Healthcare Reform Essay

1272 words - 6 pages

Eric Yee
MHR 452
Dr. Farmer

Quality Versus Quantity in Health Care System
There is health care reform happening today. According to Journal of Healthcare Finance, “Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care” (Scamperle 2014). As the demand for health services, controversies of the direction of the healthcare system stirred. Should healthcare providers focus efforts towards quality or quantity care of patients? There is an emerging trend of efforts leaning towards a quality of healthcare direction as opposed to high volume service. This issue sparked my attention because of initially hearing ...view middle of the document...

According to the article Health Care Law 3rd Anniversary: Paying for Quality Saves Health Care Dollar, the author writes:
Every year, about 2.6 million seniors – or nearly one in five hospitalized Medicare enrollees – are readmitted within 30 days of discharge, at a cost of more than $26 billion to the Medicare program. Many of these readmissions stem from preventable problems (Selbius 2013).

Easily preventable costs due to quality care can reduce hospital spending. Readmission rates also show the quality of care provided. If patients are constantly readmitted to hospitals, after being admitted, poor quality is reflected of medical practice and need to be reevaluated. To help combat such issues, an article called Health care costs: Quality vs. Quantity, suggests that “If a hospital’s patient readmission rates are above established thresholds at that hospital, they will be penalized by Medicare on future reimbursements” (Louden, 2013, para. 5). This is an effective ruling because it creates a sense of accountability when it comes to providing effective service. Being penalized on future rewards is a tangible item that health care providers are more inclined to push themselves to do improve because money can be an effective incentive.

The source of not implementing quality instead of quality is that healthcare facilities do not understand the true cost of providing health services. According to Harvard Business Review’s article, The Big Idea: How to Solve the Cost Crisis in Health Care, the author writes:

Providers share in this confusion. They often allocate their costs to procedures, departments, and services based not on the actual resources used to deliver care but on how much they are reimbursed. But reimbursement itself is based on arbitrary and inaccurate assumptions about the intensity of care” (Kaplan & Porter, 2011, para. 3).

This explains the issue of improper pricing of health services. Hospitals bill patients based on resources and services the hospital used. This article suggests that costs should not be resource based but results based. A costing system that reimburses doctors based on resources and services provided does not give doctors an incentive to improve their quality of service. Ultimately, costs should be measured by outcomes. Outcomes determine effectiveness, credibility and quality of services.
Currently, health care providers are redesigning operations to adjust to providing quality services. According to Global Healthcare Exchange Forecast Key Healthcare Trends for 2014, the author writes:
The way to mature as a healthy industry is through more deliberate collaboration. We operate in such an integrated business ecosystem that we have to apply the disciplines of working together to deliver on the promise of an effective healthcare system (Health and Beauty Closeup 2013).
This article summarizes the benefits of open communication and sharing technologies between the health institutes. Health...

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