There are a number of challenges surrounding and defining the future strategic direction of health care. They are; information technology advancements, proposed health care reform and legislation, economics; including third party payers and maintaining a skilled workforceand pay for performance are just a few of the current challenges in health care that will still have a significant effect on the strategic direction of the future.This paper will highlight the above referenced challenges and attempt to explain how organizations may adapt its direction and strategies accordingly.
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Healthcare reform is stated that it will make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable, stabilizing family budgets, the Federal budget, and the economy. There are two main purposes for the Health Care reform. The first is toput American families and small business owners in control of their own health care. Second it bridges the gap between the House and Senate bills,including new provisions to crack down on waste, fraud and abuse.
The new law could be considered a massive failure because it is not designed to meet the three most important goals:Health insurance for all Americans,reduced insurance cost for individuals, businesses and government and increased quality of care. “Newt Gingrich, former US House Speaker said the new healthcare law is socialized medicine and must be repealed. He called the legislation “a back door road to socialized medicine” that puts America at the edge of a possible catastrophic failure.” (Lazarus, 2012)
The U.S. has the most expensive health care in the world and the growth of health care prices grows more rapidly, but it still leaves the number of uninsured on the rise. Since early in the 20th century, health insurance coverage has been an important issue in the United States. The people who are uninsured or under-insured, have a higher mortality rate than those who have coverage.”The Medicaid and Medicare programs have grown substantially; federal and state spending for them soon will be unable to keep pace with the demand for services.Medicare is a valuable source of health insurance for nearly 45 million Americans, mainly seniors ages 65 and older, but also 7 million younger adults with permanent disabilities.”(Kaiser Family foundation, 2012)
“Medicare is a popular program, but faces a number of issues and challenges in the years to come. A critical challenge is how to finance care forfuture generations without unduly burdening beneficiaries, taxpayers, or the general economy. Another pressing issue relates to the role of private plans in Medicare, in light of rapid enrollment growth in recent years, and concerns about the current payment system for private plans. A third issue is the relatively new Medicare prescription drug benefit and how to address concerns about its current structure and further limit the burden of prescription drug spending. Lastly, there is the challenge of how to make health and long-term care more affordable for beneficiaries in light of rising health costs.” (Kaiser Family foundation, 2012)
Access to Health Care for the uninsured and poverty levels through trying to cut costs, have encouraged the shifting of Medicaid and Medicare beneficiaries to managed care. Medicaid provides health care to low income families with few resources. There are more requirements for Medicaid such as age, disability status and pregnancy status. “The states provide Medicaid services to people who receive federal income assistance.Some 48 million people, or one in every seven people in the US, are now enrolled in the health care program for the poor”(Randall, 2010).
“The spike comes as the recession has wiped out millions of jobs, and more people have lost their employer-sponsored health care coverage. US states are also forecasting a 6 percent increase in Medicaid enrollment over the next year, which will place increased strain on state budgets already reeling under the weight of the weak economy.” (Randall, 2010)
Pay-for-performance is a term that is used in describing health care payment system, which rewards hospitals, healthcare providers and doctors for their efficiency in a predetermined set of quality measures and performances. The adaptation of Pay-for-performance is important because in the current health care system the care providers are paid for each service that they perform that meets or exceeds the criteria set. Pay-for-performance offers health care providers financial incentives to performing more services.Hospitals need to work together with insurers, physicians, nurses, businesses, employers and individuals for better, safer and more affordable health care. Rewarding doctors, hospitals and others who deliver high-quality care can encourage accountability for patient care, offer incentives to coordinate care delivery and lead to better health care processes.
One of the most common types of quality improvement programs is the pay-for-performance programs. This program links payment to specific steps taken or results achieved in care. According to a survey of health care purchasers, “government agencies and health plans, at least half of evaluated pay-for-performance programs have significantly improved clinical performance.” (Gillette, 2008) Managers in companies and different organizations use pay-for-performance in hopes to attract and motivate their employees. They expect performance standards will outweigh the costs of whatever incentives they put in place.
The future of health care record keeping is in electronic medical records (EMR); computerized patient orders and electronic health records (HMR). However, the real recipients of the information technology advancements of automated patient records are the patients. Organizations are increasingly becoming global in their operations. Technology has made it easy to transcend geographical barriers to collaborate within the health care industry even if you are thousands of miles apart. With the advancement of technology it allows health care providers to access information about previous care, medications, prescriptions, lab results, or clinical guidelines which could support more productive discussions about current medical issues.
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The provider-patient relationship is one of our most valued and important connection, “Technology can be used to enhance communication, increase compliance, limit no-shows, and improve treatment outcomes. Health information is among the most frequently sought search categories on the World wide-web, and consumers have been increasingly empowered to participate actively in both treatment and preventions.” (Shortlife, 2005)In order for health ITs to deliver on its promise, several obstacles must be overcome. First, health IT systems must be able to speak the same language; in computer terms, they must be “interoperable.” These systems must also be linked in some way. Another issue is whether patient privacy might be jeopardized by health IT systems. We all know that technology isn’t cheap, so who pays for these advancements?
“Currently, providers are expected to bear most of the initial costs, while most of the savings accrue to others. For example, hospitals often spend tens of millions of dollars on CPOE systems, providing benefits for other stakeholders-insurers, purchasers and patients. One majorstudy found that it would cost more than $150 billion over five years to develop a nationally interoperable system, including equipping physicians with standardized IT systems.” (Kaushal, 2005)
Retaining a skilled workforce in health care is important to adding certainty in the deliverance of quality patient care. Physicians as well as the staff of health care organizations need to be trained continually and educated frequently to stay up-to-date with health care technology. Health care workers need be ready for the future direction of the geriatric population. As the “baby boomers” over 65 increases, more health care work force needs training in geriatric care. A strategic direction for health care is training in the health care sectors is training for health care jobs that require certain competencies. Caring for the needs of the elderly population and the skills to work with them is in high demand. Skilled health care workers have an understanding of chronic and terminal conditions and have valuable experience in different settings. “Health care workers need skills in how to converse in geriatric and hospice care settings in order to achieve successful patient transition “(Gentiva Health Services, 2011).
By building on established public-private partnerships, hospitals, government, educational institutions, businesses and community groups can all work together to meet our future health care needs.The Government will build on the reforms it is already delivering with further investment in new health workforce training and support measures.Maintaining a skilled workforce is a challenge in health care, and is important to the future direction of health care. This does not just refer to physicians, but front-end staff and more.
Health care organization can adapt its direction and strategies accordingly by keeping their workforce resources and competencies updated with continuous training applicable in technique and in technology. Most health care providers and their organizations study strategic planning approaches and concepts that will lead to success and improvement in the health care sector. “While an ongoing process, strategic adaptation can be greatly accelerated by a relatively dramatic and visible change or set of changes in the environment. Organizations which do not adapt their strategies and restructure accordingly in anticipation or in response to these changes may jeopardize performance.” (Zinn, Mor, Feng, &Intrator, 2007)
Strategic direction of an organization should be the guiding force and framework in which they operate. There will always be changes made in every aspect of health care. There will be improvements in technology, financial support, advancements of medicine, and overall care of patients will continue to grow. Nobody can say for sure what will happen to our health care system or what changes will be effective. Organizations need to continue to communicate and have a willingness to adjust to changes within the organization and also make room for the needed improvements.
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