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A flawed U.S. healthcare system
A flawed U.S. healthcare system
Healthcare reforms 2010
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Challenges 2 There are many challenges when it comes to our health care system that define the future strategic direction. The one chosen for this paper are reform and legislation, information technology advancements such as the electronic medical record (EMR)/ electronic health record (EHR), access to health care including the uninsured and those in the poverty levels, maintaining a skilled workforce and Pay for performance. These challenges pose threats to our health care system planning for the future. One of many challenges is health care reform and legislation. First off to reform our health care system you must have people who know what they are doing. These people should look at the global processes to see how they are doing things to set the pace of how we are to …show more content…
These initiatives provide financial incentives to hospitals, physicians and other health care providers to improve and achieve care for patients. You must be careful as we learned from (Gittleman, 2015)” Since some bonuses may be only weakly performance-related (for example, if a bonus is received in lieu of a benefit payment, or for referring a worker to the company), an examination of the sensitivity of the results to the definition is warranted.” It is important that the organization gives the employee something tangible for their achievements. Pay for performance also known as “P4P” will also penalize for poor outcomes to patients, medical errors and increased costs that is unnecessary. If a health care provider meets their performance measures for reductions in hemoglobin A1c in diabetic patients over time (year to year decrease), they will be rewarded. The reward would be for lowering hospital readmissions for the same
Each model presents different types of earning incentives for physicians to provide cost effective care which improves clinical outcome.
While most countries around the world have some form of universal national health care system, the United States, one of the wealthiest countries in the world, does not. There are much more benefits to the U.S. adopting a dorm of national health care system than to keep its current system, which has proved to be unnecessarily expensive, complicated, and overall inefficient.
For years now, the healthcare system in the United States have managed patient’s health records through paper charting, this has since changed for the better with the introduction of an electronic medical record (EMR) system. This type of system has helped healthcare providers, hospitals and other ambulatory institutions extract data from a patient’s chart to help expedite clinical diagnosis and providing necessary care. Although this form of technology shows great promise, studies have shown that this system is just a foundation to the next evolution of health technology. The transformation of EMR to electronic heath record system (EHR) is the ultimate goal of the federal government.
When you take the socialistic perspective towards implementing this system in Canada, you can see the advantages it brings to improving health care. If the government plays a larger role in funding the development of electronic health records for private and smaller organizations the benefits will immediately result in better quality of health care. As shown in a study done by the University of California in San Francisco that focused on expensive costs that make it difficult for smaller practices to incorporate electronic health records, “need policies designed to provide incentives and support services to help practices improve the quality of their care by using EHRs.” (Miller, West, Brown, Sim & Ganchoff, 2005) In this article they explain that electronic health records improve quality of health care, but the costs are too expensive for small practices to incorporate them.
Pay-for-performance (P4P) is the compensation representation that compensates healthcare contributors for accomplishing pre-authorized objectives for the delivery of quality health care assistance by economic incentives. P4P is increasingly put into practice in the healthcare structure to support quality enhancements in healthcare systems. Thus, pay-for-performance can be seen as a means of attaching financial incentives to the main objectives of clinical care. However, reimbursement is a managed care payment by a third party to a beneficiary, hospital or other health care providers for services rendered to an insured or beneficiary. This paper discusses how reimbursement can be affected by the pay-for-performance approach and how system cost reductions impact the quality and efficiency of healthcare. In addition, it also addresses how pay-for-performance affects different healthcare providers and their customers. Finally, there will also be a discussion on the effects pay-for-performance will have on the future of healthcare.
Many new technologies are being used in health organizations across the nations, which are being utilized to help improve the quality of health care. Electronic Health Records (EHRs) play a critical role in improving access, quality and efficiency of healthcare ("Electronic health records," 2014). In order to assist in expanding the use of EHR’s, in 2011 The Centers for Medicaid and Medicare Services (CMS), instituted a EHR incentive program called the Meaningful use Program. This program was instituted to encourage and expand the use of the HER, by providing health professional and health organizations yearly incentive payments when they demonstrate meaningful use of the EHR ("Medicare and medicaid," 2014). The Meaningful use program will be explored including its’ implications for nurses, nursing, national policy, how the population health data relates to Meaningful use data collection in various stages and finally recommendations for beneficial improvement for patient outcomes and population health and more.
Healthcare has been a topic of discussion with the majority of the country. Issues with insurance coverage, rising costs, limited options to gain coverage, and the quality of healthcare have become concerns for law makers, healthcare providers and the general public. Some of those concerns were alleviated with the passing of the Affordable Care Act, but new concerns have developed with problems that have occurred in the implementation of the new law. The main concerns of the country are if the Affordable Care Act will be able to overcome the issues that plagued the old healthcare system, the cost of the program, and how will the new law affect the quality of the health delivery system.
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
Formed in 1998, the Managed Care Executive Group (MCEG) is a national organization of U.S. senior health executives who provide an open exchange of shared resources by discussing issues which are currently faced by health care organizations. In the fall of 2011, 61 organizations, which represented 90 responders, ranked the top ten strategic issues for 2012. Although the issues were ranked according to their priority, this report discusses the top three issues which I believe to be the most significant due to the need for competitive and inter-related products, quality care and cost containment.
As I began watching Reinventing Healthcare-A Fred Friendly Seminar (2008), I thought to myself, “man, things have changed since 2008.” And as the discussion progressed, I started to become irritated by how little had changed. The issues discussed were far-reaching, and the necessity for urgent change was a repeated theme. And yet, eight years later, health care has made changes, but many of its crucial problems still exist.
What Seems To Be The Problem? A discussion of the current problems in the U.S. healthcare system.
The health industry has existed ever since doctors bartered for chickens to pay for their services. Computers on the other hand, in their modern form have only existed since the 1940s. So when did technology become a part of health care? The first electronic health record(EHR) programs were created in the 1960s around the same time the Kennedy administration started exploring the validity of such products (Neal, 2013). Between the 1960s and the current administration, there were little to no advancements in the area of EHR despite monumental advancements in software and hardware that are available. While some technology more directly related to care, such as digital radiology, have made strides medical record programs and practice management programs have gained little traction. Physicians have not had a reason or need for complicated, expensive health record suites. This all changed with the introduction of the Meaningful Use program introduced in 2011. Meaningful use is designed to encourage and eventually force the usage of EHR programs. In addition, it mandates basic requirements for EHR software manufactures that which have become fragmented in function and form. The result was in 2001 18 percent of offices used EHR as of 2013 78 percent are using EHR (Chun-Ju Hsiao, 2014). Now that you are caught up on some of the technology in health care let us discuss some major topics that have come up due to recent changes. First, what antiquated technologies is health care are still using, what new tech are they exploring, and then what security problems are we opening up and what is this all costing.
On February 17, 2009, President Barack Obama signs into law the American Recovery and Reinvestment Act of 2009 (ARRA). The law promotes electronic medical records (EMR) and infrastructure development, such as reimbursement-based pay, to cut health care costs (Frequently Asked Questions, 2009). Likewise, the ARRA is restructuring Medicare disbursements to reimburse for quality not quantity. While the law does not mandate EMR use, the federal government has set aside twenty billion dollars to help in the development of a strong health information technology infrastructure. Title IV states, “NO INCENTIVE PAYMENT IF FIRST ADOPTING AFTER 2014” (American Recovery and Reinvestment Act of 2009, 2009). In times of economic turmoil, hospitals and physicians, who are not hospital-based, can receive incentive payments (Frequently Asked Questions, 2009). So, most institutions will comply with the restructuring and use EMR’s, even though there are pros and cons.
It is hard to imagine life without health insurance. If you have any type of medical problem that requires attention, and you have appropriate health care insurance, you can be cared for in the finest of private hospitals. You can get great treatment and your ailments, depending on the severity, can be treated as soon as possible. Doctors, physicians and surgeons are willing to put out a big effort if they know that they are dealing with patients who are insured and have the money to go under extensive medical treatment. But imagine life without such luxuries. For example, what happens if a relative requires much needed surgery, but does not have health insurance to cover the procedure? What happens if a lack of medical insurance prevents you or your family from seeing a doctor, which could result in health problems that had not been identified but could have been treated before they became life threatening? These scenarios may seem far-fetched, but these types of situations happen to people who lack health coverage everyday. There is a true story about a patient who was insured and diagnosed with treatable cervical cancer. Unfortunately, she lost her job and with it her insurance. She was then unable to see her private doctor, and was turned away from other hospitals because ?cancer treatment is not considered an emergency in a patient who can?t pay? (?Help for D.C.?s Uninsured?). The woman later died at her home without ever being treated. This example raises the question, since when are people with less money less deserving of health care or appropriate treatment?
The new healthcare technology that is spreading nationwide it the EHR programs that are being implemented and updated in healthcare organizations. Government policies are in place for societies protection and privacy, it also helps to create a place where healthcare information can be utilized to its fullest potential. ONC authors’ regulations that set the standards and certification criteria EHRs must meet to assure health care professionals and hospitals that the systems they adopt are capable of performing certain functions (HealtIt, 2015).