The NQS And ARRA

The NQS And ARRA

The American Recovery and Reinvestment Act (ARRA) of 2009 is an economic stimulus bill explicitly implemented to aid the recovery of the U.S. economy. The Act was enacted in 2009 by Congress following the 2007 economic downturn. $787 billion is allocated by the ARRA to fund tax cuts and supplement social welfare programs, including increasing spending for healthcare, infrastructure, education, and energy sectors. One of the ARRA statement purposes for the healthcare industry is to provide investments needed to increase economic efficiency by spurring technological advances in science and health. The other three purpose statements that indirectly but can be linked to healthcare are: To assist those most impacted by the recession; To invest in transportation, environmental protection, and other infrastructure that will provide long-term economic benefits; and To stabilize State and local government budgets, to minimize and avoid reductions in essential services and counterproductive State and local tax increases (Rouse, 2018).

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The NQS Priorities

The National Quality Strategy’s six priorities address several quality concerns. These six quality priorities are patient safety, person and family-centered care, care coordination, healthy living, and care affordability (Nash et al., 2012). Funds allocated to the healthcare industry under the ARRA are expected to expand service to existing services and improve the quality of healthcare that supports better patient outcomes. In other words, funds should be put into meaningful use that directly impacts patient outcomes through enhanced service provision. The elements of meaningful use should improve care coordination, promote health information exchange, and improve data used for secondary purposes such as public health reporting and quality.

Patient safety: Hospital Acquired Infections and other harmful complications acquired from ambulatory care delivery are still common in healthcare settings. Preventing medical errors saves lives and lowers the cost of care delivery. Funding for new technology that can decrease medical errors is an area that the Act directly impacts. For example, healthcare facilities in rural areas can request telemedicine funding, as exemplified by the Eastern Montana Telemedicine Network, which utilizes two-way interactive video conferencing to deliver specialty care. This specialty care is dispersed to ten geographically isolated rural eastern Montana communities (Holloway et al., 2011).

Person and Family-Centered Care: This kind of care ensures that every person and their family members are engaged as partners in patient care delivery. Clinical syndromes’ resolution defines success and whether the desired outcomes are achieved. The family circumstances should align with the patient’s care needs and the different social backgrounds, health literacy levels, disabilities, and languages. Disparities per income, race/ethnicity are shared among low-income people and Hispanics when receiving patient-centered care. Care that is respectful and effective is at the core of person-centered care. Healthcare facilities may opt to hire language interpreters to better communicate with patients. While applying for funding, such a healthcare facility will need to specify the average number of ethnic patients it serves, the population number in the area the hospital is located, the cost the hospital incurs from wrongful medication/treatment resulting from language barrier/miscommunication, and the projected cost savings it would make if it would hire language interpreters and outreach social/healthcare workers who would visit with the locals and follow up on their treatments (Blay et al., 2018).

Care Coordination: Navigating the healthcare system of today is a complicated matter as patients often interact with several physicians, medical assistants, and nurses, among others, across several healthcare settings. This is more so for persons with chronic illnesses. Close to 50 percent of Medicare beneficiaries have more than six chronic illnesses and visit more than 13 physicians annually. Thus, healthcare providers need to coordinate these services to reduce medication errors, repetitive or unnecessary diagnostic tests, unnecessary visits to the E.R., and preventable admissions/readmissions to hospitals to lower costs, improve health outcomes, and lead to high healthcare quality. Technology that links all medical facilities within a city or county can significantly enhance communication and coordination, resulting in better service delivery. Municipalities/counties can get ARRA funding to set up such an H.C. Information Technology system and train staff on how to use it within the different facilities in the municipality or county (Conway et al., 2016).

Effective Prevention and Treatment: Small number of chronic illnesses tends to affect large population numbers in addition to accounting for the most significant percentage of expenditures and deaths. For example, heart disease has been the leading cause of death in the U.S. for several decades (Robert Wood Johnson Foundation, 2013). Improving care needs should focus on the prevention and treatment of the disease. By establishing a health partnership funded by the ARRA, more affordable care can be delivered to address leading causes of mortality and morbidity in counties. The partnership can publish scores on care quality, particularly cardiovascular diseases and diabetes, paid in primary care practices and providers in health systems within a county and perhaps adjacent counties. One such successful healthcare partnership is the Better Health Partnership which operates in Cuyahoga County in northeast Ohio (Advisory Board, 2018; Better Health Partnership, 2019).

Healthy Living: The U.S. spends more than other countries on its healthcare system, yet its citizens are the most petite compared to other developed countries. Most chronic conditions (which account for 70 percent of the country’s mortality, 45 percent of Americans are diagnosed with chronic illnesses, and 75 percent of the healthcare spending goes to the treatment of the same) are linked to unhealthy lifestyles, environmental hazards, and social support networks that are weak. The ARRA funding on public health can improve access to preventive care for higher-need and lower-income communities. This can reduce the economic and personal burden of chronic illnesses, create healthier communities, and improve the quality of life while simultaneously reducing disparities among Americans (Davis et al., 2014)

Care Affordability: Health expenditure has continued to grow in the U.S., which has increased household and business budgets, among others. Fee-for-service payments reward provides for the quantity rather than the quality of care, which comprises the patient outcomes and results in higher costs. The care delivery and current payment needs to be reformed to address these and other related problems to reduce cost and increase population health and quality of care. Counties should look into creating coalitions of healthcare providers within their jurisdiction and form an organization funded by ARRA. The section within a county will analyze health information data and assign high-utilizing patients to a care management team responsible for coordinating visits, reviewing medications, and arranging post-discharge primary care and patient home visits. This will effectively drop the monthly and annual medical costs. An example of a successful coalition is the Camden Coalition of Healthcare Providers in New Jersey. The non-profit organization addresses social barriers to well-being, health, and chronic illnesses within the State of New Jersey (Camden Health Org., 2019).

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References

Advisory Board (2011). How the Better Health Partnership prevented 6,000 hospitalizations and saved nearly $40M. https://www.advisory.com/daily-briefing/2018/06/05/better-health-partnership

Better Health Partnership (2019). https://betterhealthpartnership.org/

Blay, N., Ioannou, S., Seremetkoska, M., Morris, J., Holters, G., Thomas, V., & Bronwyn, E. (2018). Healthcare interpreter utilization: analysis of health administrative data. BMC health services research, 18(1), 348. doi:10.1186/s12913-018-3135-5

Camden Health Org., (2019). Camden Coalition: About. https://www.camdenhealth.org/about/

Conway, P., Favet, H., Hall, L., Uhrich, J., Palche, J., Olimb, S., … Bianco, J. (2016). Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs. Journal of health care for the Poor and Underserved, 27(4A), 91–115. doi:10.1353/hpu.2016.0181

Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014). Mirror, mirror on the wall. How the performance of the U.S. The health care system compares internationally. New York: Commonwealth Fund.

Holloway, B., Coon, P. J., Kersten, D. W., & Clemens, E. L. (2011). Telehealth in rural Montana: promoting realistic independent self-management of diabetes. Diabetes Spectrum, 24(1), 50-54

Nash, D. B., Clarke, J. L., Skoufalos, A., & Horowitz, M. (2012). Health care quality: The clinician’s primer.

Robert Wood Johnson Foundation, ( 2013). Return on Investments in Public Health: Saving Lives and Money. Policy Highlight Brief. Washington, DC: Robert Wood Johnson Foundation; December 2013.

Rouse, M. (2018). ARRA (American Recovery and Reinvestment Act of 2009). https://whatis.techtarget.com/definition/ARRA-American-Recovery-and-Reinvestment-Act-of-2009

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 Session 4 Assignment

I need help writing a paper for Session 4 in my Quality & Performance Improvement class.

The suggested readings for the assignment are below. Also, I attached Session 4 Topic preview to give you an idea of what the topic is for the paper.

 

The professor asked me to write a 3-page APA paper (not including a cover page and references) on the six priorities of the NQS and what that means in a healthcare setting.  Specifically, apply this to the ARRA and the meaningful use requirements for H.C. organizations. Thank you.

Assignment Reading:

Nash, D. B., Clarke, J. L., Skoufalos, A., & Horowitz, M. (2012). Health care quality: The clinician’s primer.

• Chapters 19-21

Harvard Business Review (2011). Harvard Business review on fixing the healthcare from the inside & out. Pages 133-220

Topic: Using Health Care Informatics, Involving the Public and Community Perspectives

This session provides an in-depth look at the H.C. informatics processes and what they offer the public and the H.C. organization. You will explore the government’s involvement in creating an American Recovery and Reinvestment Act (ARRA) to financially support the expansion of electronic medical records (EMRs) throughout the U.S. and how it would be used for building quality data practices in all types of settings. Barriers and strengths to such a system are discussed.

Topic Outcomes:

By the end of this session, students will be able to answer the following questions:

• What is the impact of using current Informatics on quality improvements in patient care?
• What are the governance structures for leading and guiding health informatics projects?
• What is the impact of the American Recovery and Reinvestment Act (ARRA) stimulus money (Meaningful Use Requirements) on electronic medical record (EMR) systems in H.C.?
• What are some of the major factors driving current healthcare reform?
• What are some of the critical organizations influencing the supporting ACA legislation?
• How are organizations using readmission rates for quality measurement?
• What are the six priorities of the National Quality Strategy (NQS)?
• What is the ultimate goal of the health care delivery system?
• How does the community context add to the healthcare encounters?
• Who are the key community stakeholders?
• What are healthcare delivery opportunities that can improve the population’s health?
• How do social determinants of health impact overall health?