Considering the five stakeholders in health care: consumers, providers, payers, suppliers, and regulators – what role can each play in health care quality, and cost containment?
– In your opinion, what health policy has had the greatest impact on health care in the United States? Why?
– Frame some arguments for or against the policy of mandated minimum staffing ratios in the positive versus normative economic dichotomy.
References must be within the past 5 years. Must have an introduction and conclusion.
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Health Policy and the Role of Stakeholder
Health care policy is significant since it provides a plan of action to achieve desired outcomes in decision-making. It includes standardization for daily operational activities as it communicates to the employees their roles and responsibility to achieve the desired results. Health policies and procedures are essential as they give clear guidelines for critical health and safety issues, legal liabilities, and regulatory requirements. In a health care environment, the policies should set a foundation to deliver safe and cost-effective quality care. Stakeholders in a health care system are an integral part of healthcare policies and procedures. The significant stakeholders include customers, payers, suppliers, insurance companies, regulators, and physicians. The purpose of this paper is to discuss the role of different stakeholders in health care quality and cost containment, important health policies in the U.S and their effects, and why mandated minimum staffing ratios in the positive is better than a normative economic dichotomy.
The Role of Customers in Health Care Quality, and Cost Containment
Consumers in the healthcare system are the main stakeholders in patient-centered quality care. They play a significant role in the decision-making process since they make choices that ultimately affect the value of care delivered to them. Hence, healthcare consumers have been identified as an essential tool for change in healthcare delivery. Consumers can become informed choosers of care to enhance quality care and reduce costs. Quality care is only delivered to patients who master how to use comparative performance data from public performance reports and, in turn, use it to identify high-performing providers, hospitals, and health plans (Stadhouders et al., 2019). Further, the consumers can motivate their providers toward improved performance by engaging them to seek information on how well they provide delivery care. With the report, the customer can choose high-performing providers and choose cost-effective treatment options which ensure they receive quality care and enhance quality improvement for providers (Stadhouders et al., 2019).
The Role of Providers in Health Care Quality, and Cost Containment
When considering cost-containment and healthcare quality, providers have a role in the initiative. First, they can coordinate and partner with patients towards health maintenance. Through dialogue, providers can help patients develop the essence of maintaining their health. They can motivate them to engage in effective self-care and take preventive actions. They can also collaborate with their patients towards identifying and implementing cost-effective care plans that guarantee quality care to the consumer (Stadhouders et al., 2019. Secondly, providers can support patients by giving them information about treatment risks and benefits by sharing evidence. This helps their decision-making process on the treatment options of high value and cost-effective. They can recommend treatment options that address the patients’ concerns. When providers involve patients in defining quality care, they motivate patients to be more involved in quality health care.
The Role of Payers in Health Care Quality, and Cost Containment
Payers’ participation in a health care system is vital towards improving patient quality care and lowering costs. Their transparency on healthcare quality and cost-effectiveness is essential in reducing unnecessary spending and enhancing quality care. A significant role they can play is expanding the availability of patient safety scores to the public. Transparency in healthcare is stressed since its shortcomings are associated with patient safety risks and higher costs. Payers should address transparency by collecting data about organizations and providers and sharing results with public members. This information can be obtained through patient surveys to determine outcomes and complications, using the electronic medical record to automate the tabulation of performance and hidden public records (Beauvais et al., 2021). Such information helps compare performance between providers and organizations, and patients can make informed decisions on services and providers they would prefer.
The Role of Suppliers in Health Care Quality, and Cost Containment
The relationship between healthcare organizations and suppliers continues to evolve during challenging economic times. The association’s goals are usually patient-centered to ensure that cost-effective quality care is provided for a patient. Suppliers can play a significant role in enhancing healthcare quality and cost containment by offering resources that can be used to the maximum advantage by the organization (Shrank et al., 2021). Suppliers should strive to supply health care systems with solutions and resources that are sustainable and not cost-saving for a short while. With this, the answers will sustain the organization, the health care system, and most importantly, the patient. Secondly, suppliers providing medical devices to organizations should focus on next-generation devices that will be sustainable for their operations. The collaboration of suppliers and organizations is vital since they both want to benefit from the contract. Hence the medical devices provided should provide long-term financial and environmental value.
The Role of Suppliers in Health Care Quality, and Cost Containment
Regulators in the healthcare system are critical during the planning and establishing of policies and procedures that help enhance quality care and reduce cost. Establishing health reforms that will help achieve quality and affordable healthcare is paramount. A significant role they can play is expanding insurance coverage. Policies like the ACA have significantly contributed to the number of uninsured Americans, hence the need to identify and implement approaches that close the gap of the growing number of uninsured citizens in America (Shrank et al., 2021). Expanding insurance coverage gains will help improve health care, equity, financial well-being, and reduce cost. An example of how insurance coverage is significant is the establishment of Medicare and Medicaid to a large portion of the U.S population. Secondly, regulators can establish legislation that protects employees from under-sponsored health insurance from their employers. This ensures that the employers comply with how they are supposed to sponsor their employees-insurance covers.
Patient Protection Affordable Act
The United States spends more of its economic share on healthcare than other sectors. Approximately 17.7 percent of the U.S gross domestic product was spent on healthcare in 2018 (Bauchner & Fontanarosa, 2018). It, therefore, becomes a concern for the states since they must strive towards balancing their budget. They do so by planning and establishing policies and procedures that significantly impact healthcare. My opinion on a policy they implemented that significantly impacts healthcare is the Patient Protection affordable act. The act provides a universal guarantee of affordable health insurance coverage from birth until retirement. This act has proven to be very beneficial for American citizens. With the act’s implementation, the population of uninsured Americans has reduced significantly. With the enactment of the act, more people have affordable health insurance. In addition, the cost of prescriptions is more minor, more screenings are covered, and patients with terminal illnesses are no longer denied services.
Advantages of Mandated Minimum Staffing Ratios
The mandated minimum staffing ratios is an enacted policy requiring all Medicare-participating hospitals certified to have a sufficient number of licenses registered among other providers to provide nursing care for all patients. Positive economics explains various economic phenomena. The act plays a significant role in addressing the growing issue of patient risk attributed to less staff regarding the increasing degree of illnesses and complexity of care. However, the mandatory ratio may escalate healthcare costs, especially if imposed nationally. In addition, the costs will increase with no guarantee that quality care is improving positive outcomes associated with the same. The expenses incurred to pay the additional nurses will be mandated to the hospital, which offsets more payments to the hospital by the customers. However, an approach to provide market-based incentives optimizes nursing levels while avoiding burdens to the hospital.
In conclusion, health policies are guidelines that standardize day-to-day activities, promoting overall organization outcomes and performance. Stakeholders are an integral part of the planning and development of health care policies to provide quality and cost-effective healthcare. Such stakeholders include customers, payers, providers, regulators, and suppliers, who can play crucial roles towards quality care and ensure cost containment. Consumers can become informed choosers regarding their treatment to ensure they receive quality care while reducing costs. Providers can help by engaging and reporting patients on specific issues to assist decision-making. Regulators like the government can implement legislation that ensures patients receive quality care. Payers can also help by providing information to the public on hospitals’ performance. Suppliers can also help by offering solutions that are sustainable to an organization.
Bauchner, H., & Fontanarosa, P. (2018). Health Care Spending in the United States Compared With 10 Other High-Income Countries. JAMA, 319(10), 990. https://doi.org/10.1001/jama.2018.1879
Beauvais, B., Kruse, C., Fulton, L., Shanmugam, R., Ramamonjiarivelo, Z., & Brooks, M. (2021). Association of Electronic Health Record Vendors With Hospital Financial and Quality Performance: Retrospective Data Analysis. Journal Of Medical Internet Research, 23(4), e23961. https://doi.org/10.2196/23961
Shrank, W., DeParle, N., Gottlieb, S., Jain, S., Orszag, P., Powers, B., & Wilensky, G. (2021). Health Costs And Financing: Challenges And Strategies For A New Administration. Health Affairs, 40(2), 235-242. https://doi.org/10.1377/hlthaff.2020.01560
Stadhouders, N., Kruse, F., Tanke, M., Koolman, X., & Jeurissen, P. (2019). Effective healthcare cost-containment policies: A systematic review. Health Policy, 123(1), 71-79. https://doi.org/10.1016/j.healthpol.2018.10.015