Wednesday, May 6, 2020

Aligning Incentives in Medicaid

Question: What challenges in relation to reducing healthcare costs and improving healthcare quality and health outcomes is your state and community facing and how can the federal government help address or mitigate those challenges? Answer: Introduction This report is based on the analysis of the provided case study regarding the various ways used by the states of Colorado, Minnesota and Vermont to reform care delivery and payment systems to improve the quality of the various healthcare services along with the expenses associated with the various activities involved in the healthcare services. This paper focuses on the similar attempts of the state of New York to improve the various aspects related to the healthcare services provided to the citizens of the state. The paper also focuses on the various systems and techniques used in the state to improve the quality of the various healthcare services provided by the various healthcare organisations located across the entire state (Orszag, 2010). Payment and delivery system The payment and delivery system implemented in the state of Colorado named, Accountable Care Collaborative which allows a number of regional care collaborative organisations to have an official contract of collaboration and support for the network of primary medical care providers. This payment and delivery system will also be able to provide positive result for the healthcare industry in New York. This payment and delivery system also allows the integration of the various hospitals in the state along with the healthcare service providers, social workers and specialists. The collaborative partnerships or the coalitions of this payment and delivery system includes the various health homes, home care agencies, behavioural health providers, Nursing facilities and hospitals along with various other stakeholders (Porter, 2009). The delivery and payment system in New York can be funded by a number of funds present in the state such as the Safety Net Performance Provider System Transformati on Fund which could be kept open for all the eligible healthcare service providers and the Public Hospital Transformation Fund which could be kept open to the major public hospital system applicants. The payment and delivery system for the state of New York includes the association of a number of stakeholders along with the Department Of Health. Application to New York The case study describes a number of reforms which are being done in the healthcare industry of the three states of Colorado, Vermont and Minnesota. These reforms can be applied to the state of New York as well due to a number of similarities in the processes of the healthcare industry of the states. The current situation of the healthcare industry in the state of New York requires the collaboration of the various healthcare service providers for the improved quality and standards of the various operations and processes included in the business model of the organisations. The reforms for the three states focus on the financial support for the processes involved in the healthcare industries which is also required according to the current situation of the healthcare industry in the state of New York. The reforms designed by the three states focus on the better access to the information related to the processes of the healthcare industries, which is also beneficial to the healthcare ind ustry of the state of New York. The reforms designed by the states of Colorado, Vermont and Minnesota aim at the long term nature of savings of the various activities included in the industry of healthcare (Dingwall, 2001). Challenges There are a number of challenges in the healthcare industry of the state of New York for the attempts at reducing the costs of the various healthcare activities and improving the quality of the same activities. Close to 64 percent of the healthcare organisations operating in the state of New York predict that the cost of their various healthcare activities are going to increase slightly in the next year and close to 22 percent of the healthcare organisations operating in the state of New York predict that the costs of the various healthcare services provided by them will increase significantly, which poses itself as one of the challenges for the various reforms for the healthcare industry of the state. The federal government can support a number of major and popular healthcare organisations financially to ensure some decrease in the costs of the various healthcare services provided by them. Some of the healthcare organisations expect more funding in the upcoming year for a number of its healthcare activities which in turn causes the healthcare organisations to look for corporate financing. This causes the healthcare industry in the state of New York to experience the challenge of the industry being completely commercialised (Dingwall, 2001). Lessons learnt The biggest lesson for the healthcare reforms can be maintaining transparency in the various stages which allows each and every stakeholder involved in the process to support the reform. The reform of the healthcare services of a state should be done in way to minimise the effort and maximise the positive effects. Another lesson should be for the state government to utilise the funding or resources from the federal government for the healthcare reform in the state, instead of opposing the involvement of the federal government in the name of the federalism. The state government should utilise every possible opportunity to work together with the federal government, which in turn allows the process of reform of the healthcare industry to be a smooth process. The state government can also focus on the feature of exchanging the individual insurance policy associated with the healthcare services (Feng, 2012). Conclusion This paper allowed us to have a greater insight on the various reforms for the healthcare industries of Colorado, Vermont and Minnesota as mentioned in the provided case study. The paper also allows us to identify and analyse the application of the reforms mentioned in the case study to the state of New York. The paper also included a number of early lessons which could be learnt by the state government operating on the reforms in the healthcare industries. The paper also allows us to identify and analyse the various challenges in the process of reforming the healthcare industry in any of the state and the possible solutions for the corresponding challenges by the federal government (Bentley, 2008). References Bentley, T. G., Effros, R. M., Palar, K., Keeler, E. B. (2008). Waste in the US health care system: a conceptual framework. Milbank Quarterly, 86(4), 629-659. Dingwall, R., Allen, D. (2001). The implications of healthcare reforms for the profession of nursing. Nursing Inquiry, 8(2), 64-74. Feng, Z. (2012). Macroeconomic Consequences of Alternative Reforms to the Health Insurance System in the US. Available at SSRN 2037058. Orszag, P. R., Emanuel, E. J. (2010). Health care reform and cost control. New England Journal of Medicine, 363(7), 601-603. Porter, M. E. (2009). A strategy for health care reformtoward a value-based system. New England Journal of Medicine, 361(2), 109-112.

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