Cost and Quality Analysis Roles and major activities in addressing cost and quality in health care U.S. Department of Health and Human Services - public In order to address cost and quality in health care, the U.S. Department of Health and Human Services has come up with several initiatives…
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As a result, this scheme improves quality and at the same time minimises cost as opposed to having a fixed dollar contribution and granting only two plans (The U.S. Department of Health and Human Services, 2013). The other initiative is the adoption of health maintenance organizations (HMOs) and competition. HMOs are very useful in reducing costs in highly competitive markets by through practice of hospital visits instead of ambulatory. For example, the competition between HMOs in a competitive market leads to lowering of premiums while at the same time forcing individual HMOs to maintain high quality in their services so they can remain competitive. In addition, State mental health parity mandate and managed care is a good strategy for addressing quality and cost in healthcare. The introduction of a managed behavioural health care plan by an insurer has led to a 39 percent reduction in mental and substance abuse costs. The Commonwealth Fund -private The commonwealth sponsored its first health care quality program in 2000, which has supported crucial research on the shortcomings and causes in health care delivery, while at the same time emphasizing on the importance of inventive interventions to improve health care information technology infrastructure, as well as reducing patience safety and hospital readmissions. By identifying keys and trends to success, this initiative is contributing towards the understanding of joint care models referred to as accountable care organizations (The Common wealth Fund, 2012). Analysis of the program’s State Action on Avoidable Rehospitalizations (STAAR) is the other initiative that was supported by the Commonwealth Fund, which has led to considerable reductions in hospital readmissions within 30 days of discharge. Research shows that those taking part in the STAAR initiative are more expected to espouse interventions such as enriched patient education, improved assessments of patients before they are discharged from hospital, and improved contact with post-acute care providers before they are discharged (The Common wealth Fund, 2012). In 2005, a Patient-Centered Primary Care program was launched, which is principally committed to supporting of the patient-centered medical home, a model that is very promising. This initiative is helping the country-wide primary care practices to change into medical homes, which offer uninterrupted admission to coordinated care, hence improving health care quality and at the same time reducing health care expenditures per capita (The Common wealth Fund, 2012). Possible unintended consequences As discussed, there are many strategies that are implemented by both public and private health agencies in the recent years. Although some of these including certain employer contribution techniques, managed care for addressing the cost implications of parity mandates, and competition among HMOs - have been at least to a certain extent successful, many of the others have mixed results. In some situations, shifting economic conditions may result to negative consequences. Although the above discussed programs are meant to enhance health care provision while at the same time ensuring cost-efficiency health care practices, sometimes these outcomes have some unintended consequences (Boaden et al. 2008). This is especially because positive change in a particular area causes pressure in another area, mostly leading to undesirable results. For a case in point, an
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