The Provision Of Cost Effective Care

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).

You have been asked by a health care magazine to write a series of articles focusing on health care financial concepts. The articles will be included in five consecutive issues and will be geared towards readers with little knowledge of finance. You must ensure that the articles are both informative and engaging to your audience. You must also ensure that your articles relate financial principles to the health care industry.

There are 10 key economic concepts of health care. Each of the economic concepts is important when evaluating the different issues related to health care such as the increasing cost of health care. Henderson (2015), list the 10 concepts as follows: scarcity and choice, opportunity cost, marginal analysis, self-interest, markets and pricing, supply and demand, competition, efficiency, market failure, and comparative, advantage. The concept scarcity and choice address the issues related to the limited supply resources and the need to economize (Henderson, 2015). An illustration of the importance of the scarcity and choice concept is when there is a low quantity of available resources to meet the demand of individuals and rationing occurs. Opportunity cost emphasizes

The College of American Pathologists or CAP is the accrediting organization for laboratory and testing personnel. CAP’s “accreditation process is so thorough, the Joint Commission [and CMS] accepts …their standards” in place of conducting their own survey of the hospital’s laboratory and personnel (Gartee, 2011, p. 47). This is because of the guidelines they follow to maintain their integrity and to remain the industry standard. In recent years, the “CAP [has] developed new check list” for continued improvements. Additionally, they are continuing to vet the requirements for the new next-generation sequencing or NGC-based test that is speeding laboratory procedures. So much so that the recent adoption of the new technology for clinical testing” was done prior to the new standards being approved (Aziz, et.al. 2015, p. 481).

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.

As of 2008, the Center for Medicare and Medicaid Services (CMS) identified falls as a Hospital Acquired Condition (HAC). HAC is a complication or comorbidity that occurs as a consequence of hospitalization and is high volume and/or high cost, and be reasonably prevented using evidence-based guidelines (Radey & LaBresh, 2012). The Center for Medicare and Medicaid Services will no longer cover the cost of care as a consequence of an inpatient fall based on the presumption that falls are preventable by the organization (CMS,

The nation health care system is facing significant challenges that requiring immediate major reforms. Lately close attention is drawn to the uninsured Americans, such as the most painful dilemmas of health care system. The problem of uninsured and uncompensated care continues significantly contribute to the rise of the health care cost and has been a chief topic for public debates and political campaigns for a long time. The purpose of this paper is to describe the current extent of uninsured care and provide the strategies from the nursing point of view how to change the trajectory of this prevalent issue in the USA health care system.

Health care costs, or more specific, how the United States funds healthcare, has been an issue in this

When you think about health care cost and what was done in the past to help people who could not afford it to be able to get coverage now. Many people will not be able to afford to get the mandatory coverage and if they do, they will not be able to afford to see the physician or take the medication that they needed. Some of the plans worked and others helped for short periods. With other countries, finding ways to make it work for them and stakeholders more worried in the U.S.A. over their assets. With the rise of the older generation living longer but having more health issues is a reason to look into getting better coverage that is affordable for all for health care.

The cost of health explains almost half of the budgets of the state from financing the Medicaid program to providing health care for the employees of the state and other less qualified population like the prisoners (Vanderbeaux, 2014). In America, thousands upon thousands of decisions concerning health care are made by State legislatures every year (Vanderbeaux, 2014). Some of those decisions involve how best to provide appropriate care more efficiently, and deciding on what age group of patients needs to be immunized (Vanderbeaux, 2014).

Congress held hearings at which people who had been harmed by laboratory errors testified. These hearings revealed serious deficits in the quality of work from physician office laboratories and in Pap smear testing results (R. D. Feld, M. Schwabbauer, and J. D. Olson, 2001, The Clinical Laboratory Improvement Act [CLIA] and the physician's office laboratory; Virtual Hospital, University of Iowa College of Medi-cine [www.vh.org/adult/provider/pathology/CLIA/CLIAHP.html]). In 1988, Congress once again responded to public concerns about the quality of laboratory testing by passing CLIA '88. CLIA '88 expanded the laboratory standards set by CLIA '67 and extended them to include any facility performing a clinical test. Currently, under CLIA '88,

Note: In the real scenario, the medical student would be handed test results and he/she would need to interpret them. Since there are 4 possible tests, we did not

30). According to Brunstein (2016), individual tests can be moved to a patient’s bedside or in other less formal settings to provide faster diagnosis, allowing for quicker response times when medical interventions are needed (p. 30). Bedside testing uses a method called point-of-care testing (POCT) and presents both new possibilities as well as challenges (Brunstein, 2016, p. 30). Brunstein (2016) points out some of the challenges are decreased sensitivity, specificity, or sometimes both, especially when compared to the testing that is done in the core lab (p.30). However, POCT can prove to be advantageous because of reduced response times for medical interventions. POCT with moderate sensitivity and high specificity have proven to be convenient, cost effective first-line screening tools (Brunstein, 2016, p. 30). Molecular POCT has positive implications for the future but there are some limitations. POCT used for molecular diagnosis (Madix) are limited to only

Traditionally the American health care system relied heavily a repayment model referred to as fee-for-service which is described as a form of repayment that generates a greater emphasis on the volume of patients seen rather than healthy outcomes produced under a physician’s care. The fee-for-service repayment method poses multiple issues such as: duplicating services which in turn renders some of the services unnecessary, utilization of expensive technology because of the revenue generation rather than as a valuable diagnostic tool and crowding caseloads to an unmanageable level in order to achieve highest level of reimbursement. The aforementioned events not only have the possibility of being unethical but also drive up the cost of health care in the United States. Currently, health care costs have not only increased, but the Office of the Actuary projected that U.S. healthcare spending will make up nearly 20 percent of the economy in 2019. One would argue that if as a country we are spending so much on health care that we should be a “healthier” nation, but this is not the case. Even though America continues to be the largest spender on health care, collectively we experience a lower life expectancy rate compared to other industrialized countries (hfma.com, 2011, p. 2). To assist with climbing health care rates healthcare purchasers have called for repayment reform. One such reform that has been on the forefront is Value-Based Health Care (VBH), also known as outcome

1A. Market failure is a situation in which the allocation of goods and services is not efficient. In any given market, the quantity of a product demanded by consumers does not equate to the quantity supplied by suppliers. This is a direct result of a lack of certain economically ideal factors, which prevents equilibrium.