek needed healthcare services. Access to care can be divided into 4 major problems within a healthcare setting to include, physical accessibility, affordability, acceptability, and supply and demand. While the current state of our healthcare delivery system in regards to the changes implemented by the affordable care act has attempted to address affordability and acceptability. The affordable care act may have strained the infrastructure of our system in regards to the supply and demand aspects as well as physical accessibility challenges to many populations.

The three components of the Iron Triangle are access, cost, and quality. The first part of the Iron Triangle is Access. Access is who can get the care when it is needed, not how long it took to get an appointment or how long you spent in the waiting room with a cold. The second part of the Iron Triangle is Cost. Cost involves the systems needed to make costs affordable for patients and those who pay, whether that be employers in the US, government agencies, or insurance providers. Powerful forces are driving costs up as we have noted before. The last part of the Iron Triangle is Quality. Quality is the value, efficacy, reliability, and outcome of the care being

Dr. Samuel Metz, a practicing anesthesiologist wrote an article explaining that, “Restricting access and limiting care is an expensive process, consuming more money than we would spend simply providing unrestricted access and treating all treatable diseases. How do we know? Because every healthcare system in the world that implements universal care without limiting benefits ultimately provides better care to more people for less money.”

Quality of care is a primary article of the ACA and a major goal is to insure every American has exactly that. Even though the “care” pillar is the strongest of the three pillars it still faces many challenges. One major component defining quality of care is technology. The medical community currently suffers from outdated technology, which leads to lapses in care and lack of communication between medical facilities and companies causing overlap and delay. Better technology is required to expedite file distribution between medical facilities and help share patient information between pharmacists and physicians. This, of course, is expensive and like other aspects of this bill is falling short in funding and again driving another nail into the potential Obama care coffin. More troubling, perhaps, is the massive costs of maintaining and operating the countries medical infrastructure. Its figured that the combination of hospitals, physicians, insurance companies, and the federal Centers for Medicare & Medicaid Services are projected to total almost $2.7 trillion between 2014 and 2022. If Americans are to receive actual quality care, then financial burdens must be solved before any real progress can be

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what