BUS-FPX4002_CapacetteLourdes_Assessment3

1 Historical Trend Analysis Lourdes Capacette Capella University BHA-FPX4002: History of the United States Health Care System Chanadra Whiting November 7, 2023

2 Historical Trend Analysis While a healthcare administrator's job responsibilities can vary daily, helping to save money while upholding financial accountability and offering as many patients as possible high- quality care is one of the most crucial aspects of their work. Since the 1800s, the United States has made efforts to improve healthcare access, quality, and affordability in all three of these areas. This study will address the importance and consequences of having access to affordable, high-quality healthcare. Trends and Regulations Definitions of access, quality, and cost can vary greatly depending on the intended audience. Most people would agree that all three are necessary to create a healthy population that has confidence in those working in the medical field and in efforts to improve its health. Access to healthcare can be impacted by a person's social standing, race and ethnicity, economic status, and geographic location. The ability of a patient to access their medical records may also be implied. It is suggested by quality that needs are taken into account and that problems are successfully resolved to the best of the providers' abilities. Cost comprises the costs associated with patients, locations, vendors, and our healthcare system. Many changes have occurred between the 1800s and the present; some will be further discussed. Health Care Access Over the past ten years, reports have indicated that the Academic Health Centers (AHCs) in the United States are under threat. The primary indicators of this threat are a decline in the perceived value of the patient care provided and a notable reduction in direct payments to AHC physicians. These cuts have put more pressure on AHCs to improve their productivity in patient care and research, as well as forced them to become more efficient. The difficulties posed by

4 into account as many variables as they can. Long-term care needs a range of services that are still coordinated and flexible within the service system to adjust to the changing needs of users over time (Young & Kroth, 2018). As medical errors in hospitals continue to rise in frequency and severity, healthcare administrators need to find ways to be more stringent in their approaches to improving and maintaining high-quality healthcare outcomes. We suggest that the main criteria by which health systems should be evaluated are their effects—such as improved health and its equitable distribution, people's trust in the system, their financial gain, and the care processes—which include professional care and a satisfying experience for the patient. The population and its health needs and expectations, health sector governance and cross-sector partnerships, platforms for care delivery, workforce size, skill set, tools, and resources, including data and medications, are the cornerstones of high-quality health systems. Health systems require solid foundations and the ability to measure and use data to learn. Four principles should guide excellent health systems: equitable, resilient, and people- centered (Kruk et al., 2018). The public's interest in formal professional home care services began in the late 1800s, partly because of the overcrowding and unsanitary conditions in the institutions that were then in place. Links to increased mortality and morbidity when environmental conditions deteriorated were found in a previous 1850 Sanitary Commission report (Young & Kroth, 2018). This study, recognized as one of the foundational works in the history of American public health, led to the establishment the City Board of Health in New York City in 1865 or 1866 to manage public health (Young & Kroth, 2018). The 1900s saw a continuation of the trend of acknowledging the need for higher quality with the introduction of Medicare and Medicaid in 1965 (Del Grosso,2015)., which set a

5 minimum standard of care and services for providers to qualify for reimbursement (Young & Kroth, 2018). Concerns regarding the quality of treatment and how patients were handled grew as time passed. Congress held hearings as a result, and as a result, laws about reporting elder abuse, federal guidelines governing the use of physical restraints, the creation of ombudsman programs, and stricter enforcement of standards and credentialing were all passed (Young & Kroth, 2018). The Omnibus Reconciliation Act of 1987 carried out further improvements by establishing a bill of rights for residents of nursing homes, mandating improved quality standards and survey procedures, as well as mandatory training. Health Care Cost Although they have been in style for a while, consumerism, and transparency in healthcare will probably gain more traction in 2020. There is no indication that the rising expenses for customers will stop. Due to necessity, consumers have realized that they must take a more active role in ensuring their healthcare dollars are being spent as efficiently as possible. They are starting to take the initiative to demand choice and openness in the care they receive. The ability of healthcare providers to satisfy the needs and expectations of their clients will determine their success. Healthcare providers must oversee the supply chain to give patients the highest caliber, most convenient, and most economical options (Vogenberg & Santilli, 2019). The United States has had some exciting systems for patient payment for healthcare in place since the early 1800s. Wealthy citizens covered medical costs in the early 1800s as a "civic obligation" (Zand, 2018). Moreover, physicians set their fees according to the financial situation of their patients (Young & Kroth, 2018). A portion of the population did possess health insurance, which was initially provided only to wage workers and not to family members. Its purpose was to make up

7 Conclusion Over each century, the United States has shown a desire to improve healthcare for its citizens. It has also shown that no priority—access, quality, or cost—can exist independently without unfavorable impacts on the other two. There is still much to be done, and the outcomes of previous initiatives to enhance accessibility, affordability, and quality may also have an impact due to external factors. Regardless of your opinion on abortion, one of the risks that is being highlighted at the moment is the lack of support for expectant mothers who are considering not carrying their child to term. Because not everyone has the means to travel somewhere in order to acquire information, access is an issue.

8 References Kroth, P. J., & Young, K. M. (2018). Sultz & Young's health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett. Garson, A., & Levin, S. A. (2001, January 7). Ten 10-year trends for the future of healthcare: Implications for academic health centers. Ochsner journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116776/ Young, K. M., & Kroth, P. J. (2018). Health care USA: Understanding its Organization and delivery (9th ed.). Jones & Bartlett Learning. Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., García-Elorrio, E., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., … Pate, M. (2018, November 7). High-quality health systems in the Sustainable Development Goals Era: Time for a revolution. The Lancet. Global health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734391/ Vogenberg, F. R., & Santilli, J. (2019, November 5). Key trends in healthcare for 2020 and beyond. American health & drug benefits. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996619/

10 Appendix Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Care Milestones Health Care Access Health Care Quality Health Care Costs 1800s Regulatory Legislation, Agencies, or Quality Initiatives 1862, US Sanitary Commission established  Treating Civil War casualties  Designed to raise public awareness of health issues 1800, State Medical Board  States start requiring licenses  This improves the standard of care given to patients 1850, The initial health insurance policy  Mass.'s Franklin Health Assurance Company  The first insurance provider to offer benefits for non-fatal injuries 1915, Milestone  First laws pertaining to health insurance with universal access  limited insurance benefits to those in need 1886, The Army forms the Hospital Corps  The first medical data repository in the United States  Executed by the Surgeon General's Office and the Surgeon General Library 1908, Workers Compensation  Laws pertaining to worker's compensation  For federal workers who perform hazardous work 1900s Regulatory Legislation, Agencies, or Quality Initiatives 1946, Hill - Burton Act  Give federal funding to hospitals to modernize  Capable of offering services at a discounted or no cost 1951, JC Facility Accreditation  Hospitals and other healthcare facilities must obtain accreditation  Make sure they are efficient and safe to provide the best possible care 1966, Social Security Amendments  Medicare and Medicaid recipients over 65  People in need and low income

11 1966, HIPPA  Established laws governing health care standards  Improve health insurance accessibility while reducing fraud and abuse 1976, Medical Equipment - FDA  Make sure medical equipment is safe  Including items for diagnosis 1986, Cobra  Helps families whose health benefits are lost  Proceed with benefits for 18 or 36 months in light of spouse's passing 2000s Regulatory Legislation, Agencies, or Quality Initiatives 2009, Hitech Act  Gives DHHS the power to create initiatives aimed at raising the standard of healthcare.  Advertising IT 2002, QIO  Conduct quality control and utilization reviews for Medicare beneficiaries  Changed the PROS 2000, OPPS  Medicare's portion  Utilized to cover outpatient hospital costs 2001, ARPA  ACA health insurance subsidies are expanded  Reduces expenses 2005, Act for Patient Safety and Quality Enhancement  Promotes the reporting of medical errors  Guarantee enhanced patient safety and decreased instances of events that negatively impact patient safety 2010, PPACA  Enables high-quality, reasonably priced insurance access  Co payments for deductibles related to preventative services are not to be assessed to patients.