Unit 1 Individual Project Quality Improvement in Healthcare HCM672

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Unit 1 Individual Project Quality Improvement in Healthcare HCM672 Vincent L. Smith January 7, 2024
Introduction The purpose of this unit 1 individual assignment will be to examine and explain some of the possible reasons or factors for the rising costs of health care here in the United States. Based on information or data from the health care industry, the United States continues to fall behind in quality care and treatment for the patient or individuals in need of proper medical services based on performance delivery. This assignment will also attempt to examine and explain the relationship of cost and quality of health care in the United States. This assignment will also help to identify methods in which the Patient Protection and Affordable Care Act (PPACA) manages or attempts to improve the quality of health care while trying to lower costs. Included in this assignment will also be information explaining how and if the PPACA was capable of achieving certain goals necessary for developing and implementing improved quality care (Buntin et al., 2018). Relationship between Cost and Quality in Healthcare For the most part, health care in the United States has become very expensive due to increasing costs for both services and treatments. Over the past few decades, concerns have been increasing in numerous countries due to measuring how each particular hospital is being assessed or monitored when it comes to comparing costs. Medical treatment and services are key factors which play a vital role in the complexity of hospital costs along with efforts to control or manage costs as well (Buntin et al., 2018). Costs containment and improvement for quality care is imperative for the success within any health care organization or facility. The costs and quality of health care continue to be hot topics of debate when it comes to policies and guidelines for trying to reform the health care system in its current state today. These concerns and topics surrounding health care include quality of care, increasing/decreasing costs, accessing coverage,
and affordable coverage just to name a few. While researching and examining quality and costs, there are two vital questions of importance of great concern. The first question being; “Will the improvement of quality increase health care cost?” The second question; “Will lowering costs decrease or lower the standards for health care?”. However, the assumption exist that if there is a improvement in care, that hospital costs will decrease by lowering both readmissions and complications within the health care organization or facility. Research studies have shown or indicated various characteristics are associated quality and costs. The process or method of measuring or gauging quality can be implemented in numerous ways that will have connections to costs that may be different or dissimilar. In addition to gauging quality, measuring of costs my be determined by reimbursements to health care plans or to the provider for resources used. The United States faces at least two vital factors or increasing concerns for health care such as quality and increasing costs (Engel, 2018). These two factors or challenges for the most part in many instances become a costly burden for private payers, the government and those individuals who are or maybe low to no income. The creation of the Affordable Care Act or Patient Protection Affordable was established with various provisions. These provisions serve a purpose for helping to shape United States healthcare system. The establishment of this regulation makes it possible to expand coverage to help with making health care easier to afford while also reforming and stabilizing the health care market or industry. This in some cases can make it possible to then reduce uneconomical or unnecessary spending while also fostering competition within the healthcare market which will eventually help to cause significant improvement for quality medical care. Since becoming a law, the ACA has shown the the healthcare system has managed to show signs of steady improvement in terms of quality although costs appear to be somewhat sluggish. These steady improvements
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are based on programs capable of making changes or modifications for the coordination of care, strengthening of primary care and pay-for-performance. The Affordable Care Act ensures that every american will be entitled and have access healthcare that is both affordable with improved standards of quality while also helping to control costs. The ACA can be very helpful to the United States by also helping to achieve universal coverage by sharing responsibilities with the help of the government, employers and their employees. By improving the standards of healthcare, quality, and reduced spending, the healthcare system of the United States will now be held to a higher level of accountability when dealing with a population that more diverse when it comes to patient care (Buntin et al., 2018). With healthcare costs still slightly high since the past ten years, the Patient Protection Affordable Care Act for the most part in my opinion has been successful only to a point. After being signed into law back in 2010, there have been some recognizable changes or modifications when it comes to the amount of cost, type/amount of coverage and quality of care. When it also comes to the quality of care, the settings within the healthcare environment such as hospitals, clinics, and urgent care facilities just to name a few have definitely changed when it comes to providing both care and treatment. Hospitals in many instances are encouraging patients to take part in their care by participating on websites that have the ability to allow a patient to review their personal medical records or history. The addition of more nurses can prove to be beneficial to help with accommodating patients, especially those individuals in doctors’ offices, and neighboring clinics throughout each community. With increased coverage of healthcare, the accessibility of preventative care can prove to be helpful when dealing with disease, sickness or routine check-ups necessary for maintaining a healthy lifestyle.
References Buntin, M. B., Jain, S. H., & Blumenthal, D. (2018). The Patient Protection and Affordable Care Act. In Springer eBooks . https://doi.org/10.1891/9780826128393.0010 Engel, J. (2018). Unaffordable: American Healthcare from Johnson to Trump . University of Wisconsin Pres. Oberlander, J. (2019). Lessons from the long and winding road to Medicare for all. American Journal of Public Health , 109 (11), 1497–1500. https://doi.org/10.2105/ajph.2019.305295 Papanicolas, I., Woskie, L., & Jha, A. K. (2018). Health care spending in the United States and other High-Income countries. JAMA , 319 (10), 1024. https://doi.org/10.1001/jama.2018.1150 Yearby, R. (2018). Racial disparities in health status and access to healthcare: The continuation of inequality in the United States due to structural racism. The American Journal of Economics and Sociology , 77 (3–4), 1113–1152. https://doi.org/10.1111/ajes.12230