NURS FPX 4000 Assessment 4

Analyzing a Current Health Care Problem or Issue

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Rising Healthcare Costs

Healthcare systems around the globe are enormously pressured by the situation of their increased healthcare expenses, which tremendously influence individual people and societies. Adang’s concern reveals that the integration of medical progress and financial stability within healthcare systems is a complex relationship (Adang, n.d.). Baicker and Chandra (2005) drill down on the labor market outcomes as well as how it is influenced by escalating health insurance premiums. They shed light on the possible effects on productivity. This article examines the pervasive impact of the constant rise in healthcare costs, with an aim to break it down to its root causes, and explore its impacts, while also proffering solutions. Spiraling healthcare expenditure outruns economic growth; hence, notwithstanding the efforts to provide equitable access to good quality care, the system becomes endangered. Vulnerable population is exposed for higher costs, more harmful health consequences which leads to health inequalities. Via this review, the various stakeholders can obtain insights which may ultimately drive sustainable and high-quality healthcare system services in the face of seemingly increasing costs.

Understanding the Factors Driving Healthcare Costs Up

A comprehensive view and deeper understanding of the details of the phenomena which cause the growth of healthcare expenditure is necessary to a sustainable solution of the pressing problem. One of the major factors that foster the increase of medical expenditures is the ceaseless update in medical technology. As is being shown by Brown and Brown (2003), the system for integrating new medical technologies normally carries a greater financial load, and it affects every dimension of healthcare delivery. Byrd and Byrd (2010) present the fact that health informatics technology and its operations in healthcare settings remarkably influences the systems expenses, maintaining that new technologies result in high operational expenses.

Demographic change that shows the increasing dependency on people who tend to live longer is another main factor leading to the increase in healthcare costs. Karlsson, Iversen and Øien (2018) problematize the financial sides of an aging population which implies growth in healthcare services and their costs. This occurs due to the escalation of demand for healthcare services and the factors determining care for elderly individuals. Furthermore, from Hempstead, et al. (2015) there is an significance of demographic trends on the provision of the reimbursements and patient financial obligations which not only pressurizes the provider as well as the patient’s budgets but also signifies the effect that arises on both ends. These transformations thus call for strategic thinking, resourcing, and alignment of health care initiatives with emerging requirements of aged populations.

Besides that, the socioeconomic factors are among the leading social determinants of health, respectively, mainly. Inequality in the income, education and health care provisions leads to poor equity in the health outcomes and health care costs. Chang and Gibbons (2008) opine that the weaknesses in the healthcare system, such as the fragmented care and inadequate coordination, are the embryos of disparities in healthcare and upsurge in general healthcare costs. Furthermore Sassi (2003) deals with dilemmas that often arise in a situation where there are limited resources for healthcare interventions, that has ethical and practical implications about how to allocate health resources maximally. It is of great importance to begin to solve the issues of social and economic divide together with the inefficiencies of healthcare system in order to bring down the costs and achieve equal level of care for all.

Stakeholders Impacted by Rising Healthcare Costs

The consequences of the increasing costs of healthcare not only refers to the players in the health care system but they also bear different burdens because each has a certain task to do. They are the patients who have become the most vulnerable stakeholders being stressed financially by the high cost they have to pay for medical services and medications they need. The paper by Ganguli, Thompson, and Ferris (2017) brought the lives of high-cost patients to light. It is clear from their research that such patients are experiencing tremendous financial burdens and are unsure about future medical costs. The problem of rising healthcare costs may be particularly difficult for people with chronic diseases or with limited personal resources, as this can influence their medical decisions (for example, treatment adherence) and access to needed care.

Healthcare personnel too are impacted directly, and through time-consuming paperwork, lowered reimbursements, and inadequate resources. Skinner and Chandra discuss healthcare employment growth and the overall aim of contain and the reduction of the costs and they show the healthcare providers must work with their new developing problem keeping the quality of services high and dealing with the financial constraints. Moreover, Baicker and Chandra (2005) consider the labor market effects of parting health insurance premiums together with their effects on providers like doctors and nurses wages and employment chances.

Furthermore, payers, such as insurance companies and government agencies, are one of the hegemony forces on managing these costs and assuring the long-term financial health of the medical system. Today, Adang (n.d) talks about the issue of the cost and effect of medical technologies in surgery and tackles the question concerning the difficulty of policy makers in the assessment of the cost-effectiveness of healthcare interventions. While healthcare expenditures do and will continue to rise, layman is charged with the task of finding a balance between affordability, accessibility and sustainability of the system he is managing. All the actors need to be in close cooperation to bring to light the myriad elements strengthening up healthcare costs and to prevent them from affecting patients, providers and the payers alike.

Economic and Social Implications of Escalating Healthcare Costs

The economical and social consequences of escalating healthcare costs are the two huge and multifaceted issues. Health care spendings are at an all- time high thereby reducing the amount of resources used for other sectors such as education, infrastructure, and social welfare programs. Such detour may distort the overall economic growth as well as create deepening of income disparities by heavily relying on lower-income people (Baicker & Chandra, 2005). Furthermore, high expenses in the field of public health may discourage entrepreneurial activity and investment which affects innovation and economy (Skinner & Chandra, 2018). Healthcare expenses place a heavy financial strain upon the society, which accentuates socioeconomic inequalities, as well as grants accessing to care for the most vulnerable groups, with the consequence of perpetuating the poverty and ill-health cycles (Gibbons, 2008). Furthermore, a shifting trend towards more expensive healthcare can weaken public trust of healthcare systems and instigate disagreements among healthcare actors (Chang & Gibbons, 2008).

Initiatives to enhance the economic as well as social facets of rising healthcare expenditure demand multifaceted approach which encompasses policy reforms, innovative financing systems and targeted actions. Cost control should be a priority for policymakers, which can be done with the support of value-based care initiatives, price transparent policies, and delivery reforms aimed at improving efficiency and minimizing wastage (Levy, 2016). Besides that, the commitment to disease prevention, public health programs, and social determinants of health can bring about substantial returns by curtailing the chronic conditions primarily caused by indecent lifestyle, promoting population health, and many more. The joint responsibility of governments, health care providers, and insurance companies alongside community services is a vital factor that facilitates the realization of long-term, sustainable solutions which guarantee health care of the best quality while taking care of the socioeconomic determinants of health (Fiscella, n.d).

Exploring Solutions to Address Rising Healthcare Costs

Overcoming the issue of increasing healthcare cost is multi-dimensional, and there must be a coordination of various players and action plans. A possible way has emerged in the form of adopting value-based models of care that primarily focuses on the patient outcomes and quality of care, rather than simply the number of procedures performed for getting remunerations (Porter and Guth, 2012). Improvising the providers to deliver high-caliber, fruitful, and efficient care while aligning payment modes with patient health outcomes, value-based care models could be assumption cured unnecessary healthcare expenses but on the other hand our efficiency and health outcomes of patients will be honored to elevate with a great contribution. Furthermore, the provision of adequate information about cost of healthcare services and drugs would explain the client’s judgment regarding the quality of services which would lead to the willingness to pay and the consequent rise or decline of costs among service providers with the objective of getting consumers.

In addition, investments in health-related innovation and technology might be a rather good tool for increasing operating efficiency and balancing the cost across the whole continuum of care. Included into the sphere of telemedicine, remote monitoring and digital health technology the access to care becomes easier, more treatment steps are getting digitalized, and the patient is allowed to play an important role in self-care. Healthcare organizations can achieve all this by using technology to facilitate virtual consultations to include monitoring patients without their physical visits and broaden their services to include personalized health interventions. In this case, unnecessary healthcare utilization goes down because they are expensive, prevent complications and curb healthcare spending as well. While it is required to strike a balance in the use of digital technologies for improving the cost-effectiveness of health care and population health, equal access to these technologies and sufficient literacy education on their use are the key factors in this.

Evaluating the Effectiveness of Cost-Control Measures

Assessing the performance of the cost control measures in healthcare requires careful weighing of their financial stability and the quality of patients’ treatment. Tailored value-linked payment slates, which are result-oriented and allow to reduce the cost while improving the healthcare expenditures’ effectiveness, have become very popular (Porter & Guth, 2012). Value-based purchasing aims to does this by rewarding providers for delivering practice that strict evidence-based guideline and alignment to patients’ preferences and lead to the reduction of unnecessary utilization and improvement of health outcomes. The success of these initiatives, nevertheless, largely depends on the precision and accuracy of quality metrics that drive reimbursement, along with the intensity and speed at which doctors can scale up their practice to meet these performance benchmarks.

CER is important because it provides information that can govern cost containment measures by evaluating the clinical and economic values of different health care interventions (Levy, 2016). Relying on the result of hard data of the world and the clinical trials to CER can help discover the most efficient manner for treating the divergent health conditions. Through offering compelling, empirical data regarding the comparative benefits, risks, and costs of distinct healthcare choices, CER gives governors, payers, and providers the chance to make objective decisions about the most cost-effective care solutions. Nonetheless, the data availability, methodological rigor and stakeholder engagement are some of the daunting challenges hence they must be addressed without comprising in order to maximize the impact of the CER in driving cost containment efforts and improving healthcare value.

Ethical Considerations in Managing Healthcare Expenditures

Decisions related to health expenditures require ethical consideration, and it involves finding the fair compromise between cost containment and, also, welfare of the patient and health distribution. In the context of the steepling health care costs, they need to make hard decision on the resource allocation, accessibility and priority treatments. Thus we need to be watchful that the cost saving initiatives will not have any negative influence on the quality and access to healthcare of the most vulnerable among us. In normal decision making the key practices are beneficence, nonmaleficence, justice and autonomy which should be in the forefront of decisions made so that cost saving strategies are not used to the detriment of patients not to bring harm, unjustness and infringing of their right to information and control of their healthcare decisions. Ethical governance activities in terms of expenditure management that possesses values and shield public confidence also need transparency, accountability, and participation of stakeholders as they make efforts legit and trustworthy in the direction of expenditure management.

Conclusion

Through this analysis, we understand that resolving the growth of health care cost need to be done by all parties involved and designing a strategic planning that will lead the way to success. Through the comprehension of the causes that raise the expenses, looking for creative options and measure the efficiency of the containing measures, the way forward for the sustainable and affordable health care management can be created. If we are to implement value-based model, identify health care-oriented innovations and know how to navigate the ethical dilemmas of the decision-making processes, then we can succeed. Among all, there will be complete transparency, accountability and joining hands as a community for patient-centered care that will make it possible to maneuver the future healthcare cost affordability while ensuring that everyone is provided with quality and equitable services.

References

Baicker, K., & Chandra, A. (2005). The labor market effects of rising health insurance premiums. National Bureau of Economic Research. https://doi.org/10.3386/w11160
Brown, M. M., & Brown, G. C. (2003). Cost-utility analysis: The foundation of value-based medicine. Evidence-Based Eye Care, 4(2), 114-118. https://doi.org/10.1097/00132578-200304000-00027
Byrd, L. W., & Byrd, T. A. (2010). Examining the effects of healthcare technology on US hospitals’ operational cost. International Journal of Healthcare Technology and Management, 11(1/2), 96. https://doi.org/10.1504/ijhtm.2010.033277
Chang, S., & Gibbons, M. C. (2008). Healthcare system factors in healthcare disparities. In M. C. Gibbons & S. Chang (Eds.), eHealth Solutions for Healthcare Disparities (pp. 30-38). Springer. https://doi.org/10.1007/978-0-387-72815-5_4
Ganguli, I., Thompson, R. W., & Ferris, T. G. (2017). What can five high cost patients teach us about healthcare spending? Healthcare, 5(4), 204-213. https://doi.org/10.1016/j.hjdsi.2016.12.004
Hempstead, K., Sung, I., Gray, J., & Richardson, S. (2015). Tracking trends in provider reimbursements and patient obligations. Health Affairs, 34(7), 1220-1224. https://doi.org/10.1377/hlthaff.2015.0105
Karlsson, M., Iversen, T., & Øien, H. (2018). Aging and healthcare costs. Oxford Research Encyclopedia of Economics and Finance. https://doi.org/10.1093/acrefore/9780190625979.013.24
Levy, A. (2016). Comparative effectiveness research: Overview. In A. Levy (Ed.), Comparative Effectiveness Research in Health Services (pp. 1-5). Springer. https://doi.org/10.1007/978-1-4899-7600-0_1
Porter, M. E., & Guth, C. (2012). Guiding principles of a value-based health care system. In C. Guth & T. Koch (Eds.), Redefining German Health Care (pp. 25-52). Springer. https://doi.org/10.1007/978-3-642-10826-6_3
Sassi, F. (2003). Setting priorities for the evaluation of health interventions: When theory does not meet practice. Health Policy, 63(2), 141-154. https://doi.org/10.1016/s0168-8510(02)00061-1
Adang, E. (n.d.). Medical technology assessment in surgery: Costs and effects of dynamic graciloplasty and combined pancreas kidney transplantation. Retrieved from https://doi.org/10.26481/dis.19971121ea
Fiscella, K. (n.d.). Eliminating disparities in healthcare through quality improvement. In K. Fiscella (Ed.), Eliminating Healthcare Disparities in America (pp. 141-178). Springer. https://doi.org/10.1007/978-1-59745-485-8_8

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