Discussion: Defining the Future of Healthcare Policy in Practice
Access to care, cost of care, and quality of care: what do they have in common? As you’ve learned, they are dimensions of performance used to assess a healthcare system (e.g., addressed in Assignment #2), which also makes them an important policy issue. In your Learning Resources this week, Ba
XXXXXXXXXXstates that “the conundrum of U.S. health care [is] that all three [exist] simultaneously and that attempting to remedy one [will] inevitably affect the others” (p XXXXXXXXXXFor example, if we try to control costs, then we either have to decrease access to care and/or compromise quality of care. With this in mind, what do you think is the best course for healthcare policy to follow in the future?
You have spent much of the last five weeks examining how others have created the cu
ent state of healthcare policy. In this final Discussion, you will assume the role of policy maker and create a policy that addresses access to care, quality of care, or cost of care. Recall that some of the performance dimensions have multiple indicators. For example, patient safety is an indicator of quality of care. Similarly, having medical insurance is an indicator of access to care.
To prepare for this Discussion:
· Review this week's Learning Resources. Pay particular attention to the Learning Resources that discuss trends in healthcare policy and/or practice.
· Review Healthcare policy in the United States (Ballotpedia, n.d.) in Week 1 Learning Resources. https:
allotpedia.org/Healthcare_policy_in_the_United_States
· Select a specific setting (e.g., any healthcare setting, workplace, prison, etc.)
· Create a healthcare policy that you would like to put into place within this setting (e.g., providing health insurance to all employees, offering health screenings to prisoners).
· Frame the policy using at least one dimension of performance (or an indicator, such as patient safety) and be sure the policy is realistic and complies with cu
ent law.
By Day 4
Post a comprehensive response to the following:
· Summarize your healthcare policy. Be sure to indicate which dimension(s) of performance or indicator(s) was used to frame your policy.
· What is the setting where the policy will be implemented? Why did you choose this setting?
· Who are the stakeholders of the policy? What role do they each play?
· What are the goals of your policy? In other words, what are you hoping the policy will do or accomplish?
· Who will be affected by the policy?
· What are some ba
iers that you may encounter during development and implementation?
· Support your post with in-text citations and references from specific Learning Resources and at least one outside scholarly source.
Note: Initial postings must be 250–350 words (not including references).
INDUSTRY TRENDS
48 l American Health & Drug Benefits l www.AHDBonline.com Fe
uary 2018 l Vol 11, No 1
When this view into 2018 was developed, Senate failures to repeal, re-
place, or change the Affordable Care Act (ACA) had
occu
ed, and left the market unchanged from a legisla-
tive perspective. Regardless, relentless market change
efore and after the implementation of the ACA has left
ACA exchanges in financial trouble, providers facing
decreased reimbursement, and consumers with limited
access to plans by metropolitan statistical area across the
country. As a result, commercial health insurance through
traditional ca
iers and employer self-funded market
trends have been re-energized.
Many trends from the past 2 years continue, albeit in
a transformed way because of the effect of unknown
change in the public (ie, government) sector market,
along with the tax reform legislation. Information tech-
nology remains important, but its user base and timing to
deliver information are shifting, along with potential
disruptive applications that will, in their own way, trans-
form market trends. In addition, technology innovations
will need to demonstrate a positive return on investment.
A clear consumer focus has emerged, along with efforts to
transform the healthcare experience to more positively
use a mostly unchanged delivery system and supply chain.
8 Themes Reveal Key Healthcare Trends
Going into 2018, with an eye on 2020, we have iden-
tified 8 themes that su
ound many key trends in this
energized US market.
Rural Healthcare
Outside of the largest cities and some subu
an hospi-
tals where many health systems have formed, many pa-
tients in the United States receive care from smaller,
ural institutions that offer challenges for patients and
providers. According to the American Hospital Associa-
tion, “Rural hospitals provide essential health care ser-
vices to nearly 57 million people.”1
The number of people living in rural (nonmetropoli-
tan) counties declined by nearly 200,000 between 2010
and 2016, which is the first recorded period of rural pop-
ulation decline.2
With government programs in constant danger of fi-
nancial cost-saving spending cuts, rural healthcare provid-
ers are in crisis. According to the National Rural Hospital
Association, “Cu
ently one in three rural hospitals is in
financial risk. At the cu
ent rate of closure, 25% of all
ural hospitals will close within less than a decade.”3
Adding to the unique problems of rural healthcare are
the decreasing number of physicians, the growth of
high-deductible health plans (HDHPs), a lack of choices
of private exchanges, and the opioid epidemic.
Takeaway: Rural healthcare providers and hospitals
will continue to turn to leveraging new technology as
they experience population loss. Technologies, such as
telehealth and telemedicine, and consumer health wear-
ables or smartphones, can enable rural-based care sys-
tems to consolidate specialty care services and refe
als as
ways to survive and grow in an evolving market.
Consumerism in Healthcare
Healthcare consumerism is defined by the Institute for
HealthCare Consumerism’s IHC Forum as, “transform-
ing an employer’s health benefit plan into one that puts
economic purchasing power—and decision-making—in
the hands of participants. This is best achieved by sup-
plying employees with the decision-making information
and support tools they need, along with financial incen-
tives, rewards, and other benefits that encourage person-
al involvement in altering health and health care pur-
chasing behaviors.”4
As costs for consumers continue to rise, consumers
ecome more engaged in making certain they are getting
the best value for their money. They have come to expect
transparency and choice in their healthcare experience.
The success of healthcare providers will depend on
their ability to meet consumers’ needs and expectations.
Providers will be the primary source for education, infor-
mation, and the tools that patients need to take owner-
ship of their health.
Growing in parallel with increased consumer en-
gagement in healthcare is the increase in benefit choic-
es offered to employees by their employers. More com-
panies are offering HDHPs alongside traditional plans,
as employers look to shift some of the healthcare costs
to employees.
The baby boom generation continues to drive health-
care and pharmaceutical choices and costs, and will
Healthcare Trends for 2018
By F. Randy Vogenberg, PhD, RPh; John Santilli, MBA
Dr Vogenberg is Principal, Institute for Integrated Healthcare,
Founding Partner, National Institute of Collaborative Healthcare,
Greenville, SC, and Adjunct Professor, University of Rhode
Island, College of Pharmacy, Kingston; Mr Santilli is President,
Access Market Intelligence, Trumbull, CT, and Founding
Partner, National Institute of Collaborative Healthcare.
INDUSTRY TRENDS
49 www.AHDBonline.com l American Health & Drug Benefits lVol 11, No 1 l Fe
uary 2018
continue to do so for some time. However, baby boomers
will soon be eclipsed in driving healthcare and drug
trends: millennials outnumber baby boomers by approxi-
mately 7.7 million.5
Takeaway: As patients, millennials will influence the
future of healthcare in new ways, as their use of online
esources and telehealth continues to grow. Like baby
oomers and Generation Xers changed aspects of health-
care, millennials are fully the first generation expected to
share the burden of their health benefits. They believe
that healthcare costs are too high and that third-party
health payers or insurers have too much power.
Workforce Change
Employment in the United States is undergoing in-
tense changes, and an analysis of government data from
a survey by the Pew Research Center shows that employ-
ment in occupations that require more education and
training are on the rise, and many workers are realizing
that retraining and upgrading their skills are lifetime
commitments.6 The workplace now encompasses multi-
ple generations representing a wide variation in skills,
life experiences, technical training, and college educa-
tion. Such a diverse workforce environment also creates
challenges for healthcare.7
The most difficult aspect of managing a workplace
comprising different generations of employees remains
communication. The workplace has lagged behind the
est of society in communications. Employees have be-
come used to real-time communication in their home
lives, and they expect the same from their employers. It
is estimated that US consumers now spend 5 hours daily
on mobile devices.8
Many companies experience a large technology gap in
corporate communications. E-mail, which lags behind
mobile applications in communicating immediacy, re-
mains the primary means of workplace communications.
Employees often lack access to computers or company
e-mail addresses at work. Companies often do not use the
most effective internal communication tools to reach
their employees.
The physical workplace is also changing for employers.
Today’s “borderless” workforce includes those in the Unit-
ed States and a
oad, employees in an office, those work-
ing remotely at home or at a satellite facility, and other
employees who are not connected but who perform criti-
cal service functions depending on the industry. Most re-
cently, there has been an increase in office-based employ-
ees and a decrease in home-based employees, as companies
seek to optimize their customer solutions. This is a reversal
from the previous trend of home-based employment to
more in-office and shared office space to maximize inter-
actions, creativity, and productivity among workers.
An article on working from home states, “The per-
centage of workers doing all or some of their work at
home increased from 19% in 2003 to 24% in 2015….
Among those in management, business, financial opera-
tions and professional jobs, the percentage was 35-38%.
And 68% of U.S. workers say that they expect to work
emotely in the future.”9 The author continues, “Indus-
tries that are most likely to offer remote work include the
computer and information technology fields, medical
and health, and government and finance.”9
Takeaway: As a way of improving overall communi-
cations with