NURS 8100 Week 5: Economic and Technological Influences on Policy
NURS 8100 Week 5: Economic and Technological Influences on Policy
Economic factors have long been a key driver of health care policy and reform efforts. As noted in previous weeks, for instance, health policies have attempted to improve the situation for millions of uninsured or underinsured individuals and to address the barriers to health care access that have arisen as a result of the high costs associated with insurance and health service delivery.
This week, you will examine how economics influences health policy and health care reform efforts. You will explore cost containment strategies from increasing administrative efficiency to health care rationing and the role of technology in health care reform and cost control efforts.
Learning Objectives
Students will:
- Evaluate the use of technology to achieve health care reform and cost containment goals
- Analyze the economic consequences of a health care policy
Photo Credit: [Robert Nicholas]/[OJO Images]/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
- Chapter 8, “Painful Versus Painless Cost Control”Chapter 8 focuses on the relationship between health care costs and health outcomes and its importance on the health policy agenda. This chapter also presents strategies for effectively utilizing resources as opposed to rationing health care services.
- Chapter 9, “Mechanisms for Controlling Costs”Chapter 9 examines an array of policies aimed at controlling health care costs and reviews specific financial and reimbursement cost containment methods to health outcomes.
Buntin, M., Jain, S., & Blumenthal, D. (2010). Health information technology: Laying the infrastructure for national health reform. Health Affairs, 29(6), 1214–1219. doi: 10.1377/hlthaff.2010.0503
Note: You will access this article from the Walden Library databases.
In this article, the authors examine the role of health information technology as a major component in the restructuring of health care. They suggest it will improve quality, reduce costs, and allow for seamless access to data across providers.
Margolius, D., & Bodenheimer, T. (2010). Transforming primary care: From past practice to the practice of the future. Health Affairs, 29(5).
Note: You will access this article from the Walden Library databases.
The authors propose a primary care practice of the future in which physicians act as leaders of a team of health care professionals. Reimbursement would shift from a pay-per-service model to a comprehensive model that incorporates both a standardized payment per patient and performance pay based on improved patient health outcomes.
Maxson, E., Jain, S., McKethan, A., Brammer, C., Buntin, M., Cronin, K., … Blumenthal, D. (2010). Beacon communities aim to use health information technology to transform the delivery of care. Health Affairs, 29(9), 1671–1677. doi: 10.1377/hlthaff.2010.0577
Note: You will access this article from the Walden Library databases.
Monheit, A., Cantor, J., DeLia, D., & Belloff, D. (2011). How have state policies to expand dependent coverage affected the health insurance status of young adults? Health Services Research, 46(1), 251- 267.
Note: You will access this article from the Walden Library databases.
Young adults (19-29 years of age) are one of the highest uninsured segments of U.S. population. Some states have mandated extended dependent coverage; however, the study presented in this article depicts little effect on uninsured rates. The authors suggest that the PPACA 2010 provision mandating expanded dependent coverage will have better success because more health plans will be involved in the mandate.
Rosenthal, M., Beckman, H., Forrest, D., Huang, E., Landon, B., & Lewis, S. (2010). Will the patient-centered medical home improve efficiency and reduce costs for care? A measurement and research agenda. Medical Care Research & Review, 67(4), 476–484.
Note: You will access this article from the Walden Library databases.
This article discusses the use of Patient-Centered Medical Homes (PCMHs) as a cost containment strategy. The authors maintain that credible research needs to be conducted to evaluate the actual results.
Steuerle, C. E., & Bovbjerg, R. R. (2008). Health and budget reform as handmaidens. Health Affairs, 27(3), 633–644.
Note: You will access this article from the Walden Library databases.
Wilensky, G. (2010). Health economics. Information Knowledge Systems Management, 8, 179–193.
Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Cost containment. Baltimore: Author.
Note: The approximate length of this media piece is 13 minutes.
In this media presentation, Dr. Gerald Kominski and Dr. Walter Zelman discuss the challenges policy makers face in containing health care expenditures and costs.
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Discussion: Technology and Cost Containment
In response to continually rising health care costs, the Health Information Technology for Economic and Clinical Health (HITECH) provision was created to promote the meaningful use of health care information technology through numerous incentive programs for health care providers. By enhancing data collection, streamlining electronic medical records, and increasing transparency, it is believed that significant cost savings can be realized as well as other positive outcomes. What are some of the tradeoffs involved in this type of policy?
To prepare:
- Reflect on the challenges of containing health care costs in the U.S. presented in the Learning Resources and discussed by Dr. Kominski and Dr. Zelman in the media.
- Consider how information technology may be used to address health care issues related to cost.
- Examine the Health Information Technology for Economic and Clinical Health (HITECH) provision and its goals.
By Day 3
Post a cohesive response that addresses the following:
- Briefly summarize a significant challenge to containing health care costs.
- How do policy makers envision technology could be utilized to address this challenge (above)? Provide at least one example to support your response.
- Do you agree or disagree with the policy makers? Describe why you agree or disagree and include one or more insights from this analysis that relate to the question of how information technology could, or could not, help contain costs while supporting health care reform initiatives.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Submission and Grading Information
Grading Criteria
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Assignment 1: Issues in Health Care Reform (Interview)
Continue to work on this Assignment, assigned in Week 2 and due in Week 9.
By Day 7 of Week 9
Submit this Assignment.
Assignment 2: Health Policy Proposal Analysis (Policy Brief)
Continue to work on this Assignment, assigned in Week 3 and due in Week 7. Consider the potential economic benefits of the recommendation you have selected and how the recommendation may contribute to controlling health care costs. Include this information in your policy brief.
By Day 7 of Week 7
Submit this Assignment.
Assignment 3: Policy Analysis Paper
[Major Assessment 2]
Continue to work on this Assignment, assigned in Week 4 and due in Week 11. Analyze the financial and economic context of your selected health care policy. Include an analysis of the costs of the various policy solutions and the primary funding sources. This information should be included in Part 2 of your analysis paper.
By Day 7 of Week 11
Submit this Assignment.
Week in Review
This week, you evaluated the use of technology to achieve health care reform and cost containment goals and analyzed the economic consequences of a health care policy.
Next week, you will review the four principles of medical ethics and examine these principles in the light of current health care policy.
In the world today technology is inevitable in all industry sectors. Health care is not an exception. There is an added cost in trying to make technology secure. There are however other costs that are challenging to the health care system and one such cost will be addressed in this discussion.
Significant Challenge to Containing Health Care Costs.
The cost of health care in the United States can be attributed to many reasons. A glimpse of the cost is mentioned as a summation of over four million dollars in the year 2020 alone (Centers for Medicare and Medicaid Services, 2021). Unnecessary emergency room (ER) visits in United States is one of the challenges that make containing health care costs a hard task. According to Rubin, (2021), in the year 2017 alone there were over one hundred and forty-four million ER visits that costed over seventy-six billion. This statistic is alarming.
Health care cost reduction can be achieved by eliminating of unnecessary ER visits (Walden University, Producer (2011). The root cause of these visits can be attributed to numerous factors including underpaying health care providers who opt to send their patients to ER instead of taking care of them in an outpatient clinic.
Cost containment is therefore easier said than done because to reduce ER visits means to have an effective system of health care delivery. One way this would be achievable would be to manage chronic conditions like hypoglycemia without involving ER visit. Knowing how expensive going to the ER can be has led to different interventions being put in place to reduce these visits.
According to Lyons, Olson, Palmer, Horwitz, Mandl & Fine (2017), those who frequent the ER can be identified but unfortunately there are those who use multiple ERs. These patients who visit different ERs may lead to duplicative and unnecessary care.
Policy Makers Envision of Technology
Technology has made it possible for clinicians to access health information from different sources. In the ERs clinicians sometimes have to make quick decisions and with technology it would be possible to have knowledge regarding previous care. Simple information like allergies would be accessible to clinicians. Having history and physical information in a data base that would be accessed at the ER would make the visit less time consuming. According to Ojetti, Covino, Brigida, Petruzziello, Saviano, Migneco, Candelli & Franceschi (2020), sometimes the ER is is viewed by patients as a place to have solutions to health care problems. With technology, the ER clinicians can determine after having access of health care information if a patient needs to be triaged to the next level of care or needs to be discharged.
One Example
One example of use of technology is one that is required in the state of Maryland. Chesapeake Regional Information System for our Patients (CRISP). This is the state of Maryland designated health information exchange. As a provider especially in the ER one has to log in to CRISP and is able to see all the scheduled medications that the patient is taking, the last refill, the provider who wrote the prescription and the pharmacy that the medications were filled. This information is critical because there are some patients who visit the ER expecting to be given narcotics when they already have current supply for a month.
Agree or Disagree with the Policy Makers.
The long term effect of using technology remains positive from the point of view of the provider. It is therefore fair to be agreeable with the stakeholders. According to Fereydon, Roghayeh, Ahmad & Mohsen (2020), technology has the ability of having a positive impact in health care improvement in regards to quality, safety, and efficiency. It is however important to acknowledge there would be a cost related to training and implementing and sustaining technology. However, in the ER technology offers critical information for patients that is urgently needed to aid in treatment modalities. This information sharing saves time which in turn saves the cost of treatment.
References
Centers for Medicare & Medicaid Services. (December, 2021). National Expenditure Data https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical
Fereydon ,E., Roghayeh, S., Ahmad, J., & Mohsen, S. (2020). The Use of Health Information Technology by Nurses in Healthcare. Preventive Care in Nursing and Midwifery Journal, 9(1), 36–39.
Lyons, T. W., Olson, K. L., Palmer, N. P., Horwitz, R., Mandl, K. D., & Fine, A. M. (2017). Patients Visiting Multiple Emergency Departments: Patterns, Costs, and Risk Factors. Academic Emergency Medicine, 24(11), 1349–1357. https://doi.org/10.1111/acem.13304
Ojetti, V., Covino, M., Brigida, M., Petruzziello, C., Saviano, A.,Migneco, A., Candelli, M & Franceschi, F. (2020). Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone? Medicina, 56(512), 512. https://doi.org/10.3390/medicina56100512
Rubin, R. (2021). The Costs of US Emergency Department Visits. JAMA, 325(4), 333. https://doi.org/10.1001/jama.2020.26936
Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: Cost containment. Baltimore: Author.
Bottom of Form
Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
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Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 1 or less of the following:
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| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
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| 0 Points Deducted | 5 Points Lost | |||||
| Participation
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| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Read Also: NURS 8100 Week 4: Policy Analysis Frameworks