Week 5 Discussion Questions: Challenges of Health Care Reform and The Patient Protection and Affordable Care Act (PPACA)
Follow the links below to access other assignment solutions for this course
Week 1 Assignment: Elements of a Risk Management Program
Week 2 Assignment: Risk Management Assessment
Week 4 Assignment: Organizational Risk Management Interview
Instructions:
Response to each question is approximately 250-500 words with 1 or 2 references
Reference Week 5 Lecture & References (begins on next page)
Week 5 Discussion Question 1:
Health care organizations are facing many challenges from various regulatory and government agencies. For insight, to the challenges of health care reform, view the video “College of Nursing and Health Care Professions: Do we know what our future is?”
(Video on youtube link below or see the presentation charts included in the zip file too.)
Based on this video, explain two key factors that you feel will need to be addressed by future health care workers and health care leaders.
Week 5 Discussion Question 2:
The Patient Protection and Affordable Care Act (PPACA) of 2010 focused on provider compliance with fraud, waste, and abuse laws. Identify three measures that your health care agency (or a related health care agency) has initiated, or could initiate, to comply with these measures. Support your analysis with two peer-reviewed articles.
Solution
Key Factors that Future Health Care Providers and Leaders should address
As the government focuses on reforming the healthcare sector, there are key factors that the health care workers and leaders need to address. One of the key factors is a change from volume to value by enhancing efficiency and improving quality. The health care providers and leaders must ensure that they focus on creating and implementing measures that prompt outcomes that make a difference. The major purpose should be the creation of more efficient systems, improve the effectiveness of programs, and promote performance in health care provision. The adoption and implementation of such strategies would minimize the cost of health care and illness care. Additionally, healthcare leaders should focus on implementing the principles of the reform that target on eliminating disease, boosting the value of care, enhancing proficiency, and promoting the health and wellbeing of the society. In doing so, the application of effective leadership and management of clinicity would be critical. Additionally, health care providers and leaders change perspectives in care and integrate language changes, work with individual wishes, and focus on health instead of illness (Anderson, 2013).
Another key factor is the implementation of value-based purchasing to enhance value in the delivery of care, and integrate the clinical process of care measures with patient experience of care dimensions measures. The process will improve efficiency, prompt quality improvement, and promote patient satisfaction. The leaders will need to foster change in all processes and encourage increased performance, quality, and safety. Moreover, the health care providers must prioritize patient experience of care outcomes and work on improving quality. Such issues as health care provider communication, staff responsiveness, medicine communication, pain management, and discharge communication must be efficient to guarantee patient satisfaction. Also, the health care providers and leaders must improve hospital cleanliness and quietness to boost the overall rating of the hospital. In doing so, there will be a need for the health care providers to involve the users of health care and their families in decision-making, make them understand their role in care, and engage them in promoting their health (Anderson, 2013).
Measures Set to Comply with the Patient Protection and Affordable Care Act (PPACA) of 2010
Since the PPACA was signed into law in 2010, healthcare organizations have developed measures to comply with the provisions of the law. These organizations focus on improving the quality and affordability of the health insurance and expanding private and public insurance coverage to lower the percentage of uninsured persons. Moreover, the strategies work towards the reduction of healthcare costs and the enhancement of value in the system. To comply with the provisions, however, the healthcare organization should transform technologies, create effective systems that implement the Act, dedicate resources into fighting fraud and healthcare abuse, and create a platform for reporting cases of abuse or fraud. To start with, the integration of new and efficient technologies and systems in health care would improve quality, lower costs, and make monitoring and evaluation of healthcare processes proficient (Rosenbaum, 2011). This would alleviate cases of healthcare fraud and abuse significantly.
Additionally, in the promotion of quality health care, the improvement of efficiency, and accountability is important. The PPACA promotes quality improvement, efficiency, and accountability (Rosenbaum, 2011). As such, to comply with the law, the organization must align its processes, systems, and programs with the laws and the objectives it seeks to achieve. According to Santo (2011), enhanced communication, dedicating resources towards fighting healthcare fraud and abuse, and creating platforms for reporting cases of fraud will enhance the compliance of the organization with the law. Communication will ensure the free flow of information between the health care providers, health care leaders, and the government agencies. Moreover, dedicating resources in the establishment of effective communication channels and platforms for reporting the cases would limit the negative issues the Act seeks to alleviate (Santo, 2011).
References
Anderson, R. (2013, November 13). Introduction – Part I. Retrieved February 7, 2016, from https://www.youtube.com/watch?v=ZVz_HeWRu6s&list=PLIP5_iaUyziVDu2mxReCDCwtU5geh5m8w#action=share
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Reports 126 (1), 130 –135.
Santo, B. G. (2011). Addressing the Issues: The Effectivness of the Patient Protection and Affordable Care Act in Adopting Recommendations to Combat Medicare Fraud and Abuse. ABA Health eSource 7 (5), 1-9.