Cost, Access, and Quality Cost, access, and quality are important concepts in the health care system in the United States. These concepts are interrelated and can pose as barriers to individuals in the quest of receiving health services. Throughout the years, the government has tried to manage each concept to provide low cost and easier access to quality health care services. As a nation, we spend more on health care than any other thing in our budget. Cost can be defined in varies ways in health care. Consumers and financiers defined cost is the price of health care. This includes doctor’s bill, prescriptions, and health insurance premiums. Cost can also be defined as the amount of money a nation spends on health care. The increase of prices …show more content…
One strategy is supply-side controls which provides restrictions on capital expenditures such as new construction, renovations, and buying new technology (Shi & Singh, 2015). Price control is another cost containment strategy that converted reimbursement from cost plus to a prospective payment system. The prospective payment system is based on diagnosis-related groups which have fixed payments for the treatment of certain acute illnesses. Peer reviews are also a strategy used to contain cost of health care services. The purpose of peer reviews is to monitor the utilization of services and quality of care that physicians provide to patients. This is to ensure that care that patient receive is reasonable and necessary. Cost sharing also helps control cost. This concept helps individuals control the utilizations of unnecessary services. Competitions can help control cost of health care. Employers can shop around for the best price for premiums for their employees. There are also antitrust laws that prevent business practices that interfere with competition among …show more content…
Access is defined as the ability of an individual to receive affordable, convenient, and acceptable health care services when needed (Shi & Singh, 2015). Access to care has five different concept which are availability, accessibility, accommodation, affordability, and acceptability (Shi & Singh, 2015). Availability is the fit between service capacity and individuals’ requirements (Shi & Singh, 2015). Accessibility is the locations between providers and patients. Accommodation is how resources are organized to provide care and the individual’s ability to use the arrangement (Shi & Singh, 2015). Affordability is the ability of an individual to pay for services. Acceptability is the attitudes of patients and providers and the compatibility of these attitudes. There are three levels to measure access. The first level is the individual. This measure the utilization of services that an individual plan to use and the patient’s opinion of the interaction with the provider (Shi & Singh, 2015). The second level involves the health plan. This includes the plan characteristics that affects enrollment, the practices that affect access, and the measurement of quality (Shi & Singh, 2015). The last level of measurement is the health care delivery system. Surveys are used to gain data for conducting access to care
The current health care landscape has been characterized by large scale consolidation and vertical integration of payers and providers. This has led to a handful of dominate players with substantial influence, and an increasing overlap in responsibilities between payers and providers. Although payers and providers have traditionally been on opposing sides, battling each other about quality of care versus cost-effective care, they are shifting to working together to achieve better value.
The National Healthcare Quality and Disparities Report (NHQDR) (2012) identified three key themes. The themes are health care quality and access are suboptimal, especially for minority and low income groups; overall quality is improving, access is getting worse and disparities are not changing; and urgent attention is warranted to ensure continued improvements in: quality diabetic care, maternal and child health, adverse events, disparities in cancer care and quality care among the states in the south.
Niles, N. J. (2014). Basics of the U.S. health care system (2nd ed.). Retrieved July 14, 2016, from http://samples.jbpub.com/9781284043761/Chapter1.pdf
In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
Despite the established health care facilities in the United States, most citizens do not have access to proper medical care. We must appreciate from the very onset that a healthy and strong nation must have a proper health care system. Such a health system should be available and affordable to all. The cost of health services is high. In fact, the ...
The U.S. expends far more on healthcare than any other country in the world, yet we get fewer benefits, less than ideal health outcomes, and a lot of dissatisfaction manifested by unequal access, the significant numbers of uninsured and underinsured Americans, uneven quality, and unconstrained wastes. The financing of healthcare is also complicated, as there is no single payer system and payment schemes vary across payors and providers.
2. The twin problems of the health care industry as viewed by society are cost and access. First of all, the cost of getting health care is very high and it is getting higher each day. This has been mostly caused by the combination of high cost and an increase in quantity of services provided to the communities. The other problem involves access to health care. American enjoy limited or no access to health care. Many efforts have been done to reform this, but still but still many people are left without access to the care. These two problems are related due to the fact that if the health care industry gets to high off course people no longer will be able to have any access to it. The higher prices are, the lower access people have to it.
The health care system in the United States encompasses so many individuals, businesses, and interest groups. Also, it can be difficult to pinpoint the most optimal approach to serve everyone’s unique needs and wants. This has led to a major health-care crisis in the society. As a matter of fact, the effect of the health-care crisis in the American society has been a longtime situation, and an effective policy response must focus on what is most enriching in the society: aiming to improve the overall quality of the system and positively impact the health status of all citizens, while subsequently minimizing costs.
The federal and state governments are trying to find a way to managed their Medicaid by reducing costs and improving the amount of quality the Medicaid provides. Both federal and state governments are trying to eliminate unnecessary services and rely more on their primary care and the coordination of care. sta...
Reforming the health care delivery system to progress the quality and value of care is indispensable to addressing the ever-increasing costs, poor quality, and increasing numbers of Americans without health insurance coverage. What is more, reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, preventable impediments of illnesses to the greatest extent possible. Thoughtfully assembled reforms would support greater access to health-improving care, in contrast to the current system, which encourages more tests, procedures, and treatments that are either
In today’s healthcare system, there are many characteristics and forces that make up the complex structure. Health care delivery is a complex system that involves many people that navigate it with hopes of a better outcome to the residents of the United States. Many factors affect the system starting from global influences, social values and culture. Further factors include economic conditions, physical environment, technology development, economic conditions, political climate and population characteristics. Furthermore the main characteristics of the Unites States healthcare system includes: no agency governs the whole system, access to healthcare is restricted based on the coverage and third party agencies exist. Unfortunately many people are in power of the healthcare system involving multiple payers. Physicians are pressured to order unnecessary tests to avoid potential legal risks. Quality of care is a major component; therefore it creates a demand for new technology. A more close investigation will review two main characteristics and two external forces that currently affect the healthcare delivery system. Furthermore, what will be the impact of one of the characteristics and one of the external forces in review with the new affordable care act 2010? The review will demonstrate the implications to the healthcare delivery system and the impact on the affordable care act 2010.
The role that the government plays to ensure that these challenges are mitigated and that health care is available to all American citizens is also discussed. Among these problems, poor quality of care is perhaps the most visible and troubling, resulting in nearly 100,000 preventable deaths each year (Institute of Medicine, 1999) and reduced quality of life for millions of Americans due to non-fatal yet serious adverse events such as wrong-limb amputation, hospital-acquired infection, and medication errors (Institute of Medicine, 2006; Leape, 1997). Health care must be fully accountable for quality, and the patient experience is simply the patient's perception of quality. Society should question and debate how healthcare organizations should show improvement for consumers. This can help organizations create reliable health coverage costs and evaluate medical performance for families and individuals in the future.
towards the quality and cost of health care in the United States in the general public. In
Access to health care refers to the ease with which an individual can obtain needed medical services. Many Americans face barriers that make it difficult to obtain basic health care services. These barriers to services include lack of availability, high cost, and lack of insurance coverage. "Limited access to health care impacts people's ability to reach their full potential, negatively affecting their quality of life." (Access to Health Services, 2014) Access to health services encompasses four components that include coverage, services, timeliness, and workforce
health care systems is the poor quality and outcomes of patient care. The Commonwealth Fund in New York states “although the U.S. spends more on health care than any other country and has the highest portion of specialist physicians, survey findings indicate that from the patients’ perspective, and based on outcome indicators, the performance of American health care is severely lacking” (Bernstein). Not only are Americans paying an excessive amount of money for health insurance, the patients are unsatisfied with the quality of care they receive. Higher spending is not buying greater user satisfaction, as chronically ill patients in the U.S. who are most frequently in need of care, are generally less satisfied with their care compared to their counterparts in other countries (Milstein & Darling, 2010, p. 31). Efficiency is also a factor of poor outcomes when physicians have difficulties receiving timely information, coordinating care, and dealing with administrative hassles (Bernstein).