Contribution of Primary Care to Health Systems and Health - Assignment Example

Provider payment reform can be applied whereby; financial incentives are seen to be a powerful lever that can change provider behavior. For instance, there was a marked reduction in severity-adjusted length of stay overall after a diagnosis-related group prospective payment system for hospitals was introduced. The fee-for-service payment system that is predominant facilitates the existing fragmented delivery system; financial incentives don’t reward efficiency, care coordination, or high-value care.

Consequently, it usually acts as a barrier to greater organization and more efficient and coordinated care delivery. Regulatory changes can be applied whereby; the regulatory environment may either act as a barrier or facilitate certain forms of delivery system organization. The existing regulatory environment doesn’t encourage ‘hospital–physician integration’. Patient incentives can be applied whereby financial incentives are also seen to be a powerful lever that can change the behavior of patients.

For instance, payer interventions that include provider-tiering (whereby lower copayments are offered by insurers to encourage patients in choosing providers considered to be of higher value) and network narrowing (eliminating providers of lower value or lower quality from a network) have been seen to be fruitful at obtaining enrollees to change providers. Lately, we have inadequate incentives for patients’ encouragement to choose organized delivery systems that are high-performing.

Regarding government infrastructure support, there will be areas, rural areas as well as other regions in particular where small independent practices predominate even with relevant incentives in place, or for a given population, where organized formal delivery systems may not exist. In such particular areas, the government might facilitate the shared organized delivery system infrastructure creation that includes performance improvement activities, health information technology, care management services, 24/7 access to services, and care coordination networks.

Accreditation can as well be effective whereby; Accreditation programs may seem to stimulate the organized delivery systems' growth and improve their performance as well, specifically if these programs are taken into account by payers during purchasing decisions making. 2) Despite other provisions in the Affordable Care Act which might complement the primary care fee increase, further payment reforms are a critical component of redesigning the healthcare system to be more primary care–oriented and efficient (Crossen et al, 2004).

Moving to mixed payment systems or well-designed prospective payments from fee-for-service reimbursement might move the market toward greater efficiency. For instance, payments to accountable care organizations, hospitals, groups of doctors as well as other providers who coordinate care for Medicare patients are among such existing reforms. Support and subsidies for physicians that are involved in offering patient-centered medical homes might improve care for many individuals with chronic conditions and this might reduce long-term costs.

In the health care delivery system, the widespread changes that the designed policies are to encourage will take time. Correcting pricing distortions, in the nearer term, in the fee-for-service approach through provider payments linking to healthcare value might drive the system in the correct direction. 3) According to several research, it has been shown that healthcare systems that do emphasize primary care give better outcomes at lower cost (Starfield et al,2005).