Health Insurance and Quality

Healthcare Insurance and Quality

HSA 405 Assignment 2

Healthcare Insurance and Quality

Healthcare centers today have improved due to the quality provision and availability of health insurance. This enables most medical sectors to evolve very fast due to industrialization. Health insurance is an institution and financial body with the objective to provide a platform for individuals and households at all levels accessibility and equity to healthcare services and increase the rate of utility to cover out patients and provide cost sharing solution (Rouse & Cortese, 2010). Health insurance helps to reduce the risks that may occur during any procedure, serious illness and injuries which may lead to death and continuous illness all this are a result of uncertainty in the future state of health. Use of Medicare or Medicaid is a potential pay source that can easily be adopted in the healthcare since it helps to improved care and health at reduced costs and enhance observation and measurements of changes on behavior through practice transformation. Examples include (RFI- request for information) and CHIP Reauthorization act of 2015 (MACRA) which facilitates the development of APMs by giving incentives to participant and promote additional physician focused payment models. This method finds information on large scale clinician transformation practices to achieve better care and health at affordable rates resulting in an improved system.

Casto & Forrestal,(2015). Proper and appropriate medical services improves clinical outcomes, patient retention and satisfaction and any claims on malpractice that normally occurs in healthcare centers hence quality, effectiveness and efficiency on provision of services. Proper management of systems, monitoring, planning and organizing as well as networking are the implementation made to improve and enhance quality on healthcare sectors. To achieve all this national effort is required to contribute towards the strategies and improvement of the condition of what is there already.

Safety measures employed should lead towards meeting satisfaction of patients, be of quality and lead to better patient experiences and better quality improvement plan to meet objectives. Quality initiatives help individual view things in different manners and develop modern ways or options and provide solutions to problems hence improving things work. All activities in healthcare insurance and quality make other factors arise such as access and cost which include a number of items like increase in demand, the need of medical delivery systems that are integrated, increase in prices and modernization of technology (Burge, 2014). Various parties involved in quality imitative includes service providers, consumers, employees and employers which makes the health care ranked at different levels country wide. Being a planned sequence quality initiative entails various that are aimed at achieving an improved process and has steps of plan which are plan, do check/ study and act which forms a cycle all together.

In the United States the healthcare systems have been ranked highly due to their responsive nature and high costs since it is expensive. Despite the fact the fact stated above the quality of care delivery is poor when it is compared to less developed countries that is the only area it fails. Individuals yearly More often medical errors results from fault of individuals for example the medical practitioners and faults from the industry where lessons are learnt for corrective measures to be taken. Existing kinds of care can be improved by taking new methods, creating of modernized generalized knowledge and confidentiality kept at all times (Rouse & Cortese, 2010). Since American system has been seen to fail in a number of ways every individual should strive towards improving healthcare and take responsibility, find out the causes before taking action and enhance creativity in providing better solutions. There so many factors that affect healthcare quality in most organizations which include rise in costs, demographic change, quality provision and satisfaction, management and leadership, availability of proper resources and facilities, type of illness, healthcare systems, accessibility, shortages of medical practitioners and clinicians as well as prioritizing the customer always or rather becoming customer- driven. Solutions towards controlling such factors should be employed hence achieving service provision, patient satisfaction, and reduction on costs, patient retention and experiences leading to better healthcares worldwide.

Models that suits and driven towards the consumer should be focused more than that of supply. Use of social media interactions of patients and medical practitioners shows the society is up to date and informed than before cause of existence of internet, any medical condition and treatment procedures and solutions can easily be found making it easy get quality service and reduce costs. Patients are able to make choices on their own, government policies regulated on such enable a platform to meet the needs of the citizens according to their demand, informed choice, data and services (Burge, 2014). Creating hospital networks, personalizing medicine and research translation on the advent of personalized medicine all this are the current issues on health insurance and quality that should be checked upon to fill the missing gaps and improve the healthcare systems existing today. In conclusion, due to various trends emerging, the government and individuals all around the healthcare system and all healthcare institutions should research more and evaluate changes in the health sector and by use of health analysis, health insurance exchange, content management, proper expertise, innovation, electronic methods and technology to find the most effective information system to adopt to suit their service provision and delivery systems so as to control the challenges that come along.


Burge, R. C. (2014). Engineering solutions to Americas healthcare challenges. Boca Raton: CRC, Taylor & Francis Group.

Casto, A. B., & Forrestal, E. (2015). Principles of healthcare reimbursement. Chicago, IL: AHIMA Press.

Rouse, W. B., & Cortese, D. A. (2010). Engineering the system of healthcare delivery. Amsterdam: IOS Press.

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