Trends Impacting Business Operations and Administration

7 Oct No Comments

Please analyze and evaluate the two most prominent trends impacting the business operations and/or administration. 

From my personal experience I have noticed that there are many leading trends that are impacting healthcare; however, I would like to focus on both (1) providing high quality care in the most (2) cost-effective manner.  I recall prior to the Affordable Care Act, the clinic systems that I worked for voluntary participated in various government incentivizing programs to not only improve quality of care for their patients but also because the leaders knew what was coming in the future in terms of how health care is delivered as it is today.  According to Kahn & Reineck (2013) the primary goal of the ACA is to expand health insurance coverage. Yet the law also contains several provisions designed to incentivize higher-quality care.  Prior to the ACA, PQRS, was a voluntary “pay-for-reporting” system in which physicians reporting on specific quality measures and received a small bonus payment, regardless of their performance on those measures. The ACA changed that bonus payment to a penalty for physicians that do not report to PQRS.  With that in mind, I clearly recall providers who refused to participate in any reporting program because they “did not want anyone, specifically the government, to dictate to them how to practice medicine.”  Many providers quit and parted ways and found new “work homes” however, the very places they joined are now forced to participate and additionally have volunteered to participate in National Clinical Quality Association’s (NCQA) Patient Centered Medical Home accreditation AND CMS’s Meaningful Use EHR program to help them capture and report on the reportable measures. Providing high quality care in the most cost effective manner is due to the help of all the initiatives that piggyback on one another to make it possible.  For example, EHR systems, interface, and file sharing amongst providers and facilities helps to decrease repetitive and unnecessary testing when the treating provider has the capability to access the records of his/her patient; thus, lowering health care costs.   

Are these trends uniquely different for ancillary services vs. inpatient services? 

       I do not think that the trends of improved quality of care and the benefits of in order to deliver care in a cost effective manner is not much different whether it is a form of an outpatient service or inpatient.  This, I believe, is due to the both entities following the same guidelines that CMS and payers are requiring almost all providers of care to follow suit.  Communication between in and outpatient facilities and the expectation to work collaboratively to ensure the patient is at the center of care. According to The AHA (2016) greater dialogue between providers and health plans also can help promote timely sharing of meaningful data, while simultaneously reducing paperwork burden and promoting greater efficiency. While significant savings have been already achieved, it is estimated that an additional $8 billion annually could be saved if health care organizations fully implement these standards. The benefits of administrative simplification fall primarily into three major categories: Quality, Timeliness, & Cost reduction, which I totally agree with in terms of the 2 salient trends I choose; however, timeliness is one of the three that occurs when there is improved efficiency. 

Where do you see the trends going in the future and why? 

       I see the trends becoming more salient, hence, becoming second nature to those providing care to the patients.  I think many folks naturally are not receptive to change but in time will gradually adjust making the future of care much easier to deliver for all involved,  In about 10 years we will likely all look back and see the progress that healthcare has transformed to.  Quality of care is not going away anytime soon not even with the new President elect scheduled to take office in several weeks.  I do not think that Trump will remove this provision from the ACA.




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