Economics And Quality Health Issues Essay Paper

The purpose of this assignment is to address health care issues facing the United States in terms of economics and quality. Chose (health care disparities) and write a 1,250- to 1,500-word paper addressing the following:
Explain why it is a significant health care issue in the United States.
Discuss the impact that health care economics has on your topic.
Discuss what you could do as a nurse leader to make an impact on your chosen issue in your professional setting.
Analyze the impact of quality measures on reimbursement.
Describe what impact you can have on health policy as a nurse leader.
Include 3–4 peer-reviewed resources.
Prepare this assignment according to the guidelines found in the APA Style Guide Economics And Quality Health Issues Essay Paper

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Economics and Quality Health Issues: Health Care Disparities

Healthcare disparities have been highlighted as an issue in the United States. Perez-Stable and Hooper (2023) described a healthcare disparity as an avoidable/preventable health difference related to social, economic, and environmental barriers. Health disparities most affect individuals who have encountered systemic obstacles to healthcare access, such as racial/ethnic minorities and those with low socioeconomic status.  Healthcare disparities are caused by limitations in accessing care to achieve optimal health by some individuals or groups, leading to poorer health outcomes than those with an advantage. This paper discusses healthcare disparities as a significant health issue in the United States (U.S.). It also evaluates the impact of healthcare economics on care disparities. The paper also discusses how a nurse leader can influence the issue in a professional setting. It also analyzes the impact of quality measures on reimbursement and the influence a nurse leader would have on health policy to address the issue. Economics And Quality Health Issues Essay Paper

Significance of Healthcare Disparities in the U.S.

In the U.S., healthcare disparities are a significant health issue.  The subject has gained policy and research interest since the 1990s.  The first report on Blacks and Minority Health outlined the life expectancy and leading causes of death by race.  The study indicated that 80% of deaths were observed in African Americans and other racial/ethnic minorities. The mortality causes in these groups included cardiovascular disease, diabetes, cancer, substance abuse, substance abuse and addiction, infant mortality, and accidental injuries.  The Office of Minority Health was later established to address health disparities observed (Perez-Stable & Hooper, 2023). However, the U.S. still grapples with healthcare disparities associated with racial/ethnic and socioeconomic status factors. Individuals from racial/ethnic minorities, including African Americans, Hispanics,  and Asians, are likely to have poor health outcomes. Furthermore, persons with low socioeconomic status across all groups may also have poor health (Caraballo et al., 2022). Overall, healthcare disparities in the U.S. are based on race/ethnicity and socioeconomic factors.

The differences in health have been a challenge for the U.S. in the effort to achieve quality and efficient healthcare. Persons who cannot access care may have poor health outcomes. The healthcare goal is to achieve optimal health for all Americans (health equity). Hence, having discrepancies in health outcomes in the population has implications for healthcare quality and costs. Individuals without access to preventative or treatment care may have increased emergency department visits and hospitalizations. Besides, they have high morbidity. The unnecessary healthcare utilization and morbidity culminates in high healthcare and societal costs. Addressing healthcare disparities is essential to achieve health equity while reducing healthcare costs.

Impact of Health Care Economics on Health Care Disparities

Healthcare spending and financing impact healthcare disparities. The rollout of universal health coverage is meant to improve individual and population health while decreasing healthcare costs, influencing disparities in healthcare among Americans. Under the Patient Protection and Affordable Care Act of 2010, Americans are covered by various plans, including Medicare and Medicaid.  Insured persons, irrespective of their race or ethnicity, are entitled to some health benefits based on their plans. To some degree, the legislation has increased access to care, alleviating some health disparities. Nonetheless, there are uninsured and underinsured people who cannot access quality care despite having severe conditions. Health inequalities could lead to more healthcare spending in the form of medical costs for uncontrolled diseases (Dean et al., 2023)Economics And Quality Health Issues Essay Paper.  Most of the uninsured persons are from minority groups,  including African Americans, Hispanics, and Natives. Federal, state, and local governments have been implementing measures to ensure universal care for Americans in their jurisdictions (Hill et al., 2024).  Overall, healthcare coverage and government spending plans significantly influence healthcare disparities.

Role of a Nurse Leader in Addressing Health Care Disparities

Nurse leaders can help address healthcare disparities in their practice settings by advocating for equity. Azar (2021) noted nurses form the majority of the healthcare profession in the U.S.  Their engagement in decision-making regarding health equity is crucial. At the organizational level, a nurse leader can ensure that the facility gathers data on social determinants of health (SDOH) as part of routine patient assessment. The information on SDOH should be integrated into the existing health information systems, such as the electronic health records (EHR). Furthermore, the SDOH data should be utilized to develop patient-centered care plans to promote healthcare access and quality. Healthcare disparities are closely linked to social determinants of health, including socioeconomic factors. Assessing a patient’s demographics can identify potential barriers to care and inform solutions to enable them to obtain the care they need to live a quality life.  Besides, as advocates, nurse leaders can influence local policies to improve access to care for disadvantaged groups.  Also, nurses can lobby for community-based healthcare programs to promote the locals’ health (Azar, 2021)Economics And Quality Health Issues Essay Paper. These actions can address health inequities at the organization and community levels.

Impact Of Quality Measures on Reimbursement.

Quality measures affect reimbursements for healthcare facilities and hospitals. The U.S. has shifted its reimbursement approach from fee-for-service to pay-for-performance. What this paradigm shift means for healthcare providers is that they should attain a standard performance level to obtain reimbursements. Failure to provide value attracts payment losses. The pay-for-performance model relies on standardized evaluations of care quality. Hospitals determined to have high average quality scores attract performance bonuses. Conversely, hospitals that have poor outcomes are penalized.  The measures applied in the performance assessments are adjusted to various factors, including the patient’s age, gender, location, disease severity, and comorbidities. However, payers, including Medicare fail to consider differences in socioeconomic status, ethnicity, race, and other SDOH (Sarkar et al., 2020)Economics And Quality Health Issues Essay Paper. The reason the payers give is that hospitals with underserved patients should not subjugated to low-quality care.

Excluding safety-net hospitals translates to lower reimbursement. Sarkar et al. (2020) observed that the majority of safety-net hospitals serve a high number of uninsured persons and Medicaid-insured individuals. Due to the insurance status of their patient populations, the hospitals get lower reimbursements compared to others. Likewise, people who receive care from these facilities have social and economic barriers, limiting their ability to obtain quality and timely care. Under value-based care models, these challenges could reduce hospital revenue, indirectly broadening health disparities among the underserved patient population. Strategies and policies are required to alleviate disparities caused by pay-per-performance reimbursement models.

Impact of a Nurse Leader on Relevant Health Policy

A nurse leader can influence health policy to alleviate healthcare disparities and ensure health equity.  At the organizational level, the nurse leader should advocate for patient-centered care that accounts for the differences in the patient population.  For example, the nurse leader can lobby for the inclusion of social demographics in care planning. Normally, SDOH information is gathered during the patient history taking, but in most cases, it is not incorporated into care plans.  A commitment to address barriers to care access can improve outcomes and influence organizational financial performance. Another way that a nurse leader can address healthcare disparities is by lobbying for healthcare programs for communities with limited access to care (Oruche & Zapolski, 2020). Bringing care closer to communities can enable disadvantaged persons to obtain preventative and treatment care.

Additionally, nurses can advocate for local and state policies to reduce healthcare disparities. culturally-competent care. Racial/ethnic minorities experience language and cultural barriers when accessing care. Healthcare organizations and providers should implement measures to improve diversity and inclusion. The call for the implementation of cultural and linguistically appropriate service (CLAS) standards is an example of using policy to achieve culturally competent care. Managing language and cultural challenges can improve access to care. Other policy opportunities include a call for interpreter services and the use of telehealth to ensure all people get healthcare services to gain optimal health and well-being (Oruche & Zapolski, 2020)Economics And Quality Health Issues Essay Paper. Through these measures, a nurse leader can contribute to the broader efforts of decreasing health disparities.

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Conclusion

Healthcare disparities are a significant problem in the United States. As the U.S., envisions quality and safe care for all, the health outcomes are disproportionate across population groups. Racial/ethnic minorities have poorer health outcomes compared to the majority, thwarting the efforts of achieving universal health. Healthcare economics affect healthcare disparities. Government spending and financing of healthcare are unequal. Underserved populations have challenges accessing care. The issue of healthcare disparities also affects reimbursement as it leads to low-quality scores. Nurse leaders have a role in addressing healthcare disparities in their care settings and through policy Economics And Quality Health Issues Essay Paper