Analysis of a Pertinent Healthcare Issue

Analysis of a Pertinent Healthcare Issue

Reforms in the healthcare sector, like the enactment of the Affordable Care Act in 2010 and subsequent changes that have occurred to this law, are meant to increase access to quality and affordable care. However, the cost of healthcare is rising and becoming pertinent healthcare in the United States, not just at the organizational level but also at the government level; both state and federal governments (Montero et al., 2022). This paper discusses the rising cost of healthcare across the U.S. health system despite the passage of ACA 2010 and other policies like the Quadruple Aim. The discussion provides a summary of two articles exploring the issue and how organizations are addressing it. It also offers strategies for addressing the impact on the organization of the issue and the overall effects it has on our healthcare facility.

Description of the National Health Stressor & Impacts on Organization

a). Cost of Healthcare

The cost of healthcare is increasing based on several factors, some within and others outside the control of organizations. The high cost of care is leading to imbalances and financial burdens for millions of Americans, some opting to remain uninsured and only accessing healthcare through emergency departments (EDs). In their article, Montero et al. (2022) discuss challenges that Americans are facing due to healthcare costs. The study shows that close to half of U.S. adults experience difficulties affording their cost of care while a significant share of those above 65 years encounter challenges in paying for various components of care, particularly services not covered by Medicare that include dental care and prescription drug costs. Despite the Affordable Care Act lowering the cost of health insurance, millions of Americans are not enrolling as expected due to the rise in premiums’ prices. These costs are attributed to a rise in demand for care due to an aging population, use of technology and equipment, and inflationary pressure making the equipment and cost of services increase.

b). Impact on Organization

The rising cost of care impacts the organization since it means that it must spend more on buying supplies and equipment to meet the increased demand for care. Again, the organization needs to hire more providers to ensure that all patients seeking care get services. More fundamentally, the organization must ensure that it complies with existing legislations like the EMTALA provisions which mandate it to offer emergency care even for uninsured individuals (Sommers, 2020). According to available data from the administration, the facility catered to 60 individuals who presented in the emergency department with conditions requiring stabilization but did not have medical or health coverage. This implies that the organization may make losses of close to $400,000 since it cannot be reimbursed the amounts from the Centers for Medicare and Medicaid Services (CMS).

Summary of Two Articles & Addressing the Issue in Other Organizations

i). Summary of the Articles

The first article by Buntin (2021) explores the confronting challenges to the U.S. Care system during and post the COVID-19 pandemic. The article stresses the rising cost of healthcare for millions of Americans and its impact on access to care across different populations, especially racial minorities, and low-income households. The second article by Crowley et al. (2020) focuses on strategies that can help lower the cost of care and improve coverage for millions of Americans. As such, both articles are emphatic that while the ACA 2010 made tremendous steps in increasing coverage for millions of Americans, the rising costs of insurance and service provision are causing more harm than the expected benefits to these populations.

ii). Addressing the Issue in other Organizations

Healthcare organizations across the U.S. are addressing the cost of care through innovative ways that include leveraging technologies and enrolling in value-based care models under the CMS. As asserted by the American Hospitals Association (AHA), the rising cost of care is a critical challenge for many healthcare organizations, and dealing with requires investment in technology to enhance access, even for remote patients with chronic diseases as that lowers transportation expenses. Technologies like mHealth and telehealth as well as telemedicine can allow organizations to improve access to healthcare services.

Summary of Strategies to Address Organizational Impact & Effect on Organization

i). Summary of Strategies

The scholarly sources present various strategies that organizations can use to address the effects of the rising cost of care. Buntin (2021) stresses the need to invest in technologies and innovative care models to help lower the overall costs of care. On its part, the article by Crowley et al. (2020) proposes having a single-payer system and emphasizes the use of value-based care for organizations to reduce the cost of care. These articles propose that using these strategies at the national level can help organizations lower their overall expenses, especially in situations where they cannot be compensated by CMS.

1. ii) Effects on Organization

The proposed strategies by the articles have a positive effect on our organization as they demonstrate that it will not incur losses emanating from uncompensated yet provided care. Again, implementing value-based care will protect it from these losses and allow it to offer quality care (Sommers, 2020). More fundamentally, the organization will improve its overall position as an excellent care provision center.

Conclusion

The cost of care remains a national stressor despite the existing healthcare reforms aimed at improving quality, accessibility, and lowering costs. The national stressor impacts access to healthcare as millions of Americans cannot afford care. Organizations like our facility can develop innovative approaches to address the stressor and ensure that all patients have access to quality care.

References

American Hospitals Association (AHA) (2022). 2022 Costs of Caring.

https://www.aha.org/guidesreports/2023-04-20-2022-costs-caring

Buntin, M. B. (2021). Confronting challenges in the US Health Care System: Potential

opportunity in a time of crisis. JAMA, 325(14), 1399-1400. DOI:10.1001/jama.2021.1471

Crowley, R., Daniel, H., Cooney, T. G., Engel, L. S., & Health and Public Policy Committee of

the American College of Physicians. (2020). Envisioning a better US health care system for all: coverage and cost of care. Annals of Internal Medicine, 172(2_Supplement), S7-S32. https://doi.org/10.7326/M19-2415

Montero, A., Kearney, A., Hamel, L. & Brodie, M. (2022). Americans’ Challenges with Health

Care Costs. https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/

Sommers, B. D. (2020). Health insurance coverage: What comes after the ACA? An examination

of the major gaps in health insurance coverage and access to care that remain ten years after the Affordable Care Act. Health Affairs, 39(3), 502-50. DOI: 10.1377/hlthaff.2019.01416.

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Assignment

Chosen Topic Current Healthcare Issues: THE COST OF HEALTHCARE IN THE US

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.

The Assignment (2-3 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 2-to-3-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.

Please use the Template Below as a guide to develop 2-3 page. Previous discussion is also provided below.

Current Healthcare Issues: THE COST OF HEALTHCARE IN THE US