Health Care Priorities
Inadequate access, rising costs, and questionable quality in regards to health care are worries that not only effect the American public, but policy makers, employers and insurers alike (Sultz & Young, 2014). Rapidly approaching 20% of the Gross Domestic Product (GDP), America spends more than any other country on health care. The American public and policy makers know that it appears to be a problem spiraling out of control, yet no one seems to know quite what to do about it. In recent years the American public has been slightly reluctant to get on board with any radical change or reform because, albeit that their out of pocket costs had increased, the system still worked relatively well for the majority of Americans. While rising costs and quality of care may remain obstacles, through the new Affordable Care Act (ACA), Americans that may have been previously unable to acquire health insurance coverage will be able to do so.
Costs: Past and Present
Hospitals are always looking for ways to cut costs, improve quality and become more efficient. The Joint Commission implemented its Agenda for Change in 1986 to improve the systems, processes, and, ultimately, the outcomes of care. Andel, Davidow, Hollander and Moreno (2012) state there has not been widespread adoption of these principles, in part because the incentives were not substantial enough to overcome the inertia of many hospital cultures and the US payment system. Since 1986, those hospitals that fought through the initial uneasy struggles that coincided with the agenda have seen great growth in not only quality, but performance, patient safety and satisfaction as well. Moreover, proving that there is no progress without struggle.
The Costliest 1 Percent
The costliest 1 percent of patients account for 21 percent of U.S. health care spending, according to a recent report from Kaiser Health News (Boodman, 2013). Simple math shows that this is incredibly top-heavy. If these high-risk patient populations are not managed and treated properly, costs will obviously continue to rise – not to mention the one-fifth could soon become the one-quarter of U.S. health care spending. That is a scary thought. This is where fragmented and uncoordinated care can be excruciatingly detrimental. But by classifying these populations and knowing the specific at risk health conditions, we can more effectively ensure that each patient is receiving the right care and make specific adjustments to better deliver the care at a lower cost.
A number of factors contribute to the high health spending in the U.S. Many of which are interrelated: high procedure and drug costs, higher proportion of expensive medicine, fragmented and uncoordinated care, high administrative costs. However it is the unhealthy lifestyle choices and behaviors that not only add to health burdens, but are embarrassing on a global level and are entirely self induced. Therefore, the ACA will allow employers to...