Discussion: Technology and Cost Containment

Discussion: Technology and Cost Containment

Discussion: Technology and Cost Containment

Economic factors have long been a key driver of health care policy and reform efforts. As noted in previous weeks, for instance, health policies have attempted to improve the situation for millions of uninsured or underinsured individuals and to address the barriers to health care access that have arisen as a result of the high costs associated with insurance and health service delivery.

This week, you will examine how economics influences health policy and health care reform efforts. You will explore cost containment strategies from increasing administrative efficiency to health care rationing and the role of technology in health care reform and cost control efforts.

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Learning Objectives

Students will:

• Evaluate the use of technology to achieve health care reform and cost containment goals
• Analyze the economic consequences of a health care policy

Learning Resources

Required Readings

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.

• Chapter 8, “Painful Versus Painless Cost Control”Chapter 8 focuses on the relationship between health care costs and health outcomes and its importance on the health policy agenda. This chapter also presents strategies for effectively utilizing resources as opposed to rationing health care services.
• Chapter 9, “Mechanisms for Controlling Costs”Chapter 9 examines an array of policies aimed at controlling health care costs and reviews specific financial and reimbursement cost containment methods to health outcomes.

Buntin, M. Jain, S., & Blumenthal, D. (2010). Health information technology: Laying the infrastructure for national health reform. Health Affairs, 29(6), 1214-1219. doi: 10.1377/hlthaff.2010.0503

In this article, the authors examine the role of health information technology as a major component in the restructuring of health care. They suggest it will improve quality, reduce costs, and allow for seamless access to data across providers.

Margolius, D., & Bodenheimer, T. (2010). Transforming primary care: From past practice to the practice of the future. Health Affairs, 29(5).

The authors propose a primary care practice of the future in which physicians act as leaders of a team of health care professionals. Reimbursement would shift from a pay-per-service model to a comprehensive model that incorporates both a standardized payment per patient and performance pay based on improved patient health outcomes.

Maxson, E., Jain, S., McKethan, A., Brammer, C., Buntin, M., Cronin, K., … Blumenthal, D. (2010). Beacon communities aim to use health information technology to transform the delivery of care. Health Affairs, 29(9), 1671-1677.doi: 10.1377/hlthaff.2010.0577

Monheit, A., Cantor, J., DeLia, D., & Belloff, D. (2011). How have state policies to expand dependent coverage affected the health insurance status of young adults? Health Services Research, 46(1), 251- 267.

Young adults (19-29 years of age) are one of the highest uninsured segments of U.S. population. Some states have mandated extended dependent coverage; however, the study presented in this article depicts little effect on uninsured rates. The authors suggest that the PPACA 2010 provision mandating expanded dependent coverage will have better success because more health plans will be involved in the mandate.

Rosenthal, M., Beckman, H., Forrest, D., Huang, E., Landon, B., & Lewis, S. (2010). Will the patient-centered medical home improve efficiency and reduce costs for care? A measurement and research agenda. Medical Care Research & Review, 67(4), 476-484.

This article discusses the use of Patient-Centered Medical Homes (PCMHs) as a cost containment strategy. The authors maintain that credible research needs to be conducted to evaluate the actual results.

Steuerle, C. E., & Bovbjerg, R. R. (2008). Health and budget reform as handmaidens. Health Affairs, 27(3), 633-644.

Wilensky, G. (2010). Health economics. Information Knowledge Systems Management, 8, 179 -193

Required Media

Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: Cost containment. Baltimore: Author.

Note: The approximate length of this media piece is 13 minutes.

In this media presentation, Dr. Gerald Kominski and Dr. Walter Zelman discuss the challenges policy makers face in containing health care expenditures and costs.

Discussion: Technology and Cost Containment

In response to continually rising health care costs, the Health Information Technology for Economic and Clinical Health (HITECH) provision was created to promote the meaningful use of health care information technology through numerous incentive programs for health care providers. By enhancing data collection, streamlining electronic medical records, and increasing transparency, it is believed that significant cost savings can be realized as well as other positive outcomes. What are some of the tradeoffs involved in this type of policy?

To prepare:

• Reflect on the challenges of containing health care costs in the U.S. presented in the Learning Resources and discussed by Dr. Kominski and Dr. Zelman in the media.
• Consider how information technology may be used to address health care issues related to cost.
• Examine the Health Information Technology for Economic and Clinical Health (HITECH) provision and its goals.

By Day 3

Post a cohesive response that addresses the following:

• Briefly summarize a significant challenge to containing health care costs.
• How do policy makers envision technology could be utilized to address this challenge (above)? Provide at least one example to support your response.
• Do you agree or disagree with the policy makers? Describe why you agree or disagree and include one or more insights from this analysis that relate to the question of how information technology could, or could not, help contain costs while supporting health care reform initiatives.

Read a selection of your colleagues’ postings.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

• Ask a probing question, substantiated with additional background information, evidence or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 5 Discussion

Assignment 1: Issues in Health Care Reform (Interview)

Continue to work on this Assignment, assigned in Week 2 and due in Week 9.

By Day 7 of Week 9

Submit this Assignment.

Assignment 2: Health Policy Proposal Analysis (Policy Brief)

Continue to work on this Assignment, assigned in Week 3 and due in Week 7. Consider the potential economic benefits of the recommendation you have selected and how the recommendation may contribute to controlling health care costs. Include this information in your policy brief.

By Day 7 of Week 7

Submit this Assignment.

Assignment 3: Policy Analysis Paper [Major Assessment]

Continue to work on this Assignment, assigned in Week 4 and due in Week 11. Analyze the financial and economic context of your selected health care policy. Include an analysis of the costs of the various policy solutions and the primary funding sources. This information should be included in Part 2 of your analysis paper.

By Day 7 of Week 11

Submit this Assignment.

Week in Review

This week, you evaluated the use of technology to achieve health care reform and cost containment goals and analyzed the economic consequences of a health care policy.

Next week, you will review the four principles of medical ethics and examine these principles in the light of current health care policy.

To go to the next week:

Week 6

Name: NURS_8100_Week5_Discussion_Rubric

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		Excellent	Good	Fair	Poor
RESPONSIVENESS TO DISCUSSION QUESTION Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.		Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE		Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION		Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING		Points Range: 6 (20%) – 6 (20%) Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.	Points Range: 5 (16.67%) – 5 (16.67%) Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.	Points Range: 4 (13.33%) – 4 (13.33%) Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.	Points Range: 0 (0%) – 3 (10%) Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Total Points: 30

Name: NURS_8100_Week5_Discussion_Rubric

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Discussion: Technology and Cost Containment

The U.S has one of the most expensive healthcare costs in developed countries. Healthcare costs are progressively increasing, creating a huge financial burden to healthcare consumers, health organizations, employers, and insurers. The high healthcare costs are associated with various factors, including the increasing use of advanced healthcare technology, rising prices of pharmaceuticals, growing burden of NCDs, and a growing population of uninsured Americans (Oakes et al., 2019). One of the major challenges to containing healthcare costs is the overutilization of healthcare services. The overuse of medical care is a challenge faced by most countries globally. This type of inefficient care accounts for approximately 30% of all healthcare spending in the U.S and amounts to about $780 billion annually (Oakes et al., 2019). Overuse of medical services is affected by various factors and is attributed to financial, physical, and psychological harm to consumers.

           The U.S healthcare system is faced with the problem of unnecessary medical care, which includes unnecessary diagnostic tests, medical procedures, and prescriptions. The tests, procedures, and unnecessary drugs provide no benefit to patients and are usually expensive (Morgan et al., 2019). Thus, the cost of unnecessary drugs, diagnostic tests, and procedures compared in adverse effects, time, and money outweigh the potential benefits.

           Policymakers envision that technology can streamline the processing of claims, thus reducing healthcare costs. For instance, they envision that smart technology can be used to automate the collection of patient data and communication processes while justifying the patient events that lead to a claim (Cook et al., 2018). This would reduce healthcare costs and improve customer experience. I agree with the policymakers since streamlining claims processing can cut healthcare costs by a large margin and significantly enhance turnaround times. Since the claiming process is automated, it can help health providers improve payment efficiency, promoting significant cost savings in repayment turnaround times and staffing (Cook et al., 2018). Furthermore, healthcare technology can help lower administrative costs. This can be achieved by using technology to integrate the various systems used to store data into a cohesive system, which will help reduce the expenses of day-to-day operations.

References

Cook, D. J., Duncan, G., Sprint, G., & Fritz, R. L. (2018). Using smart city technology to make healthcare smarter. Proceedings of the IEEE, 106(4), 708-722.

Morgan, D. J., Dhruva, S. S., Coon, E. R., Wright, S. M., & Korenstein, D. (2019). 2018 update on medical overuse. JAMA internal medicine, 179(2), 240-246. https://doi.org/10.1001/jamainternmed.2018.5748

Oakes, A. H., Chang, H. Y., & Segal, J. B. (2019). Systemic overuse of health care in a commercially insured US population, 2010–2015. BMC health services research, 19(1), 1-9. https://doi.org/10.1186/s12913-019-4079-0