Essay

CASE ADMINISTRATION AND REPAYMENT IN HEALTHCARE 6

The Need for Approaches to Improve Case Administration and Repayment in the Healthcare System: A Proposal Essay

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The Need for Approaches to Improve Case Administration and Repayment in the Healthcare System: A Proposal Essay

Introduction

The US spends more than twice on the provision of healthcare per person as each of the developed nations of the world. Despite the high expenditure on healthcare, the US healthcare sector still has a number of the worst healthcare outcomes including a high population of children dying before their first birthday. Besides, for every three persons in the US, one is uninsured, which drives them to spend their incomes on healthcare. For this reason, healthcare reforms in the US have focused on ensuring that patients get the highest levels of medical attention at the lowest costs possible. These two elements of the reforms in healthcare have a focus on two different elements; case administration and repayment. The focus has been on reduction of errors and making them less harmful in the event of their occurrence. Concerning repayment, the main problem has been the fact that methods of reimbursement of the healthcare providers and practitioners has been based on the number of procedures and visits made by hospitals and practitioners. Such a system has enabled the healthcare facilities and doctors to maximize their profits even while they continue to provide low-class healthcare quality. For this reason, the proposed research argues that improvement of the methods of case administration and repayment systems will improve the quality of healthcare provided to the US citizens.

Scope/Research Questions

The research paper will answer three research questions relating to the best ways of improving case administration and repayment in the healthcare system of the US listed as follows:

Are proper case administrations and improved repayment methods associated with an improved quality of healthcare?
What steps have the US taken to improve the quality of healthcare provisioning in terms of case administration and methods of repayment? Do the current approaches address the problems of low quality of healthcare and the high cost associated with it?
What approaches will best improve the quality of case administration and improve the methods of repayment in the healthcare system?

Outline

First Main Point

Proper case administration, which may include the use of proper technology and better methods of repayment have a significant positive impact on the quality of healthcare. For example, having systems of case administration that will ensure patient safety improves the quality of care provided through the minimization of errors. In addition, providing better systems of reimbursement not only makes healthcare affordable, but also improves the quality of care provided.

Second Main Point

Several healthcare reforms have targeted to improve the quality of care provisioning concerning case administration and methods of reimbursement. For instance, patient safety initiatives have led improved quality of care. However, the systems of payment remain a major underdevelopment even after several reforms have been made.

Third Main Point

Incorporation of strategies of patient safety improvement with those that will improve the methods of reimbursement will improve the quality of care.

Methodology

The proposed research paper will adopt qualitative data obtained from a review of methods of improving health care in the America that are documented in literature. The pieces of literature will be drawn from several databases including EBSCO, ProQuest, Science Direct, Medline and Academic Research.

References

McKethan, A., Morrison, M., Shepard, M., Nguyen, N., Brennan, N., Cafarella, N., Williams II, R. D, & Kocot, S. L. (2009). Improving Quality and Value in the U.S. Health Care System. Brookings Institution. Retrieved 13 February 2017, from https://www.brookings.edu/research/improving-quality-and-value-in-the-u-s-health-care-system/

Stone, P., Hughes, R., & Dailey, M. (2008). Creating a Safe and High-Quality Health Care Environment. Agency for Healthcare Research and Quality (US). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2634/pdf/Bookshelf_NBK2634.pdf

U.S. Department of Health & Human Services (2014). New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings. Retrieved 13 February 2017, from https://innovation.cms.gov/Files/reports/patient-safety-results.pdf

United Health Group (2014). Solutions for a Modernized Health Care System. Retrieved 13 February 2017, from http://www.unitedhealthgroup.com/~/media/UHG/PDF/2016/UNH-Solutions-Quality-Care-Delivery-Payment-Models.ashx?la=en

Whelan, E. M., & Feder, J. M. (2009). Payment reform to improve health care: ways to move forward. Center for American Progress Action Fund. Retrieved 13 February, 2017 from https://www.americanprogress.org/wp-content/uploads/issues/2009/06/pdf/healthpaymentreform.pdf