Week 1 Discussion
Assignment: Analysis of a Pertinent Healthcare Issue
The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.
To Prepare:
- Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
- Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
- Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.
Week 2
The Assignment (3-4 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
- Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
- Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
- Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.
Sample Paper – Week 2 Assignment
NURS 6053 – Review of Current Healthcare Issues
Curbing Healthcare Costs
Student’s Name:
Institutional Affiliation:
The cost of healthcare in the U.S both at the national level and at the organizational level is astonishing. The United States ranks at number 37 among the countries with advanced healthcare systems, yet it is the largest spender in healthcare. The huge cost of healthcare causes a financial burden to households and citizens of the United States as they have to shoulder the transferred costs as organizations strive to make profits. The citizens also have to pay higher premiums, pay taxes, and also incur extra costs on other services related to healthcare, such as acquiring over the counter medication. Some of the factors that make healthcare costs high are drugs cost, administrative costs, expensive combinations of treatment, defensive medicine, and staff wages. Dividing the healthcare expenditure budget at the national level, 59% of it caters for doctors, hospitals, and clinical services (Amadeo, 2019). The expenditure on medication rises year after year at a rate of 3.3%. The increased expenditure on healthcare is not attributed to increased use of healthcare services but rather increased prices of constituent elements in the budget. This paper aims to focus more on expenditure at the organizational level to try and find strategies that may mitigate the problem.
Impact of High Costs at the Organization
Although hospitals have the aim of providing safe and quality care to promote public health, they at time, operate as businesses as they have to ensure they do not incur losses. The need to make profits is threatened by increasing expenditures, which is a constraint to the profit margins. Healthcare costs at the organizational level replicate that at the national level. The cost of acquiring several necessary products and services is very high, while some practices within the facility contribute to increased costs. One of the practices that replicate that at the national level is wastage. It is estimated that thirty percent of the budget on healthcare goes to waste. Some of the activities that create an avenue for wastage are on over-prescription of antibiotics, paperwork adds to administrative costs and fraud. According to the CDC (2019), the rate of Opioid Prescriptions made in 2017 was averagely 58.7 prescriptions per 100 people. Overprescribing antibiotics account for over $ 210 billion, paperwork costs $190 billion, while fraud did see expenses of nearly $200 billion annually (Amadeo, 2019).
The other factor that increases the cost of healthcare is the heavy use of healthcare services by patients that cannot afford; hence, most of the bills are written off as bad debts. Though the outcomes may be positive health-wise on the patient, the hospital resources are used without anyone accounting for it. Some patients overspend on their insurance beyond the required limits forcing insurance companies to neglect them. On the other hand, reducing the number of medical errors reduces unnecessary expenses and wastage of resources on care and lawsuits. Physicians are afraid of lawsuits and tend to order multiple tests on a patient, yet from the diagnosis, they understand where the problem lies (Amadeo, 2019). According to a research in 2010 by Gallup survey attributed $650 billion wasted on defensive medicine. Offering quality and safe care can save the hospital the costs caused by a minor population such as the elderly who have multiple and expensive to cater for chronic illnesses.
The cost of supplies and healthcare technology at the facility is very high, considering the need to focus more on disease prevention and health promotion rather than on disease management (Epstein et al., 2014). The center is facing a stiff challenge of acquiring current technologies, implementing I.T infrastructure and various medical devices and prescription drugs. Implementing technology in care provision has the advantage of reducing costs, minimizing wastage, reducing errors, ensuring safety, and improving the quality of care. Our facility is over utilizing old technologies as the budgets of acquiring new devices are high, but at times there are no choices left but to constrain the budget and acquire new systems to be at par with the requirement to provide quality-based care. According to the report by AHA, annually, hospitals in the U.S collectively spend over $47 billion on health I.T, and that was between 2010-2014 (LaPointe, 2017). Costs of other supplies such as food, drugs, and medical equipment at times fall beyond the control of the organization as the suppliers set their prices considering factors such as inflation, taxes, transportation, and profitability thus hiking their prices.
The cost of remuneration of physicians, nurses, and specialists at the organization accounts for nearly half of the budget. The thought to cut back on staff is not possible considering the rising demand for care, and it may increase the workload on the few staff members, thus affecting productivity. Specialists account for higher wages; no wonder the cost of their services is high.
Reviewed Articles
The article by Navathe et al., (2017) uses an example case of the cost of replacing a joint to assess how a hospital can save on expenses. From the study, the most significant of savings came from supplies and implants, while post-acute care savings originated from reduced use of institutional care. The use of post-acute services and reduced prices of implants are simple measures that can be implemented without the need to invest heavily in care coordination. The study utilized 3942 patients at the Baptist Health System (BHS) with the need for lower extremity joint replacement. The study observed readmission rates, length of stay, emergency department visits, and hospital savings from reduced internal costs and post-acute care spending. The outcomes of the study are that it is possible to lower organizational cost, improve care coordination, and quality. The Baptist saw a reduction of implant costs by a 30% margin. The Institution used their surgeons to make a choice of the best implants in the market, identify manufactures with better prices, review medical evidence, and finally chose manufacturers that met the demands and price. The manufacturers engaged in online bidding at competitively lower prices while at the same time met the quality of products that surgeons required.
According to a study by Dexter & Wachtel (2014), they propose several strategies for checking costs and increasing shared decision-making, patient safety, and quality by minimizing wastage. The authors acknowledge that the healthcare sector uses interventions with higher costs by the justification that the health outcomes will be positive on the patient. The study uses the context of a medical home with anesthesiologists in charge of care, although the strategies applied can be used in different care settings. The article focuses on specific areas and does propose that the management can capitalize on applying medical informatics and analytics. The authors suggest on first eliminating unnecessary interventions that are not of significant benefit to the patient, and they should be evidence-based.
Data from analytics can be used to detect wastage, and the best thing when taking action is that no one can resist wastage (Dimitrov, 2016). The other factor that the authors consider is human capital. Staff needs to be coordinated such that they are scheduled, patients are booked and the right care giver assigned the task hence saving time and avoiding wastage of resources. Another strategy is to minimize the habit of cancelling patient schedules as they come at a cost. Dexter &Wachtel (2014) do also propose on reducing the time spent on given healthcare services to increase productivity. When considering healthcare, they can be accounted as variable costs, and the more time spent on a service, the costly they become. The quality of service needs to be improved to minimize a patient’s length of stay. To sum it up, the article focuses on service improvement for quality outcomes at reduced costs and on capitalizing on information and data from I.T infrastructures at the care center.
Strategies Used To Address the Organizational Impact of the High Costs of Expenditure
The concern for the high costs of healthcare has been there for years now, and different methods of dealing with the problem have been proposed. Various experts and scholars suggest ideas related to capitating some form of products and services. Current proposals though focus on Value-based care, population management, Accountable Care Organizations, and clinical outcomes (Epstein et al., 2014). Such proposal aims to cut back on unnecessary use of resources via quality and safe care. The management of some organizations focuses on prioritizing products and services and where necessary, use smart technologies and ideas such as recycling and tech with multi-functionality. Other approaches of cutting on healthcare costs have been on the promotion of fair competition and transparency on the suppliers’ part with the expectation that hospitals will benefit on quality products and services at lower costs. This has become a challenge as most suppliers have grown in size and network to take a monopolistic form. It is worth to note that there are healthcare organizations that have capitalized on procurement ideas such as forming group-purchasing organizations to take advantage of discounts from buying in bulk and having a higher negotiating power. Some organizations cut back on the costs of specialists by capitalizing on the ability of nurses and physicians to provide the same service as specialists at a cheaper cost.
From the two articles by Dexter & Wachtel (2014) and Navathe et al. (2017), it is worth to note that there is no specific strategy that can reduce the cost of healthcare in an organization independently but rather a strategy of multiple solutions should be applied. The two articles share the similarity of focusing on the quality of services and competency of staff in improving the quality of care and the use of technology in streamlining care. Nurses, physicians, and other care specialists need to be involved in analysis, budgeting, and in decision making, especially when planning on acquiring supplies as they have the knowledge to review quality products. Organizations also need to have a team that specializes in procurement by reviewing terms of suppliers and make a deal with the suppliers that provide competitive prices for quality products. Since the cost of human capital remains high, the strategy should be optimally utilizing the available staff such as nurses since they have the knowledge and skill to provide various care services. Cost of supplies such as equipment and drugs among other infrastructure can be negotiated and the terms with suppliers reviewed.
References
Amadeo, K. (2019). Health care cost facts. Retrieved from https://www.thebalance.com/healthcare-costs-3306068
Centers for Disease Control and Prevention. CDC. (2019). U.S. Opioid Prescribing Rate Maps | Drug Overdose | CDC Injury Center. Retrieved from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html
Dexter, F., &Wachtel, R. E. (2014). Strategies for net cost reductions with the expanded role and expertise of anesthesiologists in the perioperative surgical home. Anesthesia & Analgesia, 118(5), 1062-1071.
Dimitrov, D. V. (2016). Medical internet of things and big data in healthcare. Healthcare informatics research, 22(3), 156-163.
Epstein, A. M., Jha, A. K., Orav, E. J., Liebman, D. L., Audet, A. M. J., Zezza, M. A., &Guterman, S. (2014). Analysis of early accountable care organizations defines patient, structural, cost, and quality-of-care characteristics. Health Affairs, 33(1), 95-102.
Navathe, A. S., Troxel, A. B., Liao, J. M., Nan, N., Zhu, J., Zhong, W., & Emanuel, E. J. (2017). Cost of joint replacement using bundled payment models. JAMA internal medicine, 177(2), 214-222.
Looking Ahead
The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.
By Day 7 of Week 2
Submit your paper.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
- Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
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Submit your Week 2 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 2
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Week 2 Assignment
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