Traditional fee-for-service systems are considerably different from value-based healthcare. Payers reward quality of care rather than quantity of care when it comes to recompense.
In current years, the execution of value-based healthcare facility practices has been greatly increased, due to the tie-up between the private sector and government. Because of this shift and economic implications, the importance of Medical Affairs departments has increased as they play a unique role in the healthcare system.
Affordable Care Act became the catalyst for change
Improving the quality of health care at the system level requires a focus on governance issues, including refining public-sector management, building institutional capacity, and endorsing a culture of data-driven policies. Preferably, state and local governments and local health facilities would use data from administrative sources and household surveys for quality improvement efforts and liability in healthcare delivery
The transferal from the quantity of healthcare to quality of healthcare was impressively speeded up by the path of the Affordable Care Act (ACA) in 2010. The Affordable Care Act primarily had three goals:
- Make health insurance affordable for more people, by providing subsidies.
- Expand the medical program to insurance all adults with income below 138% of the federal poverty level.
- Support delivery methods of innovative medical care to lower costs of health care in general.
Five Possible avenues for achieving quality healthcare
Today, many efforts around patient results and safety, care coordination, efficiency, and cost-cutting are happening and care to restructure initiatives are being appraised to guide future healthcare quality improvements. The following methods can help achieve healthcare improvements
- Analyze the data and outcomes
Before starting with making improvements in health care, one must know what opportunities exist for improvements and then establish standard conclusions. Subsequently, look at drifts and statistics from electronic health records, outcomes studies, and other data sources to identify main areas in need of improvement.
- Progress with the goals
The pillars that can guide your improvement goal-setting to achieve the target of quality healthcare:
- Safe: The care that is intended to help them should not injure them.
- Effective: Avoid overdo of ineffective care and less use of effective care
- Patient-centered: Respect the individuals’ choice.
- Timely efficient: Reducing the time to wait for the patients and those who provide care
- Equitable: Health status should be free from racial and ethnic gaps
- Enhanced patient Diagnostics
An emerging technology called actionable diagnostics help care providers estimate patient conditions with improved accuracy. This ability reduces organizational waste and allows care providers to develop personalized treatment plans. The advanced genetic analyses lower health care expenditures, improve patient results and decrease misdiagnoses.
- Use of Electronic Health Records
Accurate health records are beneficial for health care providers to deliver better quality service. The records help to evaluate consumer illness, improve diagnostic precision, improve treatment results, improve health among populations and eliminate errors. With access to electric health records, we can view the consumer data easily, resulting in a better treatment process and improve patient safety.
- Consideration of Patient feedback
Patient contentment drives the current medical marketplace. Many health organizations use patient satisfaction surveys to create quality improvement initiatives, monitor employee performance, and pinpoint service gaps. Surveys have proven beneficial for meeting the standards of the establishment by the new value-based health marketplace. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is the present standard for evaluating consumer fulfillment. The survey lets consumers estimate service performance, which directly affects organizations’ reputations and reimbursements for conveyed services.
Quality management seeks to improve the efficiency of treatments and increase patient satisfaction with the service. As we passage from volume- to value-based reimbursement, it is essential to understand and how to best apply these tools and solutions available to get patients actively involved in their healthcare. Eventually, by attaining this goal, we will be creating better results, both for patients and the healthcare practices that care for them.
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