Strategy Brief on Healthcare

Introduction

The ongoing efforts to significantly invest in basic science and clinical discovery have impressive yield results in the United States. However, the country still lags behind in delivering high-quality care and improves on the outcomes of health due to the regular catastrophe of innovations to get to the patients in appropriate manner (Dougherty & Conway, 2008). With approximately 46 million US citizens who are not insured, and several others who are at risk of increased premiums and out-of-pocket costs it is quite indicative that the health care system needs to be reformed.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

The Problem with United States HealthCare

According to research, most Americans lack the care they required even though the government allocates more finances per individual than any other nation across the globe. The nation underutilizes preventive care, therefore, leading to paying more on multifaceted, progressive illnesses. Patients severing from chronic illnesses such as heart complications, hypertension, and diabetes often do not obtain adequate management such as self-management services and drug therapies that will allow them to manage their conditions efficiently (Brennan, Cafarella, & McKethan, 2009). This often happens to under-insured, uninsured and insured Americans. Research has documented that most patients do not receive the necessary care; most of the care is often unnecessary or even harmful. There is a tremendous variation in hospital inpatients length of stay, procedures, and testing, visits to specialists and costs across the country and from hospital to hospital in the same area. This essay draws a strategic brief on a range of payment and delivery system reforms that are drafted to improve the cost, value, and quality of healthcare.

The Main Goal

Improvement of healthcare in the United States is often complicated by activities that protect the existing interest; health insurance organizations oppose strongly an form of public provisions that will make them unable to compete while pharmaceutical companies, doctors organizations and hospitals ensure that any legislation will not hurt them. For coverage to be more efficient, insurance should improve people's care. This kind of improvement should not just rotate around how it is paid for; factors such as expanding coverage to increase access to preventive services can improve and maintain health. Tracking of either the outcomes or cost for individual patient's medical conditions is very limited among healthcare providers and insurers. Improvement in the quality of healthcare is directly proportional to tracking progress over time and making a comparison of peers either inside or outside the organizations. This can extend to international boundaries such as comparing the United States health care and other improved healthcare across the world and fixing where possible. Systematic measurement improves results.

Possible Solutions/Interventions

Wellness Initiative

About a quarter of the rising cost of healthcare are caused by the growth of "modifiable population risk factors" that are often because of lifestyle such as obesity. Therefore, to reduce the growing burden in diseases and other related increase in the healthcare cost, doctors, insurers, employers and government agencies should look for ways to encourage Americans to shift to a healthier lifestyle. Despite the widespread disagreement on an appropriate solution for the increasing cost of healthcare coverage and reforming care financing both the public and the healthcare experts agree on the utilization of preventive care.

State Initiatives

The state can take the effort to cover low-income adults and children by creating an insurance pool for self-employed and small businesses with premium subsidies that will ensure that cover is affordable for low wages workers by requiring employers to provide their employees cover or contribute to financing cover fund for working people. For instance in 2006 Massachusetts created a plan of shared financial responsibility to make cover affordable for uninsured residents (Davis, 2007).

Measuring Outcome That Matter to Patients

Results should be measured by the patient's medical condition such as diabetes rather than other factors such as intervention. The measurement of patient's outcomes should cover the full cycle of care for the situation and do a follow up on the health status even aftercare. There are three tiers of results that matter to a patient with a specific medical condition. First is the patient's health status achieved, this is how functional the patient is aftercare such as in case of prostate cancer, how the patient is useful such as sexual function. The second tier relates to the nature of care cycle and recovery. For instance, high rates of readmissions are both exhausting and expensive to patients and care providers. The level of discomfort during care such as significant delays before being attended to by a specialist increases the level of anxiety to the patient. The third is the outcome that relates to health sustainability such as a hip replacement that last 15years are superior to the one that goes for only three years. Therefore measuring results about the three tiers can significantly improve care and make it more affordable.

Measuring the Cost of Care

The healthcare field is faced with an overarching problem of high value and absence of accurate cost information. Few clinicians know how much each component of care cost leave alone how the outcome achieved relates to the overall cost. Therefore, there should be an established or a precise cost of a full cycle of a specific medical condition since most hospitals cost-accounting systems are based on departments rather than patients (Porter & Lee, 2013). Therefore, with the increased pressure to lower the cost and report outcomes, there should be a standardized method of setting up cost about the medical condition of the patient across the country.

Other initiatives as such as reducing the cost for those with no medical insurance or undercovered, to make care more affordable, reduce the cost of essential coverage, and include preventive coverage. Preventive care would make it cheaper to treat cancer and high blood sugar if it is detected early. Besides, carriers can offer similar premium services regardless of medical condition, age, and gender (Grace, 2017).

Possible Impacts of the Interventions

Wellness initiative will increase focus on prevention of readmissions after discharge from the hospitals for patients will have the chronic illness. Reports show that 17.6 percent of patients were readmitted within 30 days of release. Measurement of outcomes that matters to the patients will also ensure that such readmissions are prevented since care will be directed towards achieving the best care possible. These two initiatives will also ensure that medical institutions conduct an effective transition from inpatient providers to outpatients' providers and effective management of medication by the patient. This will have a significant return on investment saving money for the patient and system as well as fostering patient health outcomes.

State initiatives will ensure that even citizens who have low incomes can afford recommended care without being limited by their financial capacity. This will also be assisted by measuring the cost of care, which will prevent medical institutions from overcharging patients but rather establish a precise cost accounting system that can also measure and compare cost and the health outcomes of the patients. This will also reduce inefficiencies such as duplication and use of unnecessary services.

Conclusion

The best policy alternative is measuring outcome that matter to patients; this initiative will assist in identifying unnecessary services and ensure that care is directly measurable to the outcomes and that patient's pay for services that are truly reflective. The United States healthcare system can make a comparison to other countries such as Canada that have better health outcomes and implement the policies that will improve the healthcare. The wealthiest Americans with the best insurance receive better care that does not extend to the general population, therefore, the government, and other stakeholders can implement the above policies that care health make healthcare much more affordable and quality. Measuring outcomes is the most likely first step since it will focus everyone's attention on what matter most. Clinicians must put patients first and prioritize their needs and value of the patient over their burning desire to maintain their practice patterns and autonomy. After all, the increased concerns on the healthcare will eventually bring change that will be, inevitable but will require all stakeholders to adapt.

References

Brennan, N., Cafarella, N., & McKethan, A. (2009). Improving Quality and Value in the U.S. Health Care System. Brookings.

Davis, K. (2007). Uninsured in America: problems and possible solutions. BMJ, 346-348.

Dougherty, D., & Conway, P. (2008). The "3T's" Road Map to Transform US Health Care: The "How" of High-Quality Care. 1-3.

Grace, D. (2017, March 8). Some Ideas For Reducing Uninsured Healthcare Costs & Health Insurance Premiums. Retrieved May 7, 2018, from Decretralize Today: https://decentralize.today/some-ideas-for-reducing-uninsured-healthcare-costs-health-insurance-premiums-93247011d6ba

Porter, M., & Lee, T. (2013). The Strategy That Will Fix Health Care. Harvard Business Review.