Riley, M.

http://medicalstudentblog.co.uk

One of the most important social and political topics of the current environment is healthcare. Skyrocketing costs as well as an aging baby boomer population have driven concerns, especially within the socioeconomic recession. In order to control costs, the federal and state governments have passed legislation, rules and regulations to aid in cost containment.

Two major public sectors of healthcare, Medicare and Medicaid, are run through state and federal processes. Through policy changes, many Medicare and Medicaid beneficiaries have been moved into managed care systems that allow for increased structure and cost reduction because of focused and coordinated care-plans (Williams & Torrens, 2008). The Health Care Financing Administration (HCFA) “felt that managed care should play a major part in the long-term solution of Medicare’s financial woes” (Williams & Torrens, 2008, p. 133). Overall, managed care has been less then effective in solving the nation’s health care cost problems (Altman & Levitt, 2002). Despite the remaining cost containment issues, managed care options that allow for provisions for institutional preadmission programs, “onsite nurse practitioners at skilled nursing facilities to manage illnesses and prevent avoidable hospitalizations” (UnitedHealth Group, 2009), stand to trim billions of dollars in excess health expenditures.

Active federal legislation under Medicare would give financial rewards to ambulatory surgical centers and hospitals that minimize healthcare associated infections (HAI) like MRSA (Kuper & Septimus, 2009). Within state legislation, pending action would require public reporting of medical errors and other serious events (Commonwealth of Massachusetts, 2008). This legislation would require for public disclosure of non patient-identifying information; this disclosure would allow for economic regulations through consumer decision processes as well as increased competition. By increasing compatibility and accountability, costs could be reduced by decreasing time spent in hospitals due to secondary infections and clinical errors.

Single processes may aid in reducing the overwhelming cost of healthcare; however, I do not think that any single change will be effective in facilitating significant cost containment. The necessary approach will be to utilize all available options, not only policy changes but also by employing and improving technology to reduce waste and to increase efficiency.

“Health-care cost containment has triggered the need for small, low-cost, quick-response diagnostic machines” (Castellini, 2007). By using increasingly efficient, cost-effective technology that allows for accurate diagnosis, costs will be reduced through minimizing additional unnecessary testing. Following the HITECH Act of 2009, Federal encouragement through financial incentives will persuade the use and storage of electronic medical records (EMRs); costs may be reduced and the continuity of care for beneficiaries may assist in completing the managed-health care plan of reduced duplicate and excessive testing costs. EMRs would assist in long term cost containment by minimizing errors and increasing productivity and administrative efficiency (IMPAC Medical Systems, 2009). The recent changes due to the HITECH Act of 2009 will help the government to contain healthcare costs by promoting the utilization of technology to increase efficiency.

References

Altman, D. & Levitt, L. (2002). The sad history of health care cost contamination as told in one chart. Retrieved online 14 October 2009 from: http://content.healthaffairs.org/cgi/content/full/hlthaff.w2.83v1/DC1

Castellini, C. (1997). Today’s health-care industry focuses on cost containment. Retrieved online 14 October 2009 from: http://www.devicelink.com/mddi/archive/97/01/016.html

Commonwealth of Massachusetts. (2008). Senate bill, no. 2526. Retrieved online 14 October 2009 from: http://www.mass.gov/legis/bills/senate/185/st02/st02526.htm

IMPAC Medical Systems. (2009). Economic stimulus: the HITECH Act of 2009. Retrieved online 14 October 2009 from: http://www.impac.com/hitech-act.html

Kuper, K. & Septimus, E. (2009). Healthcare associated infections: other federal legislation. American Journal of Health-System Pharmacy. Retrieved online 14 October 2009 from: http://www.medscape.com/viewarticle/590265_7

UnitedHealth Group. (2009). Federal health care cost containment – how in practice can it be done? Retrieved online 14 October 2009 from: http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper1.pdf

Williams, S. & Torrens, P. (2008). Introduction to health services (7th ed.). Clifton Park, NY: Delmar Cengage Learning.