Analysis of a Pertinent Healthcare Issue
Analysis of a Pertinent Healthcare Issue
National Healthcare Issue/Stressor and Impact in the Organization
The current healthcare reforms on payment have high chances of affecting the work settings for physicians. Previously, there was the volume-based payment system where doctors in all healthcare facilities got paid depending on the volume of the healthcare or service that they provided (Gerardi, Farmer, & Hoffman, 2018). The changes that have been brought forth will change the workplace and not in favor of doctors. The value-based payment that has been proposed will require that all healthcare facilities get analyzed in terms of its cost-efficiency, quality, and also the achievements that the healthcare facility has made over the past few months. The value-based system will see physicians report on the time they take before a patient can see them and also the cancelations that get made at a particular period.
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Nevertheless, the adoption of the ideal alternative payment model has been slow. This has been due to the challenges faced in effectively delivering healthcare services in the organization. According to the hospital’s performance data, it is clear that the value-based payment system have influenced the organization’s healthcare delivery and resource utilization.
Summary of Reviews of Healthcare Issue/Stressor Addressed in Other Organizations.
Furthermore, a research carried out by LaPointe (2020), thirty nine percent of healthcare payments were done through the fee-for-service, whereas about twenty-five percent of payment featured fee for service with an aspect of quality of service delivered. These payments involved pay for performance or pay for reporting incentive payments. The main impact of the slow adoption has been linked with ineffective training on aligning healthcare management towards promoting effective value-based payment model in the healthcare center. Furthermore, the alternative payment model is deemed to be expensive due to a lack of a clear connection between the payment model and quality improvement programs.
Miller (2019) asserts that the foundation of an effective value-based payment model is a strong primary care. This is because primary care has the ability to treat and prevent healthcare issues in a community, and thus reduce the cost of healthcare and improving the health status of a community. Nevertheless, the issues identified in the organization are the increased shortage of primary care physicians in the organization. In turn, several primary care physicians are suffering from burnout, which further affects the quality of healthcare service in the organization. Miller (2019) asserts that this is mainly as a result of the failure of the alternative payment models in the US to avail adequate resources to enhance high-quality primary care.
Strategies used to address issues caused by the Changing Healthcare Payment Model
Counte et al. (2019) asserts that the US alternative payment model could also inappropriately allocate accountability to hospitals and physicians for services they cannot or did not deliver. At the same time, the new payment model fails to make healthcare professionals accountable for other primary services they deliver. Furthermore, the payment model fails to give hospitals, physicians and other providers with the required information to regulate healthcare spending without implicating patients. Hence, it can be addressed by setting a desirable target reach for every performance measure in advance. This generally means that the performance measures can include quality measures and avoidable hospitalization rate. In turn, primary care practices are conducted based on the expected level so as to receive the determined payment target.
So as to tackle the issues resulting from the alternative payment model in various healthcare settings, Tchatchoua (2018) argues that health organizations can develop a primary healthcare strategy that aligns healthcare quality measures and financial incentives. This requires a health organization to adopt a payment system that considers the needs of patients with other health issues apart from hypertension and diabetes. Basically, this strategy aims at improving primary care so as to prevent health issues that can be avoided, which actually lead to over-utilization of healthcare resources in the organization.
Impacts of these strategies on the Organization
Healthcare organizations are seen to adopt various strategies to tackle issues associated with the changing payment models. One of the strategies adopted include establishment of different performance measures for each healthcare aspect. This includes a set target for quality of healthcare as well as a separate target for preventing healthcare issues. This strategy will positively impact the organization by increasing enhancing primary care by integrating healthcare professionals with varying skills and background and training. Moreover, it will improve collaboration among the physicians and healthcare providers. There will be an increase in the number of physician clinicians, which gets aimed at reducing the cost of providing services to patients. There will be a change in the work setting
where the organization will increase the use of team-based and inter-professional clinical practice (Auerbach, Staiger, & Buerhaus, 2018).
Conclusion
On the hand, this will require effective training of healthcare administrators in the organization to effectively align the different performance measures holistically. Despite that this will improve the quality of healthcare services in the long term; the organization will have to increase its budget on training the staff and acquire the required resources to enhance the success of the strategy. This means that the strategy will require additional financial resources during its initial stage. Furthermore, the strategies may require the need of a healthcare team that is adept on contemporary healthcare standards so as to further enhance the implementation of the strategies that aim at improving quality of healthcare and reduce costs of healthcare services.
References
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice
clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi: 10.1056/NEJMp
Counte, M. A., Howard, S. W., Chang, L., Aaronson, W. (2019). Global Advances in Value-Based Payment and Their Implications for Global Health Management Education, Development, and Practice. Frontiers in public health, 6(379), doi: https://doi.org/10.3389/fpubh.2018.00379
Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared
workforce goal. American Journal of Nursing, 118(2), 43–45.
doi:10.1097/01.NAJ.0000530244.15217.aa
LaPointe, J. (2020). Entering the Next Phase of Value-Based Care, Payment Reform. Retrieved from: https://revcycleintelligence.com/features/entering-the-next-phase-of-value-based-care-payment-reform
Miller, H. (2019). The Problems with “Primary Care First” and How to Fix Them. Pittsburgh, PA: Center for Healthcare Quality and Payment Reform.
Tchatchoua, J. (2018). Strategies for Improving Healthcare Efficiency While Reducing Costs (Doctoral Thesis). Minneapolis, MN: Walden University.
Analysis of a Pertinent Healthcare Issue