Transparency in Healthcare is one of the many debatable changes in the recent healthcare reform. Consenting for pricing, outcomes reports, and standardized performance metrics to be easily accessible to all patients is causing a debate among physicians and insurance not let alone the public. Transparency will bring light into healthcare cost and pricing while enlightening the availability of information needed by consumers to make informed healthcare choices based on their selected physicians. The aspired goal is to implement transparency in healthcare to be recognized, as an important role in which the rendering physician’s contracts will be value based and not quantity driven. The consumer or also know as the patient will have fundamental information on the insurance plan product purchased by him or her, allowing them to understand their patient responsibility towards the rendered cost with …show more content…
The quality of doctor care based on outcome reports, and identifying those physicians who meet state performance measures will also be provided to consumers to benefit their health and healthcare
The change to value based purchasing has bought many challenges to the healthcare industry. With the change to value-based purchasing for payments, it has changed how healthcare organization receive payment and delivery care. The advantage of have value based purchasing is that it improves the quality of care while reducing cost in an effort of aligning patient’s with the right provider and treatment plan (Minemyer, Jun 29, 2016). However, there are many disadvantages, such as it increases the patient volume as counteracting the reduction of procedure volume (Brown, B. & Crapo, 2016). Also it makes providers more responsible for care that is beyond the expected treatment of care needed (Minemyer, Jun 29, 2016). With quality measures tied
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
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
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.
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
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.
Title three: making the quality and efficiency of health care in US to be of a higher standard. Under this title, the quality of medical care would be enhanced for every U.S citizen, mainly to those who were members of Medicaid and Medicare. A research was set to be conducted aim at mobilizing consumer on taking good care of their health. Accountable Care Organizations would also receive a percentage of the savings
Lyons T. and Payne B. (1974). The quality of physicians' health-care performance: A comparison against
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.
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
The truth is that transparency in the delivery of health care means completely different things to different people. Consumers, physicians, and providers all have different views as to what transparency would do to benefit or degrade the health care system. There have been numerous studies completed, and articles written, about how the lack of transparency in health care is negatively impacting the delivery of quality care. Many individuals in the past who work in
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
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.
I chose to review title VI of the Affordable Care Act, which encompasses transparency and program integrity. This section of the Affordable Care Act focuses on keeping Americans informed about their healthcare choices and reducing fraud and abuse in programs funded by the federal government. “It attempts to strengthen doctor-patient relationships using new medical research and access to more data to allow doctors and patients to make the decisions that work best for them” (Affordable Care Act Summary, n.d.).
Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.