Current trends in health care regulation reform and their influence on quality care

Healthcare

Trends in regulation of Healthcare reform with the potential for the most positive effect on care quality, sustainability of organizations and why they are so important

Reforms in payments, anchored on recent patterns in the private and public sectors are needed to support high quality interventions that matter to patients. Medicare has moved towards payments that are aimed at person-level healthcare. Such measures include DRG payments and penalties that have been recently applied for readmissions, person-level payment remissions in the Accountable Care Organization, Person level payment remissions in the Medicare Advantage program, reforms such as the Medicare Shared Savings Program, present and past pilot episode payments and the Pioneer pilot plan. However, Medicare payments are largely based on fees for service. Although the quality interventions at person level sought currently are not ideal, patients and providers can still gain from the change of their payments drawn from fee-for service. It allows providers to give individual-focused service as opposed to what is covered under fee-for-service. Many physician specialists across the board have pointed out ways in which some amount of their fee-for service can be directed to person-level or episode payments in the short-term to obtain better outcomes as the overall costs remain minimal (Mcclellan, 2013).

How and why the trends will bear the most negatively-inclined influence

The federal budget reduction efforts have negatively affected the health sector (Washington, D.C: Office of Management and Budget (OMB), 2011). A wide range of groups and individuals including President Barack Obama, the 'Senate Gang of Six', the Budget Committee of the House of Representatives, the National Commission on Fiscal Responsibility and Reform have proposed proposals with far reaching implications on the way health care service is handled in the U.S. It has been observed by some critics that the proposals are divergent and sometimes present partisan views on the proposed method for the reduction of the deficit; they also have a lot of common features that signal possible changes in the funding of programs for public health ( Kaiser Family Foundation, 2011).

Such clinical and economic balance faces with higher medical costs. These are typically driven by technology elements and the widespread acceptance of genomics and solutions from biotechnology. Such changes could have significant impact on the care of patients and professional practice for clinicians. However, the new shift with focus on the value of clinical results will also provide space and opportunity for innovation among health care experts to modify their business models for better performance and service delivery (Larrat, Marcoux, & F. Randy Vogenberg, 2012).

What fields of research are currently the most meaningful for health care administrators and Why?

The primary goal of providing health services is to improve and protect the health status of individuals and communities. We consider the following three areas as the most significant ones for administrators in the healthcare sector.

1. Safety of patients: healthcare services should never harm patients because these are aimed at helping them. According to IOM, between 46, 000 and 98, 000 patients are dying in the U.S. healthcare centers because of medical errors. Recent researches have demonstrated that a range of medical errors exist across the terrain of healthcare facilities in the country. The issue is not about the commitment or provision of quality healthcare service by the healthcare professionals. The problem is that there are no systems to prevent such errors from occurring.

2. Effectiveness: It is anchored on scientific evidence that subjecting a patient to treatment increases the likelihood of obtaining the desired healthcare outcomes. Such evidence is drawn from experiments in the labs, clinical research, outcomes research and epidemiological studies. Access to evidence and strength of such support depends on the type of disorder and the treatment options.

3. Equity: Everyone should gain from the healthcare system. It is evident that the current system has failed to achieve desired goals. Unequal Treatment, an IOM report, showed pervasive discrepancies in care rendered to, or received by ethnic and racial minorities. It was shown that minorities received poor quality care compared to the majority population. This still held true even after considering the differences in access to healthcare services (Health Services Research: Scope and Significance, 2008).

How might your dissertation research address one of these fields?

The healthcare system in the U.S. ranks as the most expensive globally. Ironically, there is consistent evidence that the best health outcomes do not come from the U.S. nor does it generate the highest levels of patient satisfaction. This dissertation research will focus on identifying wastage and areas of inefficiency in the healthcare service provision, and seek ways of mitigating the issues.

References

Kaiser Family Foundation. (2011, August 4). Debt Deal's Potential Medicare Cuts Echo Through Health Care Industry. Retrieved from www.news-medical.net/news/20110804/Debt-deals-potential-Medicare-cuts-echo-through-health-care-industry.aspx

Health Services Research: Scope and Significance. (2008). In R. Hughes (Ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (U.S.).

Larrat, E. P., Marcoux, R. M., & F. Randy Vogenberg. (2012). Impact of Federal and State Legal Trends On Health Care Services. PT, 37(4), 224-226.

McClellan, M. B. (2013, June 26). Improving Health Care Quality: The Path Forward. Retrieved from https://www.brookings.edu/testimonies/improving-health-care-quality-the-path-forward/

Washington, D.C: Office of Management and Budget (OMB). (2011). The Budget Control Act of 2011 (Debt Ceiling Deal): Frequently Asked Questions. Retrieved from www.ombwatch.org/files/budget/debtceilingfaq.pdf.