Review of Current Healthcare Issues: Healthcare Cost
Assignment: Developing Organizational Policies and Practices
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.
The Assignment (4-5 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback.
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Review of Current Healthcare Issues: Healthcare Cost
Healthcare costs and payment models are an increasingly critical impediment to healthcare access. The cost of running an effective healthcare system is quite prohibitive. Healthcare cost constitutes one of the primary concerns permeating scholarly, public, and political discourse. It is an acute stressor to healthcare settings where patients grapple with the high cost of healthcare. In some instances, the arising healthcare expenditures culminate in rising cases of impoverishment. It is not surprising that U.S citizens and government spend a massive amount of dollars to run healthcare characterized by high insurance premiums, copays, out-of-pocket expenditures, and other deductibles costs.
The overall impact of healthcare financing and associated challenges trickles down to our healthcare settings. Some of our patients are meeting healthcare costs though out of picket payments. The out-of-pocket payments have limited patients’ access to quality healthcare services. In many instances, patients who pay directly for health services may often skip medications or doctors’ appointments. Our facility is facing financial challenges, which has led to weakness in implementing its mission for delivering quality healthcare. The financial inadequacies inhibit progress in treatment, research, and education, in our hospital. Equally, it leads to staffing challenges where the hospital is not well-positioned to deploy adequate healthcare staff, leading to overstretching available human resources.
Our healthcare facility must understand colleagues associated with the healthcare financing model and approaches. Therefore, our hospital strives to pursue efforts that ensure patients' or consumer-centered approaches that help patients optimize their well-being. Our hospital has adopted a spectrum of approaches geared towards minimizing costs associated with running healthcare. First, it ensures that inpatient treatment is the last resort. A sounding criterion for admission has been established to allow inpatient treatment of cases that genuinely deserved such kind of management. Second, the hospital is taking care of the patients by establishing satellite clinics and establishing links with home-based care settings often associated with more affordable healthcare. Third, our facility is increasingly focused on the continuum of care by looking at primary and secondary care by offering interventions that prevent future health complications that are quite costly to manage. Our tenets of practice are aligned with the Affordable Care Act (ACA) and Quadruple Aim.
Healthcare financing and costs have unprecedented far-reaching effects across various healthcare areas. Different countries such as the U.S are enacting legislation and developing policies that are geared towards increasing access to quality, equitable and affordable healthcare (Safarani et al.,2018). For instance, legislation such Affordable Care Act (ACA) sought to reform the private insurance market by targeting individuals and small-group purchasers to grow Medicaid, especially among the relatively impoverished population, and influencing how medical decisions are made and implemented. The primary aim of ACA involved the need to address healthcare costs that acted as a barrier to healthcare access for decades. Does healthcare cost or payments impact how healthcare delivery is implemented? Does it affect human healthcare resources such as nursing personnel? Does healthcare financing or cost affect the quality of care and accessibility? These are pertinent questions that expose the extent to which healthcare cost, payments, and financing, impact healthcare delivery. Thus, the role of financing in healthcare is arguably unquantifiable.
In healthcare settings, the purpose of the Quadruple Aim is to enhance the patient experience, enhance population health, reduce healthcare expenses, and boost healthcare providers' work life. In a nutshell, the Quadruple Aim optimizes health system performance. Research findings demonstrate the associations between robust primary care with enhanced Quadruple Aim results. However, the existing fee-for-service payment system in the U.S IS inclined towards quantity rather than value-based or quality-based health care (Park et al.,2018). Hence, the healthcare payment financing system devalues primary care and obstructs the health care system from attaining the Quadruple Aim. As a result, there is increased investment in curative healthcare interventions while preventive health has substantially less investment vigor. Can focus significantly and efforts on preventive health limit disease burden in terms of curative services and interventions? Can increase investment in value-based healthcare and health promotive interventions improve the overall well-being of patients and healthcare providers?
The concept of Quadruple Aim is not comprehensive. Fiscella & Carroll (2019) argues that equity is missing. Health equity is what would improve primary and preventative healthcare. In addition, equity would likely improve health providers' well-being improve. Thus, in addition to adopting a payment system that promotes Quadruple Aim, it is essential to support it by accompanying it with equity. Fiscella & Carroll (2019) recommend the need to build adaptive feedback loops that continuously adjust and modify payment models, levels of payments, payment risk, and strategies to optimize the achievement of value and equity. Payment and health financing approaches are part of large and sophisticated health systems. Therefore, there is a need for comprehensive data-backed strategies on payer claims, behavioral risks, which optimize primary care value and equity.
Developing Organizational Policies and Practices
There are many barriers to quality healthcare in the nation. Among these barriers is the cost for a patient to receive appropriate and quality healthcare. It is an important issue to tackle because of the resulting poor health outcomes leading to fatalities. This paper aims to discuss the persisting issue regarding healthcare cost and the different aspects of healthcare that it affects. Furthermore, the current policies and practices related to the issue above will be assessed, precisely its strengths, challenges, and ethical considerations.
Competing Needs that Impact Healthcare
The allocation of resources, whether human resources, physical resources, information resources, or financial resources, is significant in the smooth operations and delivery of products and services of a company. However, issues arise due to competing needs that involved organizations are obligated to address to reach the target goals. For example, in the country’s healthcare system, providing accessible quality healthcare to the people is the priority, but there are constraints because of the increased cost of healthcare.
The financial status of the healthcare system, including the hospitals and facilities, is challenged, which then affects its priority of providing people with accessible quality healthcare. In addition to this, it also affects the development of interventions, education, research, and other resources, such as the availability of qualified human resources. This inadequacy in the budget allocated for certain aspects of healthcare results in the delivery of low-quality interventions and services that may not be enough for severe cases. The pandemic also highlighted that not all people can afford to avail the required treatment for their cases due to the costly healthcare system. Therefore, despite a patient-centered approach in dealing with patients for the efficiency improvement in their well-being, there is a gap between the healthcare cost nowadays and the accessibility of quality mental healthcare during the pandemic.
Relevant Policy or Practice Changes
The issue is extensive, and there are many considerations given the situation of the Covid-19 pandemic, on top of other factors that affect the high cost and its accessibility for patients to have quality healthcare. Therefore, the development of policies and practices becomes more vital in the progress of the current system. In line with this, current policies and practices, namely, technological advancements and the Quadruple Aim, are relevant to the issues mentioned above.
One of the practices that are relevant to the healthcare issue is the Quadruple Aim. This is a holistic model that targets the development and optimization of the healthcare system and its performance. The goals of the Quadruple Aim are to have better clinical outcomes, i...