In last week’s assignment, you developed strategies to address the public policy issue. Now you are tasked with pulling it together and developing a solution and details for your plan. Use the attache

11

Focusing on a Strategy

August 26, 2019

Peter Reeves

The health care policies in Colorado have led to the increase in household expenses for many years and it is anticipated to keep increasing. This increase in expenses impacts a significant amount of families specifically those who are trying to make ends meet. Challenges on health care costs and spending are typically used interchangeably by policy makers but have different meanings. Determining ways to handle the issue of health care costs as well as other issues related to health care policies in Colorado is essential for the state’s residents (William, 2017).

Transparency

Increasing transparency is one way that can be used to address the issue of healthcare policies in Colorado. The raising of drug prices has brought about a huge conflict among the policy makers and the consumers. New drugs are introduced and put on the market at high prices and many individuals know that the high prices are a great risk in the pharmaceutical industry. These high-priced drugs have confused and disappointed the customers and the policy makers. The various states use the policies that require transparency of pharmaceutical prices in order to force the pharmaceutical companies to take responsibility for the high prices. The manufactures are expected to provide information on rising prices and making the information available to the public. Price transparency enables cost control through customer motivation which has become the main goal among the policymakers.

Transparency aids in enhancing the quality of care as well. It helps hold the physicians responsible for patient care, thus encouraging better patient care, as well as enhancing healthcare productivity. The healthcare administrators control the system that is used for motivating the providers and set policies that encourage better efficiency in making them work more efficiently. It also aids in minimizing operating costs. This is achieved by the fact that transparency improves productivity, thus lowering the cost. It enables the employees to come up with ideas to aid in the financial stability of the health care facility. Transparency with the financial needs of each department can lead to better decision making by the staff that works within the department. For example, emergency room staff will have difficulty regulating the cost of the operating room when they do not possess the knowledge of the cost incurred on the operating room resources.

Changing the health care culture where prices are kept undisclosed can be a great challenge to transparency. Transforming this belief involves changing the workers' perceptions which can lead to workplace politics. Sometimes obtaining the information from organizations that should be public knowledge becomes difficult. Specific individuals have access to the information needed for transparency however, they need to concentrate on their duties rather than serving the management the information for transparency (USC, n.d.).

The Internal and External Impacts for Transparency

With the health care system being transparent it has cut the ability for political corruptions ability to force a reduction in medical staff, this could change the sanctioned cost to serve the patient. The government may demand payment for drugs that are normally given at no cost. It has also reduced the loss public resources through the use of regulations. The social aspect that can affect health care is that health care transparency keeps the costs lower and raising the living standards of the community. With an impartial medical treatment cost, individuals can afford to have the necessary treatments that they may need thus, reducing the mortality rate.

Other influences that affect healthcare policies are legalities, cultural, and fiscal constraints. Transparency among each of these aspects allows for the health care sector to maintain proper care of patients. The legal aspect excludes unlawfulness since things are done in the appropriate manner without biases. Cultural aspects enhance the relationship and trust between physician and patient in the health care facility, it also allows for quality and efficiency within the system. The fiscal constraints make sure the health care program does not exceed the anticipated income within a fiscal year.

The Financial Mechanisms and Budgeting Approaches for Transparency

The financial side of transparency includes indirect costs, direct costs, and cost-sharing. Some of the indirect costs include health facilities themselves, patient transportation to a health facility. Indirect costs involve innovative ways to financing such as raising funds for growth, such as funds from taxation. The next way is direct cost this is activity-based budgeting and is used to find out the total number of inputs needed to support the expected result of implementing the strategy. Then there is cost-sharing this strategy is where the patients will have to pay the portion that is not covered by insurance.

Payment Reform

Another approach that can be used to address the problem of health care policies is the payment reform. The government should reduce health care costs and make it affordable for all. It should encourage experimentation with new approaches to prices and payments such as the consumer-based care and payment methods. It should also analyze the potential of equalizing payments in rural places across the nation. It should improve the primary care payments using value related structures such as primary care payment (William, 2017).

Through payment reform, healthcare costs are reduced, this approach is mainly intended for individuals that have to spend money on their healthcare. These efforts do not have a solid success and need to have flexibility at all times. Payment reform enables individuals to manage their expenses in a sensible way. There are strategies that have been put in place to limit the financial requirements for an individual, which establishes a deduction in the spending of the GDP.

There are always financial costs required for the reformations, these changes are expected to save money for patients. The issue with these reforms is that there is always upfront capital required to allow things to flow in the right direction. Payment reforms also transform the condition of how care is provided. This may include minimized hours for employees to transition to where the cost of the care lies (Ayres, n.d.).

Internal and External Impacts for Payment Reform

Through the introduction of payment reform, the political-economy obstacle will be extracted this will lead to the attraction of more donors from some organizations. The higher the costs of healthcare, the less income people have to spend on other goods and services. High health care costs can lead to a reduction in the access to proper health care and higher debt for consumers thus lowering the rate of growth in GDP. Lower cost of health care for children provides a chance for better health as an adult it also improves the social welfare of families. With this strategy it will fill in the loopholes within the healthcare system and provide access to healthcare to the members of society. Healthcare payment reform has brought changes to cultural beliefs. For example, the belief that health care is not affordable for lower income and is only available to the wealthy is not accurate. Some fiscal restraints for healthcare payment reform is it has a negative impact on the government’s fiscal position since solvencies are used to cater to new spending programs.

Financing Mechanism and Budgeting Approaches for Healthcare Payment Reform

The financial side of the healthcare payment reform includes indirect costs, direct costs, and cost-sharing. Like transparency, healthcare payment reform has indirect costs that include transportation for patients to healthcare facility. Again, like transparency indirect costs involve innovative ways to financing such as raising funds for growth such as funds from taxation. The direct costs are paid by the patient for the services received and can cause financial strain on the average person. Cost-sharing involves the sharing of costs between the government and the patient. It uses the government financing mechanism for the government pays some of the costs incurred (McGraw-Hill Medical, n.d.).

Social Determinants

Social determinants of health care are also a factor that needs to be considered when addressing the issue of healthcare policy problems. There needs to be a minimum of national agencies to ensure medical patients get the support required to deal with their medical conditions, supports could include housing, training, and placements. They are also expected to provide the payment in the conditions set by Medicare that deal with coatomer’s social determinants of life. Hospital management is also expected to develop a preliminary program that determines urban, low-income patients and provide them with improved care and financial support (William, 2017).

Social determinants of life are mainly used to consider the least disadvantaged people in society. Social determinants of health impact health results as well as biological and individual factors. It is important since it aids in ensuring that low-income patients are provided with enhanced care and financial support. By using the data provided by social determinants, physicians may have a better understanding of the patients' needs and determine effective ways to treat them (Bernazzani, 2016).

Consideration of social determinants of health has less limitations on minimizing racial and ethnic inequalities. When resources are unavailable, social determinants can develop unpleasant events such as discrimination which involves the dynamics of social injustice. This results in poor health results and may affect various generations, even if discrimination is not present (Bernazzani, 2016).

Internal and External Impacts in Social Determinants

Consideration of the social determinants of health will eliminate the political-economy obstacles, this will lead to equal opportunities among health care. Due to the consideration of the social determinants of health care, the number of deaths due to lack of healthcare, education and racial segregation has reduced as well. The legal aspect is the consideration of the social determinants of health and will aide in displaying equalities among all individuals and of all living standards. All individuals will have the ability to attain the proper health services that may be needed. Social determinants of healthcare bring understanding and consistency among the patients and the clinicians in the healthcare facilities. It can also enhance the quality and efficiency in the healthcare system. The fiscal constraints have a positive impact on the government’s fiscal position since they bring the patients closer to the healthcare providers.

Financing Mechanisms and Budgeting Approaches for Social Determinants

The financing and budgeting approaches include indirect costs, direct costs, and cost-sharing. The indirect costs include classrooms used by patients and transportation for medical purposes. The direct costs involve money used to pay the clinical staff, health coverage and training staff needed during the process (McGraw-Hill Medical, n.d.). In the consideration of social determinants of health, they are no application of cost-sharing since the federal government is responsible for catering for all the requirements for those in need. It involves the government financing mechanism.

Conclusion

Policy strategies help to determine the benefits, cost, and effectiveness of an implemented policy. Transparency is mainly centered on clients; they have opportunities to inquire about treatment costs and options. Payment reforms are important since the cost of the healthcare was so high, medical bankruptcy has affected more than a million individuals. Increasing the medical cost risked taking up the federal government’s resources. Consideration of social determinants in healthcare is very important especially among the vulnerable populations. Factors such as the environment, education, and income are some of the crucial factors which are taken into consideration when providing the care. Therefore, maintaining the knowledge of how the healthcare system is progressing can make sure that the care people are receiving is effective and affordable.

References

Ayres Crystal. (n.d.). 18 Healthcare Reforms Pros and Cons. Retrieved from https://vittana.org/18-healthcare-reform-pros-and-cons

Bernazzani Sophia. (2016, May 01). The Importance of Considering the Social Determinants of Health. Retrieved from https://www.ajmc.com/contributor/sophia- bernazzani/2016/05/the-importance-of-considering-the-social-determinants-of- health?p=2

McGraw-Hill Medical. (n.d.). Paying for Healthcare. Retrieved from https://accesspharmacy.mhmedical.com/content.aspx?bookid=39sectionid=398835664&

USC. (n.d.). The Challenges and Rewards of Transparency in Healthcare. Retrieved from https://heathadministrationdegree.use.edu/blog/the-challeges-and-rewards-of- transparency-in-healthcare/

William Lindsay. (2017, June 30). Colorado Commission on Affordable Healthcare. Retrieved https://www.colorado.gov/pacific/sites/default/files/Cost%20Commission%20November %202017%20report%20v3%20draft_1.pdf