The Ever Changing Healthcare Environment

In 2012, the ACA found an excessive amount of readmissions of patients that were hospitalized within 30 days for the same medical conditions. This factor viewed under the ACA as a quality issue and CMS implemented value-based incentive payments based on performance in a set of quality measures. The plan is to implement a pay for performance (P4P) in formulas used by Medicare to reimbursement providers. “The objective is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system-wide costs” (Shi and Singh, 2015). In addition to the P4P, nonprofit hospitals also focus on continual improvement, data and cost containment throughout the organization (Adamopoulos,

Health care is continuously changing. In the past several years there has been a large shift in the focus in hospitals. The focus has changed from the staff to patients, patient satisfaction, and cutting costs in order to budget more tightly (Tarrant & Sabo, 2010). Because of this, along with the extreme increase in a number of patients seen and the acuity of the patients, nurses are being overworked. As a result, role conflict and ambiguity is becoming an issue. The purpose of this paper is to discuss role conflict and ambiguity, its significance, and its application to nursing.

In the past several years, there have been several changes in economic policy at federal and state levels. The two economic policies that present to be the most precedent for healthcare leaders with concern to facility reimbursement are the Affordable Care Act (ACA) and the switch from volume to value reimbursement. First, there is the ACA policy, which have affected healthcare facilities and their reimbursement methods. In fact, ever since this policy was implemented, provider reimbursement has started to decrease in terms of fee-for-service payments (The Common-Wealth Fund, 2015). In other words, the intention of this policy was to provide budget relief to the government payers as well as giving providers an incentive to provider patients with great quality of care.

Identify and describe at least three of the most difficult issues facing health care in the United States today.

Healthcare costs in the United States (U.S.) have escalated exponentially in recent years due to many factors. The Affordable Care Act was legislation passed in 2010 to attempt to change the delivery of healthcare in the U.S. and circumvent the continued rising healthcare costs. A major factor contributing to healthcare costs is the Medicare population and their readmission rates to the hospital within 30 days of discharge. This factor involves many layers of services and financial implications. This paper will discuss how healthcare quality results in hospital readmission, the fines that are imposed by the government through Health Readmission Reduction Program, the changes implemented by hospitals to decrease readmission

One of the greatest changes in healthcare in the past ten years has been the rise of managed care, much to the displeasure of many patients and physicians alike. Managed care arose out of concern about spiraling healthcare costs and was designed to encourage physicians to give patients treatments that were cost-effective out of their own financial interests. "The consumer strategy was directed at imposing some barriers to use by levying various forms of co-insurance. The most common approaches used either deductibles (where the consumer paid the first portion of the bill a technique familiar in other types of insurance) or co-payments (where the consumer paid a portion of the bill and the insurance company the rest) or a combination of both' (Kane et al 1994). Managed care has given health insurance companies an increasingly significant voice in how treatment is administered and allocated. Managed care has proliferated in the past decade despite considerable criticism of the practice of 'nickel and diming' patients as well as the considerable bureaucratic red tape it is has generated. Also, research indicates that healthy, well-insured patients tend to over-consume care without meaningful co-pays but poorer, sicker patients can be deterred even by moderate co-payments and suffer negative health consequences (Kane et al 1994). However, managed care has not gone away and is a reality that all healthcare

Change can be devastating and not always everyone agree with it. The biggest transformation in healthcare is the implementation of the Affordable Care Act. With the new health care system the government mandated U.S. citizens and legal residents to have health insurance that resulted in the rise of insured individuals. Due to the new policy more people have access to health care that means more primary physician needed to accommodate the rise of new patients. Shortages of physicians not only in the primary care area but also in specialty care area are projected between 46,000-90,000 by 2025 ("The Physician Shortage," n.d.). The pay-for-performance focuses on quality that will eventually decrease the costs (James, 2012, p. 1). This system will give a reward or a bonus to the health care providers whenever they meet or exceed quality standard that are being set (James, 2012, p. 1). In contrary the system can also penalized those providers that are unsuccessful in providing the indicated goals or cost savings (James, 2012, p. 1-2). There are 2,225 hospitals in 2013 that were fined under the Hospital Readmissions Reduction Program (HRRP) which is part of the ACA regulation (Anderson, 2014, p. 11). For the institutions to survive with the new system a lot of hospitals are merging that a year after the ACA implementation there

For this paper I have chosen to write about the future trends in the United States healthcare system regarding Financial and Insurance issues, and access to health care including the uninsured and those in the poverty levels. Health care financing is affected by many things and affects the society in many ways. The costs of health care can be kept affordable for both individuals and society. It is not really the costs of health insurance that

In the article “The Future of Healthcare-Advance, Challenges are Changing the Patient Experience” HealthCare News writer, Joseph Bednar, is trying to emphasize that the Healthcare system is in need of some reform. He says that the Affordable Care Act is going to attempt to add millions of insured patients, but there is a continued shortage on physicians that has been trending for 8 years (1). Hospitals are being asked to provide better services for less money, and there is no way they can be efficient with the drop in profit (1)

The United States’ health care system is spiraling out of control as the years pass. Health care costs are increasing, causing more Americans to fall into debt.1 In 2012, the cost per hospital day in the United States was over $12,000 as compared to other countries such as Australia and France, whose cost per hospital day were $1472 and $853 respectively.1 “If the United States health care system was a country, it would be the sixth largest economy on the entire planet.”1 In the comparison of health care and gas, a family of four spends roughly $21,000 on health care while only spending $3000 on gas per year.1 While the cost of health care is rising in the United States, the health of Americans is not increasing. In 2016, the life

Healthcare has been an every changing service as different leaders have tried to find better ways to streamline the system as costs continue to increase on an annual basis. One thing is becoming clear as Healthcare continues to evolve in that Healthcare is moving to a performance based system in which higher performing plans will get financed a lot quicker than low performing plans.

One of the biggest industries in the United States is healthcare industry, which accounts for over 17.5 percent of the Gross Domestic Product (GDP) of the country. This big representation of the nation’s economic activities impacts the overall economy. In other ways, it’s also impacted by the general economy. While the health care industry continues to grow, transformational changes also continue to enforce change in its organizational structure. Change in organizational structure enables health care providers to make arrangement for the change. In this case, the overall health care providers’ advance in new medical technology (to provide the best quality services), financial system, and the entire health care service structure, rules, and regulations are changed. Hence, a health care industry is fronting a noteworthy pressure to reduce health care cost, to prepare for an influential change in how health care is provided, financed and consumed while delivering the quality care (Hicks & Jacobs, 2014, pp. 385-402).

According to Business dictionary it defined healthcare as “The act of taking preventative or necessary medical procedures to improve a person's well-being. This may be done with surgery, the administering of medicine, or other alterations in a person's lifestyle. These services are typically offered through a health care system made up of hospitals and physicians”. I believe the access of healthcare should be a basic right because every individual working in the united states legally must pay their taxes, which indicate most of tax payer’s money go towards healthcare subsidization. With these reasons, I believe healthcare should

Imagine having an ability to soar in the future. What would the healthcare system look like? What ideas would we bring back from the future and place into practice? According to Murphy (2011) leaders will begin to “lead from the future” (p. 26). In 2009, President Barack Obama signed the HITECH Act legislation. The legislation supports the adoption of meaningful use of information technology (U. S. Department of Health & Human Service, 2013). It is imperative leaders understand the future of the healthcare system. Meaningful use of information technology included the following objectives: (1) improving quality, safety, efficiency, and reduce health disparities, (2) engaging patients and families, (3) improving care coordination, (4) improving population and public health, and (5) ensuring adequate privacy and security protections for personal health information (Federal Register, 2010). These objectives will be required to become incorporated within an electronic health record. Meaningful use is intended to result in patient-centered, evidence-based, prevention oriented, efficient, and equitable healthcare. As healthcare leaders in the twenty-first century how can we make that happen? This paper will utilize Roger’s (2003) theory related to elements of diffusion as a foundation to influence change at a small New York Hospital.

The present challenges for the healthcare industry are significant. With a population that is forever aging, escalating costs, and the unsure impact of the Affordable Care Act, healthcare providers are under tremendous pressure to meet the needs of their patients while maintaining or even reducing costs. One such organization feeling this pressure is BayCare which is a leading not-for-profit health care system that connects individuals and families to a wide range of services at 13 hospitals and hundreds of other convenient locations throughout the Tampa Bay and central Florida regions. Inpatient and outpatient services include acute care, primary care, imaging, laboratory, behavioral health, home care, and wellness. With over 3,100 practicing physicians and more than 58,500 surgeries performed annually, their budget for operating room supplies exceeds $80 million annually across all facilities. Morton Plant Hospital is faced with the challenge of reducing overall operating costs without sacrificing their high standards of patient care and safety. The hospital realized that surgical waste represented a huge opportunity to address. By providing visibility to information that was otherwise hidden, a case cart system would be able to track surgical materials issued, used, and returned; including between doctors, procedures, and locations. This could help the hospital to achieve a number of objectives including: guarantying that all material issued to the OR was accounted for