The government has a new administration hence an opportunity has presented itself to see to it that health care reforms and control of health costs have a long-term effect since government negotiation and/or market-based models rely on competitive forces (Joel, 2007).
The first thing the government is doing is improving quality and efficiency in health care. Emphasis on streamlining the health system and eliminating needless spending decreases unwarranted variation in medical practice and unnecessary care particularly with regard to geographical variation. In certain geographical conditions, higher spending on health care does not correspond to better health outcomes.
Secondly, investing in information technology (IT) has gained significant footing. Use of technology on health reform plan has been promoted and researched by the Obama administration for its possibility to more proficiently share information and trim down overhead costs hence reduce the amount paid on average for care (Joel, 2007).
For example, use of electronic medical records and disease management. Policies that focus on new and expanding technologies may also contribute to the success of reducing growth rates which in the long run bringing health spending growth closer to the overall rate of economic growth.
Altering tax preference for employer- sponsored insurance is a proposal put forward to help finance the costs of expanding coverage and reducing incentives for the generous thus expensive health plans. Presently, employees do not pay revenue on money employer’s splurge on their health insurance, regardless of benefit costs.
It is possible for tax omission to be capped at the value of remuneration received by Congress Members, and workers who are opting for more pricey health plans.
Prevention as is said is to be better than cure hence the government has put forward emphasis to reduce the prevalence of chronic diseases (like diabetes which are correlated with obesity, diet, and smoking) and avoid incurring the long-term costs of treatment which are expensive. Financial incentives to workers have been provided to engage them in prevention and wellness.
Escalating consumer participation in purchasing saves them and employers’ money as it makes them more price sensitive and more prudent purchasers as a result of price transparency (Charles, 2006).
An example is the tax favored “health reimbursement account,” to which funds contributed by employers are managed by the worker so as to spend on primary health care. Critics raise concerns about the latent impacts that the higher cost-sharing would have on people with lower income. And the potential these new arrangements used by healthy people can be inexplicable, thus making those individuals who are sick shift to more expensive insurance forms.
Adjusting provider compensation is another way in which the government has tried in controlling health costs as it aims to eliminate unnecessary care thus reducing costs. Current provider compensation system pays physicians a given fee per procedure/test.
This is about to change since proposals to refurbish some of the provider payments so as to guarantee that fees paid reward health outcomes and value rather than care volume to patients is underway (Charles, 2006). Emphasis has been increased on comparative effectiveness research as a way to determine the kinds of treatments most effective for given conditions. This enables doctors have sufficient information in order to make the best choices for patients’ care.
Medicare policies revision directly influences health care spending on the elderly. Two significant steps towards reforming Medicare are: Basing compensation of providers on pay performance and coverage requirement only for cost-effective technologies. Recommendations progressively lead to greater association and better performance which follow the strategies below:
Payments reform system fuels delivery fragmentations which stimulate greater organization and higher performance. Payers are recommended to move away from fee-for-service toward bundled systems of payment that reward high-value care.(Ken, 2004).
Full population prepayments are payments that are adequately risk-adjusted to avoid adverse selection of patients. Global case payments for acute hospitalizations bundle all related medical services from the initial hospitalization to a post-hospitalization.
Alternative payment structures for primary care providing coordinated, comprehensive patient centered for example medical homes certification. Expansion of pay-for-performance programs which should move away from measures that focus on individual processes towards broader quality measures, patient experiences, such as clinical outcomes (Joel, 2007).
Provider training programs teach competencies, system-based skills, and population health in organized systems of delivery. Accreditation programs focusing on attributes of an ideal delivery system, consumers and payers should be encouraged to make decisions basing on provider network and payments in response with performance measurement data (Ken, 2004).
Incentives of patients should be given freely so that patients can receive care from high-quality and value system of delivery. Changes in environment regulatory should be customized to aid clinical incorporation among providers. Government infrastructure supports where for specific populations development of systems needed assistance thus a proposal in facilitating the infrastructure for a delivery system that is organized (Joel, 2007).
Health information technology is a critical infrastructure that providers need to implement and utilize licensed electronic health records meeting security standards, functionality, and also take part in health information exchange across providers.
To achieve a higher-performing health system will entail reorganization at the practice, national levels, community, and state. We need to move away from a cottage kind of industry to another one since in the cottage industry no relationship exists with one another and most of all accountability.
Charles, R. M. (2006). Effective Health Care Supervisor. Boston: Jones & Bartlett
Joel, B. (2007). Essentials of Health Policy and Law. Boston: Jones & Bartlett
Ken, E. & Mary, C. (2004).Decision making for Improved Performance. San. Francisco: Jossey-Bass Publishers.
Peter, R. (2007). Essentials of Managed Health Care. Boston: Jones & Bartlett