Healthcare Cost and Quality: CMS and NCHC Roles Analyzed
This paper analyzes the roles and initiatives of two agencies addressing healthcare cost and quality in the United States: the Centers for Medicare and Medicaid Services (CMS), a federal public agency, and the National Coalition on Health Care (NCHC), a private alliance. Despite the United States spending far more per capita on healthcare than other developed nations, quality indicators such as life expectancy remain comparatively low. The paper examines CMS's Meaningful Measures initiative and NCHC's advocacy for Medicaid and CHIP preservation, discussing their current and projected activities and exploring the implications of each initiative for staff nurses, advanced practice nurses, and evidence-based patient care.
- Introduction: U.S. cost-quality paradox and paper purpose
- Roles and Major Activities in Addressing Cost and Quality: CMS and NCHC missions and organizational roles
- Current and Projected Initiatives: Meaningful Measures and Medicaid/CHIP preservation
- Implications for Nursing: Impact on nurses, patients, and evidence-based care
- Conclusion: Synthesis of agency contributions and reform impact
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What makes this paper effective
- Clearly frames the central paradox — high U.S. healthcare spending paired with relatively poor quality outcomes — as context for the agency analysis.
- Maintains a parallel structure when comparing CMS and NCHC, covering mission, current initiatives, and nursing implications for each agency in consistent sequence.
- Grounds abstract policy claims in concrete program details, such as the five principles of NCHC and the Meaningful Measures quality criteria used by CMS.
Key academic technique demonstrated
The paper uses comparative institutional analysis: it selects one public and one private agency, describes each organization's mandate, then evaluates a specific initiative from each before synthesizing their shared relevance to nursing practice. This approach allows the reader to see how policy-level decisions translate into clinical and professional outcomes for nurses and patients.
Structure breakdown
The paper follows a five-section structure. The introduction establishes the cost-quality paradox and states the paper's purpose. The second section profiles CMS and NCHC and their organizational roles. The third section presents one flagship initiative per agency. The fourth section connects both initiatives to nursing practice and patient outcomes. The conclusion synthesizes the argument and reinforces the importance of agency-driven reform for healthcare quality and access.
Introduction
Healthcare is significantly costly within the United States. Recent research has indicated that there is no strong correlation between healthcare cost and quality. Despite a substantial increase in spending, U.S. per capita expenditure is approximately 200 percent higher than that of other developed nations. Yet, despite ranking at the top globally in terms of costs, the United States ranks 26th in life expectancy and performs poorly on other healthcare quality indicators (Burke and Ryan, 2014). The purpose of this paper is to analyze one public agency and one private agency, delineate their roles and major activities in addressing cost and quality in healthcare, examine their current and projected initiatives, and explore the implications those initiatives have for nursing.
References
Burke, L. A., & Ryan, A. M. (2014). The complex relationship between cost and quality in US healthcare. Virtual Mentor, 16(2), 124–130.
CMS. (2018). About CMS. Retrieved from https://www.cms.gov/About-CMS/About-CMS.html
CMS. (2018). Meaningful Measures Hub. Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/MMF/General-info-Sub-Page.html
NCHC. (2018). About us. Retrieved from https://nchc.org/about-us/
NCHC. (2018). Preserving and improving Medicaid and CHIP. Retrieved from
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