Research Paper on Cost and Quality of Medical Facilities

Introduction

The existing disparities in the quality of health care services are determined primarily by the prevalent health inequalities between the cost and quality. A study by Petersen, Woodard, Urech, Daw & Sookanan, 2006) has determined the relationship that exists between cost and quality in relation to healthcare. The quality and costs of healthcare especially in the American ` are influenced by social stratification. Many researchers have conducted studies to determine the causes of the wide disparities in healthcare provision in the United States. Studies have determined that social stratification in the society greatly influences the disparities in the healthcare. Other researchers have suggested strategies to mitigate these disparities in terms of the quality and cost of healthcare services. This research paper seeks to determine and discuss the relationship that exists between the cost and quality of healthcare.

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Center for Medicare and Medicaid Services and Joint Commission

The Center for Medicare and Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS). The organization is tasked with administering the Medicare program in the United States. It works in partnership with the state government's health departments to administer healthcare. The Joint Commission of the other hand is a nonprofit tax-exempt organization in the United States that accredits more than 21,000 US health care organizations and programs.

CMS strengthened its approaches and strategies towards the delivery of cost-effective and quality healthcare in Medicaid and Medicare services. The organization has developed a quality strategy which is aimed at optimizing health outcomes by improving quality and transforming the healthcare system. To achieve this the organization seeks to; make care safer by reducing harm in the delivery of care, making care affordable, promoting effective prevention and treatment of chronic diseases, working with communities to promote best practices in lifestyles, promoting effective communication and coordination care and strengthening persons and their families as partners in their case. CMS is determined to reduce the cost of care by introducing quality payment program and quality reporting programs. On the other hand, Joint Commission core measures provided standardized processes and best practices to improve patient care specific to the patient's particular condition.

Initiatives to Improve Quality of Healthcare and Unintended Consequences

Over the past two decades, the focus on quality improvement in healthcare has led to the development of several types of initiatives i.e. public reporting programs and internal quality improvement programs whereby information on healthcare is made public. Examples of such initiatives in the United States are the Medicare's Hospital Compare program, pay for performance and the Leapfrog group initiative (Bardach & Cabana, 2009). A number of unintended consequences have resulted as a result of improved measure performance in the healthcare. In terms of the unintended effect on resource use, research has determined that the initiatives lead to more unpredicted costs. Increased availability of resources in the healthcare system does not necessarily mean that the resources are equally available thus resulting in increased health disparities (Bardach & Cabana, 2009). In terms of the unintended effects on provider behavior, research has showed that healthcare providers may tend to use the process measures to define what is important leading to a scenario where nurses and healthcare providers are unintentionally encouraged to improve the measure as opposed to improving the intended goal of measure (Bardach & Cabana, 2009). Unintended effects on patients occur whereby the preferences on clinical care by individual patients do not directly match quality improvement performance measures.

Impact of Advanced Practice Nursing on Quality and Cost of Care

Advanced nursing practice in healthcare improves the quality and cost of care in a number of ways which include; increased patient satisfaction, cost savings, improved length of stay, improved time to consultation and treatment, reduce mortality among others. It is therefore important that healthcare providers capitalize on nurses in advanced practice (Newhouse et al., 2011).

References

Bardach, N. S., & Cabana, M. D. (2009). The unintended consequences of quality improvement. Current opinion in pediatrics, 21(6).

Newhouse, R. P., Stanek-Hutt, J., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., ... & Weiner, J. P. (2011). Advanced practice nurse outcomes 1990-2008: a systematic review. Nursing Economics, 29(5), 230.

Petersen, L. A., Woodard, L. D., Urech, T., Daw, C., & Sookanan, S. (2006). Does pay-for-performance improve the quality of health care?. Annals of internal medicine, 145(4), 265-272.