Health care cost and quality are the main indicators that have been benchmarked to determine the best practices in the United States in the contemporary days. As much as the US is among the top countries in health spending, it has done less with regard to the quality of healthcare. According to Burke and Ryan (2014), the per capita health care spending of the United States is at least 50 percent more as compared to other developed countries with comparable economies in the world. This has raised questions about the relationship between the cost and quality. The paper seeks to describe the connection between the cost and quality of health care.
Public and Private Agencies
The Center of Medicare and Medicaid Service (CMS) is one of the public agencies that works to ensure that health centers achieve quality care as well cut costs. The function of the CMS is administration management of the Federal Health Programs such as the Children's Health Insurance Program (CHIP), Medicaid and Medicare. The CMS helps various kinds of people ranging from adults low-income, under 21 years and the disabled to acquire the health insurance. It has also participated in the Affordable Care Act to assist in lowering the costs for the provision of better care.
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Likewise, The Joint Commission (TJC) is one of the nonprofit private organizations that accredits and certifies several health care programs in the US. The TJC aim is to progressively improve the public health care with the help of other stakeholders by assessing the organizations of health care and inspire them to observe safe and effective care of unwavering quality and value. TJC majorly focuses on the provision of safe, high-quality care while keeping the patient in mind. The activities done by TJC are patient safety promotion, information dissemination, accreditation, and certification as well as the creation of public policy initiatives (TJC, 2015).
Initiatives to Improve Health Care Quality and Minimize Cost
The public and private organizations have current and anticipated activities that concentrate on enhancing quality of health care while attempting to limit the cost of health care. Since prevention is better than cure, CMS with its ACA 4108 is working with the states to provide incentives to the beneficiaries of Medicaid of any age who are partaking in prevention programs and also demonstrating health care changes and results (CMS, 2015). In 2008 for Medicare and 2012 for Medicaid, the CMS executed the pay-for-performance (P4P) to stop payment of preventable list and acquired conditions of health that were part and parcel of the health care quality measures. Later on, CMS is anticipated to begin the model of Comprehensive Care for Joint Replacement (CJR) for the beneficiaries of Medicare for the replacement of knee and hip
From 2013, TJC has been asking relevant healthcare stakeholders to initiate the fight against the prevention of Central Line-Associated Bloodstream Infections (CLABSIs) to limit the cost and improve health results. One of the TJC projected activities is to have an institutionalized execution measure for the replacement of knee and hip surgeries. The surgeries are costly whereas the demand for the service is high. The CMS and TJC have had unintended outcomes from some of their drives. In 2015, CMS completed minimal experimental proof to discredit or bolster the likelihood that the undesired impacts was as a result of the utilization of health care measures which incorporate nursing homes, mobile settings as well as hospitals.
Nurses Implications to Quality and Cost
Both the staffs as well as Advanced-Practice Nurses(APNs)have played key roles in the containment of cost as well as quality improvement in healthcare as the public and private organizations continue to quest. The significant role of nurses is to deliver quality and efficient care but hospitals attempting to minimize labor costs for nurses which accounts for the largest workforce in the hospital will affect their contribution in healthcare. This is not recommended because from the argument of the Institute of Medicine (2003) it is stated that the way nurses care about patients directly affects the health of the patient and sometimes is a matter of life or death. Over the coming years, better quality as well as cost containment process changes will be executed. Therefore, professionals of health from various disciplines should collaborate and work together to enhance quality and cost in the healthcare industry.
References
Burke, L. A., & Ryan, A.M. (2014). The complex relationship between cost and quality in US health care. AMA Journal of Ethics, 16 (2), 124-130. Retrieved from http://journalofethics.ama-assn.org/2014/02/pfor1-1402.html
Centers for Medicare & Medicaid Services. (2015, August 6). Medicaid Incentives for the Prevention of Chronic Diseases Model . Retrieved from https://innovation.cms.gov/initiatives/MIPCD/
Institute of Medicine. (2003, November 3). Keeping Patients Safe: Transforming the Work Environment of Nurses . Retrieved from https://iom.nationalacademies.org/Reports/2003/Keeping-Patients-Safe-Transforming-the-Work-Environment-of-Nurses.aspx
The Joint Commission. (2015b). Facts about Joint Commission standards. Retrieved from http://www.jointcommission.org/facts_about_joint_commission_accreditation_standards/
