Regulation and Sustainability SWOT. Health, Medicine, Nursing Essay

SWOT Analysis of External Regulations
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SWOT Analysis of External Regulations
The healthcare sector of any country is one of the most crucial aspects. Maintaining optimal health of a nation functions as the backbone of any economy in the world. However, like any other facet of a country, there is a need for regulations that help to enforce certain requirements within the healthcare sector. In the U.S., there are several state and federal regulatory agencies whose roles may be clearly defined but can overlap at times. The overwhelming role of these agencies is to help enhance the healthcare of the public. Their relevance is made evident in how they help ensure compliance while also ensuring that everyone has access to the services offered in the public healthcare system. In this paper, four external regulatory agencies will be assessed and their strengths, weaknesses, opportunities, and threats clearly outlined. Additionally, this paper seeks to determine the ways in which healthcare leaders should manage internal and external regulation to help promote quality of care and organizational sustainability.
SWOT AHRQ
AHRQ is short for the Agency for Healthcare Research & Quality. It is a federal agency that like the rest seeks to improve the quality of healthcare albeit through the collection of data and provision of evidence-based practice guidelines for healthcare practitioners. The relevance of AHRQ has indeed been felt in the U.S. since its inception in 1989. However, there have been some issues as well which offer an opportunity for growth for the agency. Below is an in-depth analysis of the agency.
Strengths
One major strength of AHRQ is its good relationship with healthcare providers. Without great partnerships, all of AHRQ’s projects would never return any data that could be deemed usable. Kronick (2016, p. 230) writes that it is because of AHRQ’s great relationship with the healthcare provider community that ensures its tools and resources eventually find their way into the settings of care.
Another AHRQ’s strength is its reputation as a crucial asset to the nation as a credible provider of information to policymakers, patients, and providers (Kronick, 2016, p. 230). It is through its reputation as a national treasure that AHRQ was able to sponsor the Healthcare Cost and Utilization Project (HCUP) which is a family database (AHRQ). The HCUP database is made of other small databases including the National (Nationwide) Inpatient Sample (NIS), Kids’ Inpatient Database (KID), the Nationwide Emergency Department Sample (NEDS), the Nationwide Readmissions Database (NRD), etc.
Weaknesses
The first weakness of AHRQ is its inability to provide accurate and timely data. In a post from Khanna, this weakness is listed as a major challenge because the agency is unable to provide a holistic view of the nation’s healthcare system (2019, para. 8).
Aside from the above, there is the issue of medical errors that continue to curtail the enhancement of healthcare in the U.S. Currently, the predictive analytics employed by AHRQ are limited and cannot be served effectively to reduce these errors (AHRQ, 2019, para. 10).
Opportunities
Enhance research and investment in predictive analysis to help reduce the impact of medical errors in the U.S. Allen and Pierce (2016, para. 1) write that medical errors are the third leading cause of death in the U.S. Approximately 250,000 people die every year because of medical errors. Preventive measures are indeed crucial here because some of these errors are preventable and result as a result of negligence.
Threats
The major threat for AHRQ is technologically based. Any organization or agency that deals with vast amounts of data are subject to the threat of hacking. So, it is crucial that AHRQ maintains high security of its databases to help prevent hackers from stealing, tampering, or manipulating patient data.
SWOT CMS
CMS or what is otherwise known as the Centers for Medicare & Medicaid Services (CMS) is the agency charged with ensuring every American is able to access healthcare regardless of their age, condition, or income. While Medicare is a federal program that caters to individuals who are 65 years and above as well as some disabled people, Medicaid is a program that caters mainly to low-income individuals and families.
Strengths
With Medicare, as of 2016, 57 million Americans received Medicare benefits. The Alliance for Retired Americans estimates the specific numbers to be 47.9 million individuals who are 65 years and above and 9.1 million disabled individuals. On the other hand, Medicaid also continues to report increased enrollment with 64.5 million people reported to have enrolled as of 2019 (Medicaid, 2019, para. 2). The strength of this program lies in its ability to reach many people which showcases faith in the system without which there can never be sustainability in healthcare.
Weaknesses
However, like any agency, CMS has its weaknesses. For Medicare, one major issue is the presence of gaps in its coverage. Often, patients are left to grapple with some costs that could include copayments and deductibles. This, therefore, necessitates private covers such as Medigap that continue to exploit patients.
For Medicaid, the main issue lies in its coverage limitation. As explained by Touschner (2013, para 2), there are instances when Medicaid is not considered MEC or Minimum Essential Coverage and this particular point can determine the availability of premium tax credits.
Opportunities
One opportunity for CMS is to improve coverage of the disabled population. Lagu et al. note that the lack of mechanisms to ensure that care is being provided to the disabled is the underlying challenge to their access to care (2015, p. 2). CMS needs to be empowered so that it can reach beyond its current mandate and maneuver beyond the bureaucracy that often derails government agencies.
Threats
New diseases, for example, the Coronavirus. New diseases will always threaten the promotion of patient care in the country as well as organizational sustainability. This is mainly because of the erosion of the belief in the ability of the healthcare sector to protect the citizens. CMS might have done a great job of increasing the number of Americans with health insurance covers. However, the advent of a new disease and one as deadly as Coronavirus renders these covers null and void if a cure is not discovered.
SWOT CDC
Strengths
One of the key strengths of the CDC or the Centers for Disease Control and Prevention lies in its ability to surveil diseases and evaluate the health of a nation through its laboratories and medical research. This is indeed a major factor as far as the promotion of patient care is concerned.
Another major strength of the CDC is the many partnerships that the agency has. The CDD has partnerships with other institutions that are in the private sector, the World Health Organization, the Un...