External and internal influences are relevant in health care. These influences continue to affect the total operations of a health care facility. I will summarize the insights I have gained into the external influences of the new health care reform policy and quality initiatives. The recent health care reform legislation was passed in the house and senate this year. The senior vice president, that I have interviewed, states that health care reform is an “unknown” for organizations. In addition, I will research the quality improvement initiatives and how these external influences include implications for organizations and health care administrators.
The Health Care Reform legislation passed on March 21, 2010. It promises to overhaul health care delivery in the United States and guarantee health insurance to millions of uninsured Americans. According to the Congressional Budget Office (CBO), it will regulate private insurers more closely, banning practices such as denial of care for pre-existing conditions. The CBO states, that the legislation will cost the government about $938 billion over 10 years; reducing the federal deficit by $138 billion over a decade.
(W. Lease, personal communication, July 23, 2010), the “unknown” of the recent health care reform legislation is an external influence that is most relevant to our organization, stated by William Lease, senior vice president of clinical support services. Mr. Lease states, that health care reform legislation will impact our organization in many ways; especially after 2014. While more employees will have health insurance coverage and there will be more patients to treat; the need for controlling costs and improving efficiency is invaluable. Health care administrators would need to continue to track spending and identify what is driving costs, and come up with actions needed to control them. Mr. Lease states, that the hospital will not increase full-time equivalents (FTEs) or begin any major construction projects in the next fiscal year because of the “unknown” of health care reform. Mr. Lease indicates that illegal immigrants will not be permitted to participate in health insurance. He states if private payers and providers lower costs to make up for public payers, the reimbursement will be much less than the hospitals' costs.
Mr. Lease indicates that quality in health care is another external influence in the delivery of health care services. The integration of medical services into larger payment groups, when using value-based purchasing and improving...