NR 451 DeVry Week 7 Discussion

Healthcare Economics (graded)

Health care costs are on the rise. What is an example of wasted health care dollars in your clinical practice and how do you propose improving the utilization of these dollars?

ADDITIONAL INFO

Wasted health care dollars in clinical practice and solutions

Introduction

Health care spending in the United States is a crisis. This has been true for years, but it’s taken on a new urgency with the Patient Protection and Affordable Care Act (ACA), which was enacted to limit hospital readmissions, improve health outcomes and reduce costs. The ACA also established new payment models that encourage improved quality of care through incentive payments and value-based reimbursement.

Excess health care spending is a challenge in the United States.

Health care spending is a challenge to the economy and individuals, businesses, and families.

The United States spends more than $2 trillion each year on health care—and that number is growing rapidly. According to the Centers for Disease Control and Prevention (CDC), Americans spent $3.3 trillion on their health care in 2015—a rate of growth that has outpaced inflation and population growth since 2010. In fact, our nation’s total health spending reached nearly $3 trillion for the first time ever last year!

Heightened focus on cost-effectiveness will be a sea change for physicians, patients, and health systems.

The health care sector has been under a microscope for years, with an increased focus on cost-effectiveness. As the price tag of health care continues to rise, it’s clear that patients and providers need new ways to mitigate waste in clinical practice.

The new paradigm offers opportunities for innovation; however, there’s no doubt that we will need to work together to make progress toward improving patient outcomes without compromising quality or safety—and those are the two biggest challenges facing this field today.

The new paradigm offers opportunities for innovation.

The new paradigm offers opportunities for innovation. Increased focus on cost-effectiveness and the integration of cost savings into clinical practice can help improve patient outcomes while reducing costs, creating a virtuous cycle that leads to better quality care at lower costs.

Health care spending can be reduced by addressing overuse in clinical practice.

Overuse is a major contributor to health care costs. It can be defined as the use of a medical service that is not recommended by clinical guidelines or best practice. Overuse can be addressed by:

• educating providers about appropriate use of services, including performing more tests than necessary

• implementing policies that limit unnecessary tests and procedures (e.g., eliminating unnecessary imaging)

Conclusion

There is a growing consensus that the health care system in the United States is not sustainable, and that it needs to be reformed. One of the most important steps toward realizing this goal is changing how we practice medicine. The new paradigm offers an opportunity for innovation; we now have an opportunity to address overuse in clinical practice by focusing on cost-effectiveness and patient outcomes rather than simply volume metrics like surveys or admissions.