Table of Contents
- Incentives for the Organization
- Supporting Factors that Reduce Health Care Costs
- Difference Between Quality in Free Market Healthcare System and Single Payer Government System
- Common Law Quality Initiatives in 21st-Century Healthcare Organizations
- The Importance of Health Care Quality for the Organization
- A Plan to Protect Patient Information
- Related Health essays
Improvement of patient care highly relies on the consideration and responsiveness to patients’ preferences, needs, and values. Conventionally accepted dimensions of quality patient care include health care coordination, family engagement, emotional care, physical care, and respect. With the improved patient care, public value for services develops and advances as well. Therefore, the duty of the Quality officer of a healthcare organization, which is the largest facility in the state, is to ensure that the best standards of the patient care in service delivery are attained and maintained. Health policy, as guided by the legal framework, is the backbone of this discussion. In this regards, the following paper is aimed at providing a comprehensive summary suggesting the incentives towards implementing and interpreting the Patient Protection and Affordable Care Act (ACA) which serves as an ideal basis for health reforms.
Incentives for the Organization
Improving the quality of patient care demands the adoption of selective policy drivers such as financial incentives, public reporting incentives, and performance incentives. A lesson from both private and public healthcare institutions in the world suggests that there is a need to integrate service quality with financial resources provider. Consequently, patient care is the resulting metric of quality financial based incentives which ensure that services are oriented towards patient care provision (Diamond & Kaul, 2009). There is indeed a commitment from the US government to assist in driving the financial incentives agenda to the health care providers that are determined to ensure the improvement in quality health care, including patient based care principles (Diamond & Kaul, 2009). Ideally, driving this agenda emphasizes the ‘pay for performance (P4P)' policy, which is a performance incentive. This approach is the best for ensuring that the organization is more focused on patient experience. Under the P4P policy incentive, health care providers will receive rewards for their achievement within a range of objectives as outlined by the payer. They include the improvement of patient safety, quality care, and delivery efficiencies. This incentive advocates for P4P as a crucial way of realizing quality improvement objectives. For instance, the Blue Cross Blue Shield Massachusetts proposed an improved quality contract, according to which the health care providers received performance incentives for giving quality measures. Under this plan, the organization can earn an additional percentage to the total budget after meeting its outlined targets. The public reporting, on the other hand, provides the incentives that eliminate the gap between present and high-quality practices of health care provision. Furthermore, public reporting is a factor of transparency in explicit decision-making processes.
Supporting Factors that Reduce Health Care Costs
There are three methods that lower the volume and the cost of healthcare services without reducing the quality of healthcare as a whole. The primary one is the inventory of wasted spending. In health care, waste is generally divided into five categories. They include inducing excess costs in health care and the health insurance sectors, charging prices that are non-competitive for products and services, using methods that are not sufficient in delivering services that are useful, failing to use the opportunities meant to reduce net spending through preventing injury and illness, and giving services that are not likely to improve one’s health. According to Kyeremanteng (2013), these embedded waste streams represent a big percentage possibility in reducing the healthcare spending per capita while improving the outcomes of the clinic and the experience of the patient in their care.
Waste in administration imposes numerous direct or indirect costs on the health care consumers, health plans, and clinicians. What is more, a lot of time is consumed by patients in completing paper forms and waiting for sessions with health care providers, especially, considering that schedules are frequently not managed well. Such factors may significantly lower the workforce productivity.
Secondly, the availability of waste trimming tools is another supporting factor that could help in reducing the cost of healthcare and improve the overall quality of care for patients. In this regard, electronic health records act as enablers to other tools and as waste trimming tools too. The application of such methods saves about $78 billion a year, provided its implementation in the nation is successful, at the same time improving the outcomes of health care (Kyeremanteng, 2013). In addition, electronic health records assist physicians in accessing patient’s health information easily. The patients’ health care information includes their medications, immunization, demographics, and laboratory data, past medical history, progress notes, and radiology reports. When physicians have all the required information about particular patient, they are able to provide fast and safe care.
Another factor that helps to reduce the healthcare cost, but at the same time enhances the quality of health care is the public policy opportunities. After trimming the waste, continuous improvement further offers everlasting means that will aid in improving general health as well as bringing the increase in health care spending into closer alignment with the nation's gross domestic product growth. In order to attain this vision, new policies set should be coordinated across the range of various fronts. The federal government must strengthen the policies that are antitrust to make sure that no participants of health industry can opt for a noncompetitive increase of prices and tepid gains annually in cost and quality efficiency. Stronger policies should ensure that people in every community have the places that are safe and accessible for playing games and doing exercises. The government should also pay special attention to issue of obesity, which appears to be a burden to the spending of healthcare, by introducing the programs that would help people to deal with the problem thus reducing the number of those who suffer from it..
Difference Between Quality in Free Market Healthcare System and Single Payer Government System
Since health care cost greatly impacts health systems, the increase in it has developed into a major debate within the public discourse. High costs influence the system by compromising the quality of health, lowering the coverage of insurance, and the accessibility of services. As a result, the analysts and critics have turned their attention to suggesting the reforms that are geared towards the matters of quality and cost. As part of these reforms, free market health care has been factored. Generally, free market health care system is a kind where government regulations are minimized or not involved at all. In this manner, health care providers can give their services freely, without a necessity to meet compelling regulations. The free market health care system is associated with the key benefits in addressing the issues in today's health provision. It is possible to realize the latter by means of improving the quality of health care and hence becoming competitive – a scenario that becomes realistic with the privatization of health care system and the adoption of improved business models (Himmelstein, Woolhandler, Goodman & Sade, 2007).
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On the other hand, the free market health care causes a major downsizing of the organization through its business models, with critics arguing that they involve the policies that advocate for cost reduction. The lowering of costs is associated with the high competition among the providers. Nevertheless, cost reduction policies and downsizing are the main factors of the decrease of the quality of health services. Overall, the persons who defend free market argue against single payer with the claims that the latter has high inefficiency, delayed wait period, is costly, and results in mismanagement.
On the other side, the single payer health care system involves the state in catering for all the health-based costs in place of commercial insurance market players. Unlike the free market healthcare, single-payer system increases accessibility and affordability of health care, as pointed out by Himmelstein et al. (2007). The reason for the above consists in the fact that single-payer strategy adopts savings on administrative waste in a bid to ensure funding for the coverage of uninsured Americans, while reforming the benefits for those insured. What is more, compared to the market-based system, the single-payer one has enacted the reforms that are aimed at preventing which is a crucial aspect defining quality care. Within the market-based system, there are numerous cases of preventive efforts falling off the main course mainly because financial payoffs amount is in the long run, but costs have an immediate effect (Diamond & Kaul, 2009). Overall, single payer system is better than the free market health care because it ensures the enhanced coverage among all people. The latter coverage is rather reliable because of government’s ability to control the funds.
Common Law Quality Initiatives in 21st-Century Healthcare Organizations
The major law quality initiatives that are still found in the 21st-century health organization are medication errors prevention, implementation of information technology, and health profession education. The implementation of the core competencies helps to enable healthcare providers to gain the knowledge and skills required for the best outcomes of care. Health profession education is an integrating factor to the healthcare quality. Information technology adoption involves electronic health records system usage and the standards for measuring and evaluating the healthcare organizations performance. The lack of sufficient information and poor communication are the major causes of the majority of medical errors (Teitelbaum & Wilensky, 2007).
Electronic healthcare records are safe, quality, and efficient. They help in providing the accurate services in healthcare which align with the condition of a patient at specific time. Professions give the standards that guide the course of collecting, processing, classifying, and coding the patient's safety. In healthcare organizations, most cost is incurred due to medication errors. However, the latter can be prevented by improving the quality of healthcare. Quality healthcare provision is universal in any organization relating to the sphere discussed. Furthermore, the confidence of the patient is enhanced through it; his or her overall healthcare is improved by the provision of quality healthcare. Finally, mortality and morbidity rates are reduced by providing patients with quality healthcare through caring for them at proper time and through preventing the complications development.
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The Importance of Health Care Quality for the Organization
There is no doubt in the importance of health care quality, as outlined by the Institute of Medicine (IOM). First, the health care system is a safe platform to be used by anyone and at any time. According to Kyeremanteng (2013), an example of the application of this standard is the patients’ need to provide their information only once and its further safe preservation for the future reference, or the possibility to enjoy high standards of service at night and during the weekends. Second, the significance of the high quality health system lies in its patient-centered nature. With this regard, there is an ensured high respect for the patients' values, well-coordinated information and communication as well as emotional consideration. Third, healthcare quality is greatly important to both patients and the care providers, which is ideal for the identification of service failures as well as delays in addressing patient's needs, and thereby mitigation measures can be employed in advance.
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A Plan to Protect Patient Information
According to the Health Insurance Portability and Accountability Act (HIPAA), patients' information ought to be kept confidential. A good plan for protecting this information involves a system in Electronic Health Record (EHR), which is bound to ensure significant benefit by increasing financial and productivity benefits in the following steps: conduction of a risk analysis through the review of responsibilities governed by HIPAA security rules, evaluation of firewall protection, and the review of protected health information. Another essential consideration is the establishment of administrative safeguards by putting in place data security policies. Furthermore, the actual building of the technical safeguards by auditing applications and testing the vulnerability of networks is equally important. Finally, the plan involves creating an online backup, which has well-outlined emergency access procedures and an all-time web support.
From the discussion above, it is apparent that studying policy and law is crucial for understanding health care. It is clear that finding the solutions of health care problems invariably involves the creation of proper policies along with the support of a robust legal reform, as outlined in the Affordable Care Act. In this regard, the approach adopted in the current discussion considers health policing and law in providing the framework for patient care.