Health care cost and quality
In a paper of 500-1,000 words, describe the relationship between health care cost and
quality.
1) Select one public health care agency and one private health care agency and differentiate
their roles and major activities in addressing cost and quality in health care.
2) Analyze current and projected initiatives to improve quality while simultaneously
controlling costs. Describe any unintended consequences.
3) Synthesize implications for staff nurses and advanced practice nurses, including
evidence-based practice, relative to cost and quality.
Describe the relationship between health care cost and quality–Fully describes the
relationship between health care cost and quality with no inconsistencies. Clear examples
given.
Differentiate the roles and major activities between one public and one private agency in
addressing cost and quality in healthcare.– Clearly and systematically differentiates the
roles and major activities between one public and one private agency in addressing cost
and quality in health care utilizing references, examples, and supporting details.
Analyze current and projected initiatives to improve quality while simultaneously
controlling costs. Describe any unintended consequences.– Comprehensively analyzes
current and projected initiatives to improve quality while simultaneously controlling costs.
Fully describes unintended consequences. Clear examples given.
Synthesize implications for staff nurses and advanced practice nurses, including evidence-
based practice, relative to cost and quality.- Comprehensively synthesizes implications for
staff nurses and advanced practice nurses, including evidence-based practice, relative to
cost and quality. Clear examples given with no inconsistencies.
Healthcare Costs
Select one public health care agency and one private health care agency and differentiate
their roles and major activities in addressing cost and quality in health care.
Medicaid for instance, is a healthcare program that presents a bussing assurance for a
wider-segment of the populace, and especially for those with severe as well as costly medical
expectations. The scheme meets the cost of more than 30% of all maternity care, funds health
care to the ration of 1:4 of American kids and supports more than 60% of the underprivileged
(Charting Nursing’s Future, 2008). The scheme also caters for nursing care in totality, lowers
Healthcare Costs 2
acute care for new underprivileged Medicare beneficiaries. However, the issue of managing
costs and enhancing quality of the scheme has been hard to crack for policymakers both at the
state level and nationwide. To check rising costs, the Medicaid scheme has been instrumental to
formulate what is known as managed care, where more than 30% of the scheme’s beneficiaries
are put under controlled care. Such deliveries have been able to manage not only costs but also
the quality of care. When it comes to the private sector for instance, various companies have
reacted to spiraling cost forces by persuading workers to subscribe to controlled care schemes
and also by streamlining their packages and contribution methods to meet these demands. In
addition, hospices and medics and other healthcare providers have adopted what is know as
merger and acquisition in bid to consolidate their financial capital and exploit on their core
competences for purposes of quality and cost. Another approach adopted by the private sector
has been about sharing costs, where individuals pay a fraction of their healthcare expenses from
their own cash, this leads to controlled healthcare expenses by sensitizing people on the rising
costs of healthcare, as a result people become rather sensitive (Keehan, et al. 2004).
Analyze current and projected initiatives to improve quality while simultaneously
controlling costs. Describe any unintended consequences in improving healthcare costs.
Strategic investment in technological tools has been mooted as the best way forward. The
right technology ensures that health care units are able to integrate and correlate their services by
implementing effective management and communication strategies. This helps to improve the
health care services and facilities database in their organizational culture, because future
reference and auditing services can easily be done helping the health care delivery system to
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improve its standards thus provide quality health care, while lowering costs. Escalating prices of
health care are regulated as a good ICT platform increases efficiency, omit bottlenecks and helps
to reduce the cost of health care while increasing the efficiency and effectiveness of the health
care delivery systems as per the demands of the patients (Keehan, et al. 2004).
The federal government in conjunction with the private should work towards providing
opportunities for continued education and health care training on appropriate strategies of health
care delivery systems, health care maintenance, health care management and communication to
the health care practitioners. Both the private and public agencies should promote the built up of
public trust to the health care units as the quality of health care is improved and the risks arising
from the injury of patients and health care practitioners are minimized, with effective risk
management strategies stipulated in the policies of health care high costs should be controlled,
without comprising healthcare quality (Charting Nursing’s Future, 2008).
Programs should be sponsored that not only improves health services and facilities but
also enhance the cohesion, cooperation and team work within the facilities by evaluating the
hospitals policies to develop them in accordance to the stipulated standards of treatment and
management procedures (Charting Nursing’s Future, 2008). The programs will help different
health facilities to network and in the process adopt the strategies that govern each health unit;
this places health care delivery system in a better place, as health care facilities create a good
public image from their good reputation which is advocated by other health care facilities,
patients or accreditation organizations.
Provide technical assistance to State policymakers and administrators seeking to improve
their Medicaid programs
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Policy makers should develop and execute modalities that would otherwise bring
healthcare costs down. This would be realized though science-based studies to assist Federal as
well as state approaches in controlling escalating healthcare costs. Policy maker should equally
be able to publish research outcomes and procedures that controlled care proposals and Medicaid
providers can employ to manage high costs and enhancing quality. The federal government
should formulate policies that warrant for increased funding on research and innovation, to help
wield technological wonders, towards improving healthcare services which in turn lowers the
costs thereof (Monheit, 2003).
Synthesize implications for staff nurses and advanced practice nurses, including evidence-
based practice, relative to cost and quality.
The nursing profession is very fulfilling especially in the area of pediatric oncology
nursing. This is because nurses assist children; who are fragile, to face the treatments bravely so
as their support really matters. Some cases might be devastating at first but they usually turnout
great and it is this hope for caring and treating the young that keeps nurse going. For this reason,
nurses need to be supported by other medical practitioners so that they can improve their skills
and work in many areas in oncology so as to continue providing proper care for the children. As
the one of the largest group of health care experts, nurses can now use APN practices to generate
enough power that enables them to reform the healthcare system. Through the advanced
practices that they have they have power to resist political power and manipulation in the health
sector by the political aspirants who aim to benefit themselves only (Charting Nursing’s Future,
2008).
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Advanced Practice Nurses must comprise of multidimensional specialist in the nursing
career. This means that APN contains a combination of skills and practices from a wide variety
of specialty with an aim of designing an effective health care delivery. This also means that APA
needs to have a competence demonstration in a number of roles that a nurse operates. In order for
these advanced practices to function effectively in a political activist role, APA should have a
clear scope of the whole policy process. Nurses play a play an essential role in the future of
health care. APNs are often primary care providers who are in the front line in the provision of
anticipatory care to the public (Monheit, 2003).
Some of the driving forces that are evident from the APN are that there is a solid
foundation of a focused education and experience. In this case, nurses are able to embrace a
whole range of alternatives that are contained in some parts of the policy (Charting Nursing’s
Future, 2008). They are also initiating some available opportunities in order to be able to have an
ongoing trend with those who organize public programs. The nurses under the umbrella of APN
are able to stand tall in the decision making process within the health sector. The practices are
also enabling Nurses to become leaders and help in planning and decision making process in the
healthcare practice. From a political point of view the role of nurses has taken a new route where
the are able have realized that there is need for them to get involved in the legal decision about
health that are often made in government arena. Through APN, the mentality within nurses that
the political activism meant involving others has changed and they now jingle in to bills that
reflect to a particular enthusiasm in the health care (Charting Nursing’s Future, 2008).
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References
Charting Nursing’s Future ( 2008) Strengthening public health nursing-Part 1.
Keehan SP, Lazenby HC, Zezza MA, et al. (2004). Age Estimates in the National Health
Accounts. Health Care Financing Review Dec. 2; 1(1); Web Exclusive.
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Monheit AC. (2003).Persistence in health expenditures in the short run: prevalence and
consequences. Med Care; 41(7) suppl:III-53-64