HCA 615 Topic 5 Pros and Cons of different methods for improving delivery of Care

HCA 615 Topic 5 Pros and Cons of different methods for improving delivery of Care

HCA 615 Topic 5 Pros and Cons of different methods for improving delivery of Care

Pros and Cons of different methods for improving delivery of Care

Different approaches have been used to improve the delivery systems in health care organizations. Bundled payment programs are among the approaches of reimbursement of health services delivered based on the expected costs of clinical care. The approach works on a framework of shared risks and, therefore, patients receive quality care at relatively low costs. The method has attracted commercial payers who provide an avenue for fee-for-service reimbursement based on care delivered to patients (Kinney, 2015). However, bundled payment has a limitation of operational barriers related to the management of cash flows and developing a budget that consistently conforms to the episode-based payments. It is also challenging to keep a track of enrolment of the commercial payers to the bundled payment model.  

           Health care organizations can also use quality reporting programs as methods to improve care provided to patients. In this context, health providers receive incentives for quality measures delivered to clients. The method ensures that professionals provide higher-quality care to patients at lower costs (Hammer, Vice, & Manchikanti, 2016). Conversely, the effectiveness of quality reporting programs is challenged by misuse of cost measures information where professionals may avail false report about the health status of patients for them to receive value-based payments.  Besides, the method has a limitation of low confidentiality as the information about the patient may be shared to the third party payers without the consent of the client.

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           Health care organizations can use methods that incorporate Accountable Care Organizations (ACOs) programs to ensure that patients receive high-quality care (Kinney, 2015). However, inconsistencies of the third-party payers or delays in remittance by the federal government for patients in Medicaid programs can compromise the quality of care provided to patients using this method.

References

Hammer, K. M., is Vice, H., & Manchikanti, L. (2016). Physician Quality Reporting System (PQRS) for interventional pain management practices: Challenges and opportunities. Pain Physician, 19(E15), E15-E32.

Kinney, E. D. (2015). The affordable care act and medicare in comparative context. New York, NY: Cambridge University Press.

Hospitals are indeed becoming more efficient in the delivery of health care services. In the present dispensation of health care, the application of technological systems such as HER in the management of data and evidence-based practice in the delivery of treatment services has ensured that this becomes the case. However, the two systems also have their downsides. One of the most critical cons of health care entails costs. Paradoxically, the adoption of technology was intended to not only improve efficiency but reduce costs as well.

The continuous quality improvement and the Six Sigma processes form the most potent and effective quality. Indeed, the CQI creates a constant stream of organizational improvements. As a result, it gives organizations the capacity to identify areas that need enhancements and ensure that solutions are found. However, such continuous changes may be detrimental to certain aspects within a facility. As is with other organizations, certain changes m ay take ages before their benefits can be seen. Having said that the Continuous Quality Improvement and the Six Sigma can help organizations to produce quality services such as improved patient satisfaction if utilized appropriately.