Recent reforms that swept across all factors touching healthcare

Recent reforms that swept across all factors touching healthcare

The current and past U.S. Healthcare system is not short of challenges. Studies comparing the U.S. Healthcare system to that of other developed countries confirm that it is the least effective but most expensive in the world. Experts are not short of ideas on how to turnaround declining satisfaction, lagging quality, and rising costs of the health care. The $2 trillion question is how wills this happen. The U.S. healthcare system today is a collection of components such as medical device manufacturers, hospital systems, health plans, and insurance plans, and all these factors are not connected. The result is making the U.S. healthcare system the most expensive industry in the United States, accounting for more $3.6 trillion, which is approximately 17% of the Gross Domestic Product (Bohigian & Klingele, 2018). U.S. citizens and those who seek medical care in the country expect that such a nation should have the best care system in the world, given the high stake of GDP it receives. However, this doesn’t mean that no changes have happened in the United States concerning healthcare reforms. It is almost a century since President Theodore Roosevelt called for health reforms and much have happened. The most recent reforms that swept across all factors touching healthcare came from the Obama administration.

The Affordable Care Act (ACA) of 2010 also called ‘Obamacare’ from 2010 to 2016 added more than 20 million people into health insurance scheme for the first time in the U.S. history. Actuaries working with the Centers for Medicaid and Medicare Services predict that less than $2.6 billion will be spent on ACA in near future.

The Challenge

For decades healthcare providers and policymakers have lamented of U.S. health care system: hundreds of thousands of avoidable errors have been committed leading to lose of life, millions of people still not insured and the cost of health in the country has outpaced GDP growth rate (Bohigian & Klingele, 2018). One of the reasons for these challenges is insisting on fee for health care services which has become the main driver in U.S. health care. Experts say that it is easy to understand where these high costs come from and why they will not disappear anytime soon; the system insists on paying for the volume of services rendered without taking into account the outcomes. In such cases, the former will always win. Clinicians and doctors in the United States have a commitment to provide the best care to their patients but one thing lacks: incentives to do that.

In our system of fee-for-service each screening, procedure and visit is rewarded but the clinicians on duty go uncompensated. Clinicians corresponds with the patients, review lab tests and communicate with the doctors on what to do and how it will be done. Most clinicians are involves in about three uncompensated tasks per day. These tasks involve discussing what care should be administered to the patients with a specialist or working alongside nurses to address effects of medication given to patients.

Such barriers to the best care end up frustrating payers, providers and patients. For the U.S. healthcare system and be the best as we all want then such issues need to be addressed first.

Improving quality and access of health care in the United States while at the same time is achievable and imperative to the nation. As a result, reforms on U.S. healthcare system to make it the best in the world is a debate that will continue. President Barack Obama said that “the strongest democracies flourish from frequent and lively debates (M.D., 2019).” This article is a debate on the future of U.S. healthcare system with special mention on what needs to change to make it the best in the world.

Reforms in Delivery System

The system we seek providers are not disconnected components like they are today but a collaborative team that will make sure care experience is safe and coherent. In future U.S. health care the providers will have flexibility and experience to innovate and as a result be rewarded for coming up with solutions that lowers cost of health in the United States. Use of electronic records will be a step forward in preventative medicine. Instead of using reactive measures technology will take centrestage in revealing the patterns of a patient’s health and this will help in managing conditions before they become incurable (Bohigian & Klingele, 2018). Today using of wearable devices that monitor heart rates, temperatures and other vitals is already in use. In future health care we expect experts to come up with invisible devices to replace the wearable devices and make the patient even more comfortable. In this case, the consumers and patients will be actively engaged when making their health care decisions. Decisions will be centered on how to better the patient’s experience. The patients will be in a position to schedule their appointments easily, understand their health using their medical records and know how to use their benefits to improve care quality.

These delivery system reforms will be achieved using three strategies.

Firstly, the future system will change the way people pay for their health care. Patients will be based on value of care that a patient receives and not the quantity of health care services received as it is today. These actions will not only adopt a system that pays for quality care and brings down the cost of medication but will also calls for collaboration with states and private payers to test a healthcare payment model that changes the practitioner’s incentives (Bohigian & Klingele, 2018). Primary care givers, clinicians and other medics will not look at the quantity of services they have rendered and how that translates to money but at how their services improved quality of care.

Second strategy involves prioritizing prevention and wellness alongside promoting coordination in healthcare. The future system will achieve this by giving medical professionals freedom and flexibility to make innovations that will benefit their patients/clients. The healthcare system will not be all about treating the sick but intervening in lifestyle and making new partnerships (Batra, Davis, & Betts, 2019). By making lifestyle interventions and new partnerships the future healthcare will be taking an active responsibility in helping people healthy. Chronic diseases will be defeated by these measures. Most of these diseases are not curable can be avoided through preventative care. Future healthcare will be dealing with means on how to avoid diabetes, heart attacks and cancer rather than waiting for people to be sick and start treating them.

The third strategy that will be used to achieve better care in America will be through unlocking information and data so that people can use those details to make informed decision about their care. The data will also empower medics to make more and better informed decisions about their patient’s care. Improving portability and access to health care records will have prevented errors and reduced redundancies currently experienced in health care industry.

The three pillars of system delivery changes will rely on the Center for Medicaid and Medicare Services (CMMI). The CMMI has been the agent of healthcare changes in the past and in future it will be used to scale, test and develop innovative reforms to service delivery and payment models. Inputs from clinical officers and stakeholders will reduce costs and strengthen quality in the Children Health Insurance Program (CHIP), Medicaid and Medicare (Batra, Davis, & Betts, 2019). This tool alongside support from the private sector the U.S. health care system will have changed from what it is today to a strategic plans centers its operations on best care for patients.

Future U.S. Health Care will Change the Way We Pay

The first time in history measures were put into place to change the Medicaid program from a quantitative services to a value-based approach was in January 2015. A set of metrics and a clear timeline were put into place. Before then there have been innovations in the U.S. healthcare system but this was the first time the administration came up with the idea of making changes in the Medicaid program. The goals of the changes were to institute a value-based system of payment. This is an indication that more than 5 years ago professionals in healthcare industry and the administration at the time were aware of the inefficiencies of the current system of care payment.