Improving the Quality and Efficiency of Health Care - Research Paper Example

? Improving the Quality and Efficiency of Health Care Introduction Majority of Americans have no access to Medicare services because of the high cost incurred while accessing this service. Having a common and cheaper healthcare program will deliver Medicare services not only to the private insured patients but also to the other beneficiaries who cannot afford this service. However, there has been emerging challenges in the quest for reforms that will cut down the Medicare spending to make this service cheaper for all. Achieving this goal will helping out the whole of healthcare system. Cutting down the cost of Medicare would lead to an efficient and effective health care system. It is sad to note that quite a number of Americans do not have access to better Medicare services because of the high cost of health care services (PMF ,2012). It is clear to note that there is a huge link between cost or payment of Medicare and the quality outcome of Medicare. Therefore, it is the responsibility of the government and other medical stake holders to chip in and come up with strategies that will facilitate efficiency and effectiveness of Medicare to each and every American equally. However, even as the government wants to help out, it does not have the right to restrain the total costs of this program. It is the mandate of the government and other medical stakeholders to encourage development of New Patients care models. In addition, an increase in Medicare expenditure to rising demand and constantly growing health abilities by a huge majority of Americans together with an inefficient delivery system are the key issues that are affecting the medical department and the federal budget. This increase is straining all budgets, which include localities, state, businesses, and family budgets. Transforming the Health Care Delivery System Linking Payment to Quality Outcomes under the Medicare Program Over the past decades there has been a lot of linkage between Medicare payment and the quality outcome. To advocate for affordable healthcare and patient protection is something of great importance for each and every American. The government has managed to achieve this goal by implementing a two acts which are health care and education reconciliation act of 2010 (HCERA) and patient protection and affordability care act of 2010 (PPACA). These acts are meant to look at measures of the value and effectiveness healthcare services that Medicare benefactors receive in relation to the payment that they make (Rivlin, 2011). However, there are emphases limitations on efforts to measure quality of Medicare and to provide payment. The congress is only mandates to provide payment for only those procedures and services that meet the required healthcare standards. National Strategy to Improve Health Care Quality The federal government and other medical stake holders have had raised more weight on the imperative to progress the worth and efficiency of healthcare services. Therefore, healthcare managers have a he challenge to come up with strategies that will lead to the improvement of quality and efficiency of healthcare. However, there has been minimal linkage between initiatives to quality and efficiency improvement programs with the leadership development programs (HHS, 2011). The leadership development program is based on four important opportunities that advance the efficiency as well as the value of healthcare. These opportunities include an increase in the workforce, reducing turnover and related expenses, improving efficiency in the administration’s development and educational accomplishments, and Focus of the organization on specific strategic priorities. Several studies have been carried out to help and the findings have been of great help for the healthcare managers who want to embrace the leadership development program. The studies have come up with a number of strategies that will help in the realization of quality and efficient healthcare. These strategies include Interagency operational group on healthcare value: the collaboration, consultation, and cooperation between healthcare workers will lead to lead to the attainment of a quality and efficient healthcare. Quality measures development: Medicare managers and administrators are mandated to countercheck the quality measures of each medical department and come up with measures to improve, expand or update the gaps with no quality measures that they have detected. Quality measurement: healthcare managers should establish a consensus-based entity for quality measurement and make a list to the intended parties a list of quality measures under consideration. Finally the managers need to evaluate the worth influence of the use of recommended actions and give feedback to their staff. Data collection, public reporting: healthcare managers are required to aggregate and collect consistent data on quality and efficiency on healthcare delivery. These data are useful because they help to implement on the factors that will improve the performance of health workers thus promoting a quality Medicare service. Following these strategies would promote better care, healthy people in America, and affordable healthcare for individuals, families, employees, and government. Encouraging Development of New Patient Care Models Patient care model is an important thing to consider for the realization of better healthcare services for all. In the realization of a better health services government and other medical stakeholder should develop new patient care models. These models will help improve healthcare services in private and public facilities. These models include Engaging each individual as well as family as allies in their care Promotion of wide use of best practices by working with communities to enable a healthy living Reduction of harm caused in delivery of care by making care safer to every patient Promotion of effective coordination and communication between health workers and patients To have the most effective treatment and prevention practices, and To make healthcare services more affordable to every individual regardless of their status. Improving Medicare for Patients and Providers Ensuring Beneficiary Access to Physician Care and Other Services Access to Medicare has continually remained to be a fee-for-service (FFS) system. This is a system whereby the government is mandated to cover all the expenses for eligible beneficiaries for specified services. In order for providers of these services to deliver effective and efficient they have to follow certain incentives. On the other hand, costs of these services differ widely from one provider to another. However, it is not in the jurisdiction of the government to contain the entire budget of the program. The government has key prospects to provide leadership to improve health service delivery as well as slow down the increased healthcare spending. Rural Protections Healthcare services in rural America has been a critical subject to discuss and to put more emphases on it, President Barack Obama signed up a Patient Protection and Affordable Care Act. The key goal of this bill is to alleviate the hardship encountered by people seeking health services in rural areas and who are considered to be poor in society. A Majority of people in rural America cannot afford medical cover. This was the first comprehensive healthcare and reform bill in America which was meant to advocate for better healthcare services for everyone including the neglected people in the rural America (Rivlin, 2011). After signing of the bill into law, the concept of ‘shared responsibility’ was realized. Everyone contributed to reduce the cost of insurance coverage thus making healthcare services cheaper for people in the rural America. This would reduce discrimination in the healthcare industry and also provide security and stability for Americans especially the ones living in the rural areas. Ensuring Medicare Sustainability Independent Medicare Advisory Board The Independent Medicare Advisory Board is an American agency comprising of 15 members which was formed in 2010 under the Patient Protection and Affordable Care Act. The 15 members are hired by the president through the help of the congress. The main mandate of this board is to regulate savings in the Medicare service without affecting quality of the service (McClanahan, 2012). To achieve this, the board follows certain steps. First, the board track spending growth for Medicare then comes up with a plan to restrict the growth in cases where growth is greater than target, and later the board comes up with a list of recommendations on how payment of certain services and items should be done. However, the board is not mandated to raise revenue, ration care, or raise Medicare payments. Afterwards, recommendations are submitted to the Medicare Payment Advisory Commission and the secretary of health and human services. The changes are submitted to the congress by the secretary and the president who finally come up with a decision but at times the secretary does come up with the final decision. Revision of certain market basket updates and incorporation of productivity improvements into market basket updates that do not already incorporate such improvements With all the achievements in the realization of better health services, there has been emerging criticism. These critics have led to slower incorporation of productivity improvement in the health industry. One of the organizations against this incorporation is the American Medical Association (AMA). The AMA has greatly opposed organizations such as IPAB which are trying to improve productivity in the health sector (McClanahan, 2012). The main reason for this is lack of flexibility and the scope of authority in its obligation of these concerns and continues to fight for its elimination. Summary It is important to advocate for quality and efficient healthcare for each and every person regardless of their financial status. The government has come up with acts that promote efficiency and quality of Medicare. Different medical departments have come up with several models that will enhance the quality of services they offer and their goal is to do this at minimal cost. Conclusion Every individual in America and the rest of the world is entitled to quality and efficient healthcare services. Government and other Medicare stakeholders have a mandate to come up with effective plans that will enhance provision of quality healthcare services at a cheaper price so as to incorporate every citizen regardless of their financial status. Lastly, emerging criticism should not slow or stop the fight to the realization of a better healthcare and every organization in the health industry should emphasize on the need to have quality and efficient healthcare that is affordable for everyone. References: Department of Health & Human Services (HHS). (2011). National Quality Strategy will promote better health, quality care for Americans. United States Department of Health and Human Services. Retrieved June 28, 2013 McClanahan, C. (2012). What Is the Independent Medicare Advisory Board? - Forbes. Information for the World's Business Leaders - Forbes.com. Retrieved June 28, 2013  PMF. (2012). Principles for a Sustainable Medicare Program | Partnership for the Future of Medicare. Partnership for the Future of Medicare. Retrieved June 28, 2013 Rivlin, A. M. (2011). Making Medicare, Medicaid and Social Security Sustainable for the Long Run | Brookings Institution. Brookings - Quality. Independence. Impact. Read More