Health Care Challenges

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There are many challenges that affect the direction of health care today. Proposed health care reform and legislation, accreditation, quality of healthcare, and organizational compliance, economics, including third party payers, future funding, rising costs, the Medicare and Medicaid programs, access to health care including the uninsured and those in poverty and the elderly, and maintaining a skilled workforce have created many obstacles for providers (Ashford, 2016). Healthcare reform and legislation are continuously creating new challenges the US Healthcare System and beneficiaries. Every American is entitled to access of quality and affordable coverage of their choosing. America’s healthcare system should be the example for all other countries …show more content…
It has included additional preventative care benefits through the Medicare system (Tierney, 2014). These include the responsibility of the government regarding Healthcare reform, provider responsibilities of patient confidentiality, access to quality and safe care for all regardless of plan, accountability of clinics, healthcare providers, insurance companies and drug companies. Affordability of healthcare plans. Accountability of those who set the standards. Specific regulations, legislation criminal and civil actions, HIPPA, Human Resources, Patient Advocates, staffing issues, and lack of patient confidence must be addressed by healthcare organizations if they are to succeed. Unqualified and poor staffing is the underlying issue in all of these areas. The advantages of having an HMO is being required to have a PCP who has the responsibility of coordinating all health care needs. Some enrollees may prefer this type of coordination as it alleviates the burden of finding specialists in the health insurance network. Generally, an HMO does not require pre authorization through an insurance company prior to care. Often times, waiting for the insurance companies to authorize a treatment or service can delay important tests or procedures. In the event that a pre authorization is required, the PCP will take care of that for the patient. Due to this level of coordination from a PCP, the cost sharing, premiums, and …show more content…
Inadequate numbers of nurses, fatigued nurses, and negative emotional feelings anger lack of empathy are a common trend found during inspections. An organization can correct these shortfalls by conducting a population based surveys. Electronic exchanges and records also contribute to patient trust and confidence. Organizations must determine ease of use versus safety and confidentiality of patient information. Patient consent must be a priority and carefully documented and kept on file. Healthcare organizations have protections and guidance available to them. They include regulations, civil, criminal law, HIPPA, AMA, Associates for Electronic Health Care Transactions, all had a part in the eventual formation of The Health Insurance Portability and Accountability Act of 1996. The Patient Privacy Act, H.R. 1699.Social Security Act; repeals of health identifiers and penalties for wrongful disclosure. Patient Safety and Quality Improvement Act of 2005 (PSQIA) the HIPAA Breach Notification Rule, 45 CFR §§ 164.400-414c. Ethical and legal federal regulations that are required of health care organizations to ensure the delivery of high quality health care that protects patient safety must be adhered too. Patient-centered care and effective care success depends upon the physician, nursing, and overall organizational role in the delivery of quality health care. The organization must maintain current and extensive

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