COST AND QUALITY ANALYSIS 6
Running head: COST AND QUALITY ANALYSIS 1
Cost and Quality Analysis
Student’s Names
Institutional AffiliationCost and Quality Analysis
The existing health inequalities between cost and quality are used to determine the available disparities in the quality of healthcare services. Recently, many researchers have determined the relationship between cost and quality in healthcare organizations. The reason for the aggravated inequalities in the healthcare sector is because, in the American population, people belong to different social classes hence have different access to care. Various healthcare agencies have worked hard to minimize healthcare disparities among different populations. Due to the low value in the provision of healthcare services in the United States, studies have been conducted to analyze the case and determine the reason behind the differences. The widening economic inequality in the United States has been associated with the increasing disparities in the health outcomes (Dickman, Himmelstein & Woolhandler, 2017). The public agencies that have majored in limiting the healthcare disparities include the Center for Medicare and Medicaid Services and the Joint Commission.
Both the Center for Medicare and Medicaid services together with the Joint Commission play a great role in controlling cost and quality of healthcare. Medicare and Medicaid programs provide health insurance to the disabled, the elders as well as those individuals who are low-income. Despite the presence of inequalities in healthcare quality, Medicare and Medicaid programs ensure that the disadvantaged and the elder population access quality care regardless of the cost of care (Basu, Andrews, Kishore, Panjabi & Stuckler, 2012). What is more, they ensure that taxpayers’ monies are spent accordingly to improve care. The programs help people obtain quality care which could not be afforded without the insurance. The two programs provide health coverage to the disadvantaged in the population, aiding in access to quality healthcare which on normal cases could not be accessed due to inequalities in healthcare. Medicare and Medicaid relieved every American the burden of choosing between who should receive quality care and who should not. Besides this, they assured hospitals and doctors that they could provide care without any loss. They led to the end of life decisions and the elderly were prioritized healthcare was a concern. Generally, Medicare and Medicaid improved on the quality of care and facilitated the reduction of cost of care.
On the other hand, the Joint Commission helps healthcare organizations to improve performance strategies. These strategies include safety and quality of care, therefore, the agency work towards reducing medical risks and eliminating low-quality care. The agency is a not-for-profit group, based in the United States and assists hospitals and other healthcare organizations to balance on their performance while maintaining the manageable cost of care (Izumi, 2012). The primary goal of the Joint Commission is to improve patient safety by evaluating whether organizations meet standard compliance. The body pushes state regulatory bodies to depend more on private accreditation rather than using mandatory state licensure inspections. This ensures adequate safety of healthcare procedures thus improving the quality of care offered in hospitals.
Current and Projected Initiatives
Several initiatives have been used to control healthcare costs and improve the quality of care. Some of the commonly used initiatives include common provider fees which save in administrative costs for health plans and providers. Most of the major health plans spend a lot of time especially when the contract involves physicians, hospitals, laboratories. These plans spend a lot of money and time, but they have been limited recently as a way to minimize cost and still enhance the quality of care given (Collins & Kevin, 2013). The decided way is to select a few people as representatives of the health plan who act as liaisons with the new contracting entities. Most physicians’ offices spend less time conducting the negotiations of the health plans and ensure they use one contractor under the same fees for all the health plans. This has managed to reduce cost and improve the quality of time.
Physician council is the other initiative aiming to improve the quality of care where physicians will be trained on the application of the new medical procedures. The changing medical practice requires a change in the best practices so that they can match the new technologies. Also, best practices will also be added which are cheap and which will maintain a high quality of care for all. The physician council meant to train physicians so that they can provide the best care and minimize healthcare cost. The use of national data warehouse is another strategy currently being used and will be used in the future to improve the quality of care (Collins & Kevin, 2013). Having the needed volume of data is an assurance of quality healthcare and the reduction of cost due to minimizing errors and minimal repetition of procedures. When all data is set together, it allows for better analysis and interpretation of a problem, hence better quality of care is assured.
The notable unintended consequence of these initiatives is the lack of finances to support healthcare processes and procedure. With the reduced healthcare costs, hospitals are likely to experience fewer finances since most patients are insured and more likely to pay less for the services. If the processes and equipment are not well maintained, they can translate to low quality of healthcare. This is an unintended consequence that can occur if the initiatives to reduce cost and maintain quality are successful.
Implication for Nurses
Reduced healthcare cost and improved quality of care mean that al the staff nurses and advanced practiced nurses will be forced to advance their education to meet the new quality standards. Initiatives to reduce on cost and improve on quality will promote nursing efficiency thus making them more productive in care. Nurses also will have reduced workload since the enhanced quality of care minimizes medical errors and length of stay of patients (Izumi, 2012). There will be minimal medical procedures thus reduction in nursing workload. Nurses will also learn new strategies from the evidence-based practice that are meant to improve on their performance. The ultimate result will be meeting ethical responsibilities expected for nurses at all levels through the provision of quality and less costly healthcare.
References
Basu, S., Andrews, J., Kishore, S., Panjabi, R., & Stuckler, D. (2012). Comparative performance of private and public healthcare systems in low-and middle-income countries: a systematic review. PLoS medicine, 9(6), e1001244.
Collins, S., & Kevin, B. (2013). The opportunity for health plans to improve quality and reduce costs by embracing primary care medical homes. American health & drug benefits, 6(1), 30.
Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441.
Izumi, S. (2012, October). Quality improvement in nursing: administrative mandate or professional responsibility?. In Nursing forum (Vol. 47, No. 4, pp. 260-267).