The NQS And ARRA
The American Recovery and Reinvestment Act (ARRA) of 2009 is an economic stimulus bill that was implemented specifically to aid the recovery of the US 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 as well as supplement social welfare programs, including increasing spending for healthcare, infrastructure, education, and energy sectors. With regard to the healthcare industry, one of the ARRA statement purposes 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, in order to minimize and avoid reductions in essential services and counterproductive State and local tax increases (Rouse, 2018).
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 be used 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 improved service provision. The elements of meaningful use ought to improve care coordination, promote the exchange of health information, 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 in the delivery of 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 the care delivery of the patient. Clinical syndromes’ resolution defines success and whether the desired outcomes are achieved. The family circumstances should align with the patient care needs and the different social backgrounds, health literacy levels, disabilities, and languages. Disparities per income, race/ethnicity are common among the poor and Hispanics when it comes to 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 6 chronic illnesses and visit more than 13 physicians per annum. Thus, healthcare providers need to coordinate these services to reduce medication errors, repetitive or unnecessary diagnostic tests, unnecessary visits to the ER, 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 greatly improve communication and coordination, which will result in better service delivery. Municipalities/counties can get ARRA funding to set up such an HC Information Technology system in place and also 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 largest percentage of expenditures and deaths. For example, heart disease has been the leading cause of death in the US for the last 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, delivered in primary care practices and providers in health systems within a county and perhaps adjacent counties. One such successful health care partnership is the Better Health Partnership which operates in Cuyahoga County in northeast Ohio (Advisory Board, 2018; Better Health Partnership, 2019).
Healthy Living: The US spends more than other countries in the world in its healthcare system, yet its citizens are the least healthy 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 communities that are healthier, and improve the quality of life while simultaneously reducing disparities among Americans (Davis et al., 2014)
Care Affordability: Health expenditure has continued to grow over the years in the US, which has resulted in an increase in household and business budgets, among others. Fee-for-service payments reward provides for the quantity rather than the quality of care provided, 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 so as 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 coalition within a county will analyze health information data and assign high-utilizing patients to a team of care management 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 located in New Jersey. The non-profit organization addresses social barriers to well-being and health as well as chronic illnesses within the State of New Jersey (Camden Health Org., 2019).
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 utilisation: 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 US Health care system compares internationally. New York: CommonWealth Fund.
Holloway, B., Coon, P. J., Kersten, D. W., & Ciemins, 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 just 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 cover page and references) on the six priorities of the NQS and what that means in a health care setting. Specifically apply this to the ARRA and the meaningful use requirements for HC organizations. Thank you.
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 HC informatics processes and what they offer the public and the HC 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 (EMR’s) 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.
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 healthinformatics projects?
- What is the impact of American Recovery and Reinvestment Act (ARRA) stimulus money (Meaningful Use Requirements) on electronic medical record (EMR) systems in HC?
- What are some of the major factors driving current health care reform?
- What are some of the key organizations influencing the supporting ACA legislation?
- How are organizations using re-admission 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 health care encounters?
- Who are the key community stakeholders?
- What are health care delivery opportunities that can improve the population health?
- How do social determinates of health impact overall health?
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