Our lesson and textbook readings this week list quality, efficiency, and cost as three of the drivers of high performance healthcare systems (CCN, 2017; Mason, Gardner, Outlaw, & O’Grady, 2016). Do quality improvements projects equate to higher healthcare costs, or do they decrease costs by reducing adverse outcomes and readmission rates and increase efficiency? Do reductions in cost translate to a reduction in the quality of care? It is with good reason that Hussey, Wertheimer, and Mehrotra (2013) state that the connection between the quality and cost of healthcare is one of the most debated subjects in healthcare today. In their systematic review of 61 studies, the authors found only a small to moderate relationship between quality and
Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (Eds.). (2008). The healthcare quality
Quality and financial viability being closely tied is an extremely salient point. Furthermore, the Affordable Care Act has influenced the requirement for high-quality, cost-effective care provision by implementing Value Based Purchasing (Aroh, Colella, Douglas, & Eddings, 2015). In addition, there are presently Centers for Medicare and Medicaid (CMS) quality indicators that effect reimbursement for hospitals (Xu, Burgess Jr, Cabral, Soria-Saucedo, & Kazis, 2015). For example, if a facility does not meet the indicator threshold for catheter associated urinary tract infections, central line infections and/or pressure ulcers their reimbursement is affected. Given that the quality of care provided by a hospital is
Quality can be difficult to measure, which is what has halted the strong pursuit of quality in the past. Healthcare organizations use quality assessment to measure quality against some established standard. This includes “defining how quality is to be determined, identification of specified variables... and the collection of appropriate data to make the measurement possible (Shi, 2015, pg. 493). The Affordable Care Act set new standards and incentives for achieving quality of care. This includes offering Medicare reimbursements for hospitals with low readmission rates, and ensuring that (not-for-profit) hospitals complete a community health needs assessment (to ensure that the needs of the community are being met) and by implementing HCAHPS scores, which measures efficiency and efficacy of care using patient surveys. HCAHPS and hospital readmission good example of how quality of care can be measured in efficiency as well as
Raymond, a 78-year-old man living in a motel, is found by the housekeeper lying on the floor of his room, semiconscious. The motel manager calls 911, and Raymond is taken to the closest emergency room, where he lies on a gurney in the hallway for 6 hours before a physician examines him. Because it is unclear what is wrong with him and he cannot speak coherently, the physician admits him to the hospital for observation. Later, when it is determined that he had suffered a stroke; he is discharged to an inpatient rehabilitation facility that has no knowledge of his medical history including his current medications for hypertension and high cholesterol. He dies there several weeks later.
Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow.
The articles I chose for my annotated bibliography were about healthcare cost and quality. The theme in many of these articles was about healthcare cost and does it affect patients experience. In some settings like hospitals, the cost of quality affects patient experience. The largest component of the U.S. Gross Domestic Product goes to healthcare spending (17% in 2009), and yet the quality is unsatisfactory. It was also interesting to find out that more people die each year in the United States from medical errors than from highway accidents, breast cancer, or AIDS (National Academy of Science's Institute of Medicine, 2002).
Medicaid is a vital lifeline for some 72 million Americans. Two-thirds of all Medicaid spending supports senior citizens and persons with disabilities. Cutting Medicaid would jeopardize the quality of healthcare, long-term services, and nursing home care for tens of millions of Americans. There are significant cost issues in America’s healthcare system that must be effectively addressed, but these challenges will not be remedied by benefit cuts to vulnerable
The movie shark water is explaining how amazing and beautiful the sharks are. They are trying to tell us in the movie that sharks are not dangerous and that they should be protect not killed. The mission of the film is to go in country where there is illegal fishing and try to stop it. They are telling us that sharks are really important in ecosystem of this world and also important in the food chain of the sea. But the shark week is trying to tell people how big and dangerous sharks are. All the videos I watched of the shark week they were showing people getting attack or even kill be the sharks. Most of the time they are looking for the biggest sharks in this world just to show people how big they can be. I thinks that people are scared
The Institute of Medicine’s (IOM) publication of the landmark reports To Err is Human and Crossing the Quality Chasm: A New Health System for the 21st Century led many healthcare agencies to begin investigating ways to transform the healthcare industry. To Err is Human, published in 1999 outlined that despite rising healthcare costs, quality and patient outcomes were not improving. To Err is Human hypothesized that faulty processes and not people were to blame and set a goal that in the five years following the report, a reduction of 50% of healthcare errors would occur. In 2001, IOM published their report, Crossing the Chasm. In the years since their first published report, there was no noticeable improvement in the quality of healthcare. In the Crossing the Chasm report, the IOM introduced a six-aim framework to transform healthcare and improve quality. Fast-forward to 2010 and the Affordable Care Act. In the face of rising healthcare costs, 17% of the gross domestic product and rising, the government sought to control costs and improve quality by shifting from a fee for service healthcare system to a health care system where providers and hospitals receive reimbursement related to the quality of care and outcomes.
With the Centers for Medicare and Medicaid (CMS) providing coverage for over 100 million citizens in the United States and being the largest care delivery system, it is hard to ignore their presence in the ever changing health care delivery system. Some say, that where Medicare goes, private payers will follow. Today, hospitals, health systems and other providers have been highly influenced by Medicare. Medicare, Medicaid, the Children 's Health Insurance Program, and the Health Insurance Marketplace are leading the way in the movement to provide coverage under this system. As the Affordable Care Act is ironed out, there are still billions of dollars being spent within the Medicare/Medicaid programs. In an effort to try and combat some of the overwhelming costs of these programs, the Accountable Care Organization (ACO) Model has slowly begun to integrate itself into the Medicare/Medicaid system. This has brought about some interesting changes with reimbursement, cost containment, and quality of care. Each making slow shifts towards change and developing new systems of providing quality health care.
Though the spending has lessened in recent years ,when compared with other economically developed countries the cost of the health care in U.S is much higher and ranks poorly on quality indicators (Burke & Ryan, 2014).Evidence suggest that patient quality outcomes not generally correlated with variation spending .Beneficiaries are expected and deserved for high quality care within affordable
It is essential to acknowledge the fact that the costs of health care in the United States is expensive. Furthermore, many factors influence the inflation of health care costs. Consequently, there have been numerous failed attempts to control the costs of health care. As a result, some of the failed attempts to control the increasing costs of health care were lowering health care provider payments, decreasing health benefits, and increasing out-of-pocket costs for patients (Shannon, 2009). Overall, one definition of cost containment is to contain health care providers ' profits and income (Oberland, 2011). However, it seems that containment should also focus on the high medical service prices as well. The purpose of this paper is to reconcile cost containment and quality of care.
Cost, the number one thing on people’s mind nowadays. People’s worry about the cost of healthcare usually leads to them being uninsured. For my healthcare system, I want it to publicly funded by public taxes (private donations are always welcome), similar to how healthcare in Europe is modeled. For check ups and routine things, the cost of those visits will be covered, if one visits a preferred doctor provided by the healthcare company. But if the medical expenses go over a certain amount, the patient will have to pay a percent of the cost. Such as if you go to the doctor a yearly check up, that visit will be covered. If the doctor happens to find a brain tumor and surgery is required and the costs exceed the amount able to be covered, a percentage of the remaining amount will be billed to the patient and the rest paid for by the healthcare system. I believe this is the fairest way of rationalizing and dividing up the cost and the money of a healthcare system. Routine things should not cost an arm and a leg, I believe they should be free to promote good health and wellness. But at the same time, the system should not be completely free, because then taxes would be ridiculously high. Also, to make sure patients are not getting ripped off, I would impose price control. This would only affect doctors that are under our healthcare system. Private practices can continue to run independently since they are not funded by the public. Although the public doctors will get paid less,
The quality of care In the United States Health Care System, unlike a lot of people’s perceptions, is not the best in the world. In fact, Rose Ann DeMoro, the Executive Director of National Nurses United, Which happens to be the nation’s largest professional association and union for registered nurses, wrote in “How US Private Insurance Healthcare is Failing,” “A study published [in June 2011] from the university of Washington in collaboration with researchers at Imperial College London found life expectancy rates in eighty percent of US counties were fare behind the standard set in the top ten nations” (DeMoro 2).Also, in a study shown in “Forbes” America’s quality of care ranked fifth out of eleven industrial nations: Australia, Canada,
The publications of these reports were put forth to improve the healthcare system. The aims were to lead all healthcare professionals to fundamentally better care. Since implementation of the strategies presented in these reports it has led our healthcare to a safer, more effective, patient centered, timely, efficient and equitable system. Every report in the Quality Chasm series requires specific research to further develop the evidence base related to quality care. “Research targeting quality improvement has been supported and implemented by various stakeholders, ranging from health profession organizations to Federal agencies to health providers themselves. Findings are being applied in a variety of ways, from changing internal drivers