Health Care Reform Paper: 5 Focus Areas

Details:

1) Write a paper of 1,000–words that lists the top five elements of the health care system that most need reform, in your opinion. Justify your choices through a logical analysis of the elements’ impact on the current system.

2) Refer to the assigned readings to incorporate specific examples and details into your paper.

3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

Introduction

Health care is the backbone of any society and the catalyst that promotes productivity within said society. As such, it is prudent that the delivery of healthcare services is taken very seriously by all. While the delivery of health care services is vital to the success and growth of the society, there are some core elements of health care that need to be subjected to serious reforms in order to improve the current state of health care delivery in the USA.

Insurance

Typically, any growing society is subjected to a significant strain in the delivery of healthcare services. This is often the result of inadequate infrastructure and expertise to facilitate the delivery of health care services. Inevitably, demand for health care services outweighs the supply of expertise and infrastructure that is responsible for delivering said services. This significantly raises the costs of health care services (DeNisco & Barker, 2016). In such situations, insurance companies will often develop insurance plans aimed at providing health care services. Unfortunately, a significant number of individuals and their families are often unable to access insurance based on their inability to satisfy the minimum conditions required by insurance providers. For instance, roughly 47% of people in the USA are unable to acquire insurance under the Affordable Care Act due to low incomes, non-expansion of Medicaid within the state and several other reasons (Foutz, Squires, & Garfield, 2017). This problem calls for the development of inclusive insurance plans that stand to cater to a wide variety of individuals. Furthermore, it is vital that insurance providers are subjected to regulations insofar as health care plans are concerned to ensure that they can remain competitive without forcing individuals to pay unnecessarily high premiums.

Health Care Cost

The cost of health care services in the USA is relatively high, especially considering the USA is a fully industrialized country that does not provide universal care to its citizens. The costs are often high for the majority of citizens due to the dynamic of payment between physicians and insurance providers. In the US, a blend of capitation and fee-for-service (FFS) systems is used in an attempt to reduce the cost of care (Diffen, n.d.). Ultimately, the use of a capitation system enables patients to access health care services from physicians for a relatively low price. This works in favor of both physicians and patients. However, the current system that subjects many basic services to capitation models and more specialized services to an FFS model is discriminatory and unnecessary. It results in significantly high costs of health care for individuals should they develop medical conditions in need of specialized services (Farkas & van Biesen, 2011). This transition can be devastating to the finances of an individual as well as his or her family. Health care reforms should focus on developing a capitation model even for specialized services to ensure that the public can benefit from affordable health care services regardless of whether they are basic or specialized.

Health Information Management

In a world that is rapidly embracing technology and incorporating it into almost every aspect of life, it is vital that this same approach is extended to health care. Quite often, patients may visit various physicians across different hospitals and even states (Kronenfeld & Kronenfeld, 2004). In such cases, accessing the medical history of such patients is often an unnecessarily long process that could benefit immensely from significant reforms. The development of an integrated health information management system that will allow physicians to access the medical history of patients with significant ease is bound to improve the delivery of services. It will also allow physicians to track the medical history of patients even after they change physicians, hospitals, insurance providers, and even states (Kronenfeld & Kronenfeld, 2004). Such a system is bound to be essential to revolutionizing the delivery of health care services.

Delivery of Quality Care (evidence, patient-centered)

One of the core aims of health care professionals and providers is to provide patients with high-quality care. As such, patient-centered care and evidence-based care are two important reforms that need to be fully integrated into the health care system (Hernandez, 2011). It is vital that providers work to provide their patients with tailored care that not only meets the specific needs of the patient, but which also ensures that the care provided is of high quality. Similarly, it is essential that even when the care is tailored to the needs of the patient, it should be based on reliable evidence (DeNisco & Barker, 2016). These reforms call for intensive research into various health care delivery approaches and how they affect patients and stimulate healing (NLM, 2018). Essentially, such research should build on the existent methods in order to develop improved methods of health care delivery that are of high quality, based on reliable evidence, and tailored to meet the needs of each patient.

Policy Development

Policy development and implementation is one of the core duties of every government. Developing effective policies, passing them into law, and implementing them is a surefire way of facilitating change and growth within any society or system (Kronenfeld & Kronenfeld, 2004). The same can be said of the health care system. Being the core regulator of the health care system, all the above aspects of health care can significantly be improved through the development of policy (Hackbarth & Miller, 2009). Consequently, it is vital that both state and federal governments actively participate in the development of progressive health care policies that stand to help realize the above developments (Farkas & van Biesen, 2011). Presently, the absence of firm and progressive policies addressing the above factors is one of the main reasons why such elements of health care are in need of serious reforms. In essence, policy development is the only way various elements of health care can be reformed to the benefit of the entire public.

Conclusion

The health care system is built upon various elements, which when implemented combine to facilitate the provision of quality health care services. Although a number of systems are in need of reforms, insurance, cost of services, health information management, delivery of quality care, and policy development are in urgent need of reforms. These elements are essential to the delivery of quality services and unless they are subjected to progressive reforms, they stand to lower the quality of services provided over time. It is essential that these elements are reformed as soon as possible.

References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for          the profession. Boston: Jones & Bartlett.

Diffen. (n.d). Capitation vs. fee for service. Retrieved from https://www.diffen.com/difference/Capitation_vs_Fee_For_Service

Farkas, C., & van Biesen, T. (2011). The new cost-conscious doctor: Changing America’s healthcare landscape. Bain.com. Retrieved from http://www.bain.com/publications/articles/the-new-cost-conscious-doctor.aspx

Foutz, J., Squires, E., & Garfield, R. (2017). The uninsured: A primer – key facts about health insurance and the uninsured under the Affordable Care Act. Retrieved from https://www.kff.org/uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-under-the-affordable-care-act/

Hackbarth, G., & Miller, M. E. (2009). Reforming America’s health care delivery system. Statement before the Senate Finance Committee Roundtable on Reforming America’s Health Care Delivery System, 5.

Hernandez, J. (2011). Responding to the emergence of new healthcare delivery models. Clinical Leadership & Management Review, 25(1), 2.

Kronenfeld, J. J., & Kronenfeld, M. R. (2004). Healthcare reform in America: A reference handbook. Santa Barbara, Calif: ABC-CLIO.

NLM. (2018). HSRIC: Health care reform, health economics, and health policy. Nlm.nih.gov. Retrieved from https://www.nlm.nih.gov/hsrinfo/health_economics.html