Health Care

Write a 1,500-word paper on the following:

Describe the current health care environment in the United States from both the health care administrator and the patient perspective.
What are some recent changes in legislation and how do these changes influence the way that an administrator would operate within the health care system?
How can administrators account for the value and dignity of individuals and groups when creating legislation?
What current trends are emerging in health care? Using the current trends, speculate on the future of health care risk management from the perspective of both the health care administrator and the patient.
Support your position by referencing four or five academic resources. Incorporate the research into your writing in an appropriate, scholarly manner.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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ANSWER

Healthcare Environment in the United States

Introduction

The U.S. healthcare environment has evolved from the charitable era, medical education era, insurance era, and managed care to consumerism. Various factors have influenced the implementation and enforcement of change in the healthcare industry. The healthcare reforms and technology changes have been the key players in the changing healthcare environment. This paper will focus on the current healthcare environment in the United States and the recent trends and legislations, and how they influence the role of healthcare administrators.

Current Healthcare Environment in the United States

The healthcare system in the United States is fragmented and uncoordinated and focuses on intervention rather than comprehensive health management and prevention. Over the past two decades, health outcomes have improved in the United States. Healthcare has been enhanced in capacity, affordability, access, and quality. In terms of affordability and access, health coverage has increased due to the new legislation. In terms of quality and capacity, the United States has improved in healthcare technology, with a high number of hospitals having electronic medical records. Concerning patient safety, the mortality rate has decreased due to high quality of care, insurance coverage, and reduced medication errors due to technology.

Healthcare costs have continued to increase at a higher rate, with the quality being far from ideal. The healthcare system has implemented healthcare policies such as the Patient Protection and Affordable Care Act and the Children’s Health Insurance program, which have extended the accessibility of care. The healthcare coverage has increased, with millions of previously uninsured and non-Medicare eligible children and adults receiving care (Harrill and Melon, 2021). The most significant gains in health coverage have happened to the most vulnerable individuals and young adults. Considerably, ensuring that people in the United States have received affordable care has been essential in moving to a productive and healthier society. In the United States, healthcare has undergone many technological changes but remains expensive. The amount the government spends per person healthcare is higher compared to other countries. The Gross Domestic Product on healthcare has been substantially higher than any other nation. Considerably, when people spend more on healthcare, the national debt increases and the funds being offered for other programs tend to lower.

Healthcare reform has been at the center and front in the political and public forums in the United States. These have been primarily driven by concerns about the cost, access, quality, and economic burden that has been placed on patients, payers, and employers. The 2010 enactment has led to significant health reforms to the United States healthcare system. The legislation has improved the healthcare environment through various provisions focused on comprehensive health coverage and affordable care access (Manchikanti, Benyamin, and Hirsch, 2017). The additional features by the legislation have mandated that everyone is covered by a qualified healthcare plan or be charged for not being covered. Through the expansion of Medicaid, they have facilitated access to care among thousands of previously uninsured adults at risk of stroke, heart disease, and other chronic diseases.

Recent Changes in Legislation

Some of the recent changes in the legislation include HITECH Act and The Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act, also known as Obamacare, was signed into law in 2010. The Act is a sweeping piece of legislation that seeks to reform the United States healthcare system. The goal of the Patient Protection and Affordable Care Act is to provide affordable health insurance coverage for all Americans. Currently, the country’s primary goal in healthcare is to reduce cost while maintaining or improving quality. The Patient Protection and Affordable Care Act aims to reform the current healthcare system by providing affordable insurance coverage for all Americans who do not get health benefits through their employer and allows young adults under 26 years old to remain on their parent’s insurance plan (Courtemanche et al., 2019). The Act also includes financing these reforms: there will be tax penalties for uninsured individuals and families who can afford insurance but choose not to participate. To help pay for the increased costs of expanded insurance coverage and subsidies, there will be revenue increases such as Medicare payroll taxes and spending reductions from Medicare providers.

The HITECH Act stands for the Health Information Technology for Economic and Clinical Health.  The primary goal of the HITECH Act is to encourage widespread adoption and meaningful use of health information technology through Medicare incentives. The Act intends to achieve widespread health information exchange through interoperable certified EHR technology and encourage the advancement of a uniform national framework that promotes a learning health system (Lin, Lin, and Chen, 2019). The HITECH Act includes incentives for using electronic medical records, promoting interoperability among health care providers, and advancing federal efforts in sharing clinical data.

The Affordable Care Act enacted in 2010 focused on making health insurance more accessible with more subsidies that reduce the cost of care. The health care reform has also expanded the Medicaid program to cover all individuals and support innovative medical care delivery approaches designed to reduce healthcare costs (Courtemanche et al., 2019). Improved healthcare access among the most vulnerable people and low-income households has increased the number of patients in healthcare settings. Therefore, there are more patients in the U.S. healthcare system than a few years ago. This has led to the demand for more nurses, doctors, and medical support staff, thus putting more pressure on the healthcare administrators. Healthcare administrators have been forced to stretch their resources and find ways of providing high-quality care to all patients despite their financial constraints.

The health care administrators have been forced to understand Health I.T. and boost their experience working with technical staff. Healthcare administrators have to partner with other professions while moving into the digital world in healthcare provision. The ACA and HITECH Act, among other healthcare legislation, have boosted the role and use of technology in healthcare settings. Therefore, to facilitate the compliance of healthcare settings with the new regulations, the healthcare administrators have been responsible for managing digital systems such as electronic health records. These laws have impacted the Health administrators, and it continues to impact them through changes in their role.

The Patient Protection and Affordable Care Act has impacted health administrators because of the individual mandate, which requires that all American citizens have health insurance coverage. This has led to an increase in the number of eligible people for Medicaid, which is a government-sponsored health insurance program. The HITECH Act has impacted the health administrator because the Act covers the incentives that promote health information technology. This includes electronic medical records, sharing clinical data, and interoperability among providers. It is a major task for health administrators to keep up with these changes to stay compliant with all requirements and continue to benefit their facility or organization.

Administrators create legislation and make decisions that have consequences to the well-being and value of individuals. Therefore, they need to focus on ethics to be accountable for the value and dignity of individuals. Adhering to the code of ethics offers the administrator guidelines for integrity in their operations, thus fostering dignity and value of individuals and groups. The administrators consider the culture and history of people affected by the legislation and the economic and social conditions. Focusing on public opinion also allows the administrators to respect the dignity and value of individuals and groups affected by the legislation.

Current Trends in Healthcare

Health consumerism is rising, with most patients focusing on responsibility and personal choice in paying and managing their health. The patient financial responsibility has grown, with patients becoming primary payers in their healthcare and major influencers of their wellness. The healthcare provider groups have focused on implementing technologies that make it easier for consumers or patients to access their healthcare choice and interact with the systems. These have included call center technologies, patient navigation tools, online appointment scheduling, digital payment plans, and other technologies that have supported the healthcare settings in boosting the path towards the consumerism care era.

Healthcare technologies have been on the rise with the consumerism movement. Artificial intelligence and automation have been a big part of the rise in technology adoption. These have enabled a lot of transactions to be done using fewer resources and staff (Jones et al., 2018). The healthcare industry has been on the rise with technology adoption. There are now more automated solutions that have come into play in the market to help reduce costs. One of these is robotic process automation. This is a software program that uses artificial intelligence, machine learning, and analytics capabilities to service all workflow requests within an organization. Healthcare companies are now improving their business processes. Biometrics will now be used for authentication purposes for patient identity management and payment services. Wearable devices are being made to collect patient data, which will then be analyzed by big data systems, where it will be shared across different organizations within the same ecosystem. IoT technologies are also being implemented to allow health care providers to access vital patient information through smartphones or tablet computers (Qadri et al., 2020).

Healthcare risk management comprises the processes and systems that mitigate, uncover, and prevent risks in healthcare settings. Healthcare organizations employ risk management systematically and proactively, safeguarding patient safety. With the current trends and changes in health care settings, healthcare risk management has become more complex due to issues such as cybersecurity concerns, ever-changing regulatory and fast pace medical science. Healthcare risk management is expanding due to the broader lens of the healthcare ecosystem. For instance, the risk domains of Enterprise Risk Management have expanded the responsibility of risk management across healthcare facilities. The future of healthcare risk management will require a more holistic approach due to the shifting healthcare landscape.

Conclusion

The United States healthcare environment is growing in terms of technology and ever-changing legislation. The healthcare industry has paid attention to improving the quality of care and healthcare processes. Legislations such as the Affordable Care Act and HITECH act have impacted life expectancy, quality of care as well as healthcare costs. The healthcare system in the United States has been driven by interests, institutions, and ideas that drive policymaking and decisions.

References

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2019). Effects of the Affordable Care Act on health behaviors after three years. Eastern Economic Journal, 45(1), 7-33.

Harrill, W. C., & Melon, D. E. (2021). A field guide to U.S. healthcare reform: The evolution to value‐based healthcare. Laryngoscope Investigative Otolaryngology.

Jones, L. D., Golan, D., Hanna, S. A., & Ramachandran, M. (2018). Artificial intelligence, machine learning and the evolution of healthcare: A bright future or cause for concern?. Bone & joint research, 7(3), 223-225.

Lin, Y. K., Lin, M., & Chen, H. (2019). Do electronic health records affect the quality of care? Evidence from the HITECH Act. Information Systems Research, 30(1), 306-318.

Manchikanti, L., Benyamin, R. M., & Hirsch, J. A. (2017). Evolution of U.S. Health Care Reform. Pain Physician, 20(3), 107-110.

Qadri, Y. A., Nauman, A., Zikria, Y. B., Vasilakos, A. V., & Kim, S. W. (2020). The future of healthcare internet of things: a survey of emerging technologies. IEEE Communications Surveys & Tutorials, 22(2), 1121-1167.