Transparency In Healthcare

Mandatory outcomes reporting, such as core measures for Acute Myocardial Infarction (AMI) and Congestive Heart Failure (CHF) have also changed the way consumers select what provider they will choose, in addition to these quality indicators being part of the pay for performance initiative

A powerful force for change can be created by embracing transparency. According to the Department of Health and Human Services, “transparency is a broad-scale initiative enabling consumers to compare quality and the price of health care services so they can make their own informative choices among doctors and hospitals. This initiative is laying the foundation for pooling and analyzing information about procedures, hospitals and physicians services. In order to create value driven health care, there are four steps to turn raw data into

Transparency in Health Care Janessa Choquette Rhode Island College Abstract This paper takes a look at four published articles that delve into the topic of how transparency in health care would affect patients, providers, and the system as a whole if the United States ever took this route. The articles break down how the lack of transparency that is currently in place in the United States is either not good, or fine, for the health care system. The research that was conducted to write these articles was completed both online and offline, through phone interviews, online surveys, and face-to-face conversations. The purpose of this paper is to examine whether changing to full transparency in health care will result in better health outcomes in the United States than we have now, a worse impact, or none. Each article gives perspectives from different people within the delivery system to ensure that all aspects are being considered before a decision is being made.

Through the history of health care, the standard of care changed from protecting our patient from injury and illness to a systemic entity to make money for insurance companies. Access to services and clinical outcomes are dependent on what health insurance providers will “pay” for in a clinical or community setting; as a result, patient safety, care and satisfaction has been negatively impacted.

Reimbursement and Pay-for-Performance HCS 531 November 11th, 2013 Regina Pointer Introduction There is a growing trend in the United States called pay-for-performance. Pay-for-performance is a system that is used where providers are compensated by payers for meeting certain pre-established measures for quality and efficiency (What is Pay-for-Performance, n.a.). We are going to be discussing what pay-for-performance is. There are different aspects of pay-for-performance which include; the effects of reimbursement by this approach, the impact cost reductions has on quality and efficiency of health care, the affects to the providers and patients, and the effects on the future of health care.

Where there is transparency, there is good accountability thereby reducing government deficit. “Its past time to require transparency of cost and outcomes, so consumers can make informed choices about their care. As patient – consumers increasingly transition to high-deductible plans and other models that increase their cost exposure, they will demand more transparency and information for the choices they need to make. However, simply having some awareness that not every hospital is performing equally well and consumers should be making informed choices is an important first step towards a true market-based healthcare system”(Rita Numerof

Currently it is often difficult to make informed decisions about their care because of the opaque nature of health care pricing. Houk and Cleverly (2014) contend that pricing transparency could give health care providers a chance to garner increases in patient census; even if they do not have the least expensive price for a specific procedure, by allow health care providers the qualify why their services cost what they do. The demand for price transparency should be embraced in the future because it could create a forum that allow actual competition for patients and allow health care providers a chance to differentiate

Why Change is Difficult in the Healthcare Environment A major change is occurring in the healthcare system as the United States continues to move toward enhancing patient care quality and access while also decreasing cost. This significant transformation is driven by a variety of forces, including changes in managed care, a shift from pay for service to pay for quality, and ever-evolving client characteristics. This paper aims to discuss each of these factors and the ways in which they make this major transformation a difficult one for the nation to undergo.

It is important to understand as the years pass by and the time is changing, the world of healthcare is changing as well, especially in terms of healthcare reform. One major change in healthcare reform was a course of action that required healthcare organizations to submit mandatory data on the quality care of their patients. This plan was initiated by the Centers for Medicare and Medicaid in 2015, in which they implemented the Medicare Access and CHIP Re-authorization Act (MACRA). This act modernized how Medicare payments are tied to quality and cost of care (EClinical, n.d.). MACRA initially focused on Meaningful Use (MU), PQRS and Valued-Based Modifiers (VBMs). In fact, when it came time to report quality data, if an organization did

In the United States the quality of health care that people receive changes in accordance to the region and is more than often just not sufficient. Because of the lacking care among these hospitals, federal policy makers and private organizations have put in motion a very important program that will collect and publicly report that gathered data on the quality of health care

Statement of Purpose I work as an home care occupational therapists in the field and provide services to people from children to old age. I see the effects of laws and policy discussions not only on the patients but also on the workplace itself. The Patient Protection and Affordable Care Act

In the United States the quality of health care that people receive changes in accordance to the region and is more than often just not sufficient. Because of the lacking care among these hospitals, federal policy makers and private organizations have put in motion a very important program that will collect and publicly report that gathered data on the quality of health care that the American people are getting. The Hospital Consumer Assessment of

In recent years, emphasis has been placed on improving the quality of health care services and the overall patient experience. Innovative measures are needed to meet these expectations, while also containing the rising costs of health care. The government has enacted new laws in attempts to provide incentives that base Medicare payments in part on quality. In fact, the Patient Protection and Affordable Care Act of 2010, requires the implementation of value-based purchasing (VBP), which bases Medicare reimbursement rates on the quality of care (Kennedy, Wetzel & Wright, 2013). Hospitals may experience a decrease in revenue initially, however, it is theorized that the increase of transparency and accountability will serve as an incentive for improvements in the overall quality of care provided in the United States.

A New Social Contract for Health Care Insurance Costs The new social contract between the health care system and employers, patients, and the government has given everyone involved some breathing room. They have provided a clearer picture of the costs of health care; however, it is evident that there is still work to be done regarding the transparency of complete and exact costs. For example; all hospitals have a price list called the chargemaster that includes nearly 20,000 health care procedures. The prices on this list are the prices that patients will most likely see on their bills; however, the terms are not standardized and many are bundled services that make it difficult to compare them with other institutions. It is obvious

From family members, to health care professionals, to insurance companies, to researchers, to the government, a lot of people hold stakes in the well-being of the medical world. However, there needs to be transparency across all levels, things such as the chargemaster need to be abolished as they do not reflect accurate cost statements. Creating an unfair divide across hospital, and patient costs. Each individual involved in the medical billing process needs to understand how it works and why, so that at the end of the day each person is given the best option for their means. Furthermore, health care policies need to be made to counteract the large profit margins that companies are making off of their products in the hospital. The margins are much too high and there is an unequal balance between the cost the patient incurs and the profit that companies reign