HCA 675 Health Care Reform Paper

HCA 675 Health Care Reform Paper

HCA 675 Health Care Reform Paper

The implementation of the Affordable Care Act has enabled the significant improvement of the healthcare system since its implementation. However, the American healthcare system is still not meeting the demands of the citizens (Clarke, Bourn, Skoufalos, Beck, & Castillo, 2016). The insurance companies and hospitals have turned Medicare into a profit-oriented business in order to make more money. The quality of healthcare services in the United States has not yet hit the bar. Additionally, the complexity of the large, fragmented and uncoordinated United States healthcare system is still a challenge despite the efforts put forward to improve quality outcomes. This paper provides five elements of the healthcare system that need reform and how they impact the current system.

Access to Healthcare Services

Access to healthcare is still a major challenge in some parts of the United States of America. The cause of this problem ranges from insurance and high prices to lack of adequate medical services. Clarke et al. (2016) report that in the four largest states of the US, about 12 percent to 30 percent of residents lacked experienced problems accessing care and most of them were not medically covered in 2014. The problem exists even today, whereby, many rural areas suffer from an inadequate supply of healthcare professionals which compromises access to healthcare. In some parts of rural America, hospital facilities lack primary care physicians, emergency physicians, and paramedics.

According to Putera (2017), about 57 million Americans living in the rural parts of the country have problems accessing their clinicians. When patients cannot access clinicians, it becomes impossible for them to receive sufficient health care services and achieve their overall patient wellness. Therefore, the American healthcare system still needs reform to improve access to medical services, especially for the 57 Million and above residents in the rural parts of the country.

Cost of Healthcare

The rising cost of healthcare in the United States is an issue of concern among many residents. Despite the diminishing rate of escalation, the health care cost remains high which is an impediment to care delivery. Clarke et al. (2016) assert that about 42 percent of Americans in a recent survey suggested that either the cost of, or access to, healthcare is the major problem facing care delivery in the United States of America. An eleven country survey suggested that adults in the United States are more likely than those in the other 10 countries to go without needed care due to high costs. This survey was conducted among 11 countries such as the United States of America, the United Kingdom, Netherlands, Switzerland, Sweden, Norway, Germany, New Zealand, France, Canada, and Australia (Osborn, Squires, Doty, Sarnak, & Schneider, 2016). About 33% of adults went without recommended care or failed to fill a prescription due to cost. The U.Ss overall healthcare cost, private and public spending inclusive, is expected to grow by an average of 5.5 annually. The amount is expected to rise from $3.5 trillion in 2017 to $6 trillion by 2027. Therefore, this element of the healthcare system needs to be reformed to provide the American people with affordable care services.

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The Quality of Healthcare and Safety Issues

Even though the United States of America is often perceived as having some of the best healthcare systems in the

HCA 675 Health Care Reform Paper
HCA 675 Health Care Reform Paper

world, the reliability and validity of this claim are still questionable. According to Putera (2017), the quality of healthcare in America is a bit of a mixed bag, doing relatively well in areas such as cancer treatment and care while facing increased mortality rates from preventable and treatable diseases. Despite the implementation of the Affordable Care Act, the United States was still ranked last among the 11 industrialized countries (Osborn et al., 2016). Researchers identified that the US has the highest cost while also displaying the lowest performance.

Low-quality healthcare is associated with a lack of patient satisfaction, bad patient outcomes, and increased mortality rates.  Serious gaps in care guidelines may cause adverse influence on care, especially in outpatient settings (Clarke et al., 2016). Additionally, ineffective patient communication and patient education along with poor coordination processes may lead to low-quality care.  Keeping this knowledge in mind, every reader can see sense for the need to reform the quality of care delivered in the United States of America.

Health Information Technology (HIT)

Although the health care communities across the country are making steps in the adoption and implementation of health information systems, there is still a lack of widespread adoption of telemedicine to share and integrate communication (Clarke et al., 2016). Problems are identified in many healthcare facilities during the transition of care, in the longitudinal management of medically complex patients, and when individuals with chronic disease have clinical episodes that need acute interventions. Therefore, it is important to encourage the implementation of innovative ways that improve care coordination and communication among providers, patients, and families/ caregivers.

Telemedicine should be implemented in all sectors of healthcare such as outpatient settings, inpatient settings, workplaces, nursing home care, and summer homes (Sharma, Fleischut, & Barchi, 2017). In areas where this health information technology has been implemented, physicians can work with high-resolution videos, access patients’ medical history using electronic health records, and remotely print discharge instructions. The implementation of telemedicine will improve healthcare. For instance, telestroke programs will connect regional hospitals with a neurologist who can effectively evaluate CT images and consult with a physician onsite to the best cause of action (Sharma et al., 2017). These programs can help coordinate healthcare even in rural America where medical services are facing several challenges.

Waste and Frauds in Healthcare

American hospital finances go to waste due to fraud and waste. The United States is spending more on healthcare than any other country as the cost is about 18 percent of the gross domestic product (GDP) (Bauchner & Fontanarosa, 2019). 54 studies and reports published since 2012 have indicated cases of fraud and waste in US healthcare. The studies revealed that about 20% to 25 % of American healthcare spending is wasteful. Approximately $65 billion yearly goes into waste due to mismanagement and fraud. Researchers and editorialists support taking different approaches to deal with these cases. Although the Department of Justice has made efforts to deal with fraud, the waste is still felt in the sector (Bauchner & Fontanarosa, 2019). Fraud cases may stem from false billings and improper data analysis by the doctors and other health professionals and administration complexity. There is a need to reform healthcare to prevent cases related to fraud and abuse.

Conclusion

Based on the presented information, the American healthcare system is still not meeting the demands of the citizens. Access to healthcare is still a major challenge in some parts of the United States of America, especially in rural America. The top five elements of healthcare that need reform include access to healthcare, cost of healthcare, quality of healthcare, health information technology, and waste and fraud in healthcare. Addressing these issues will improve the quality of care, patient outcomes, and patient satisfaction.

References

Bauchner, H., & Fontanarosa, P. B. (2019). Waste in the US health care system. Jama322(15), 1463-1464. DOI:10.1001/jama.2019.15353.

Clarke, J. L., Bourn, S., Skoufalos, A., Beck, E. H., & Castillo, D. J. (2016). An innovative approach to health care delivery for patients with chronic conditions. Popul Health Manag.20(1): 23–30. DOI: 10.1089/pop.2016.0076.

Osborn, R., Squires, D., Doty, M. M., Sarnak, D. O., & Schneider, E. C. (2016). In new survey of eleven countries, US adults still struggle with access to and affordability of health care. Health Affairs35(12), 2327-2336. https://www.commonwealthfund.org/publications/journal-article/2016/nov/new-survey-11-countries-us-adults-still-struggle-access-and.

Putera, I. (2017). Redefining health: Implication for value-based healthcare reform. Cureus9(3).  doi: 10.7759/cureus.1067.

Sharma, R., Fleischut, P., & Barchi, D. (2017). Telemedicine and its transformation of emergency care: A case study of one of the largest US integrated healthcare delivery systems. International journal of emergency medicine10(1), 21. DOI 10.1186/s12245-017-0146-7.