Moana is a newly appointed quality reporting analyst for a Northeast Accountable Care Organization (ACO). Her director tells her that the U.S. health care system is going through a quality revolution. The drivers of this movement are years of proposed, failed, and enacted legislation; many regulatory agencies lobbying for change; and the myriad of quality initiatives implemented before and after the Affordable Care Act. Other influences in this trend are Medicare, Medicaid, employer groups, and the managed care markets’ drive to improve quality and reduce costs. The beneficiaries of these plans—patients—want transparency of their services in regard to quality, safety, and cost.
To achieve these desired health service outcomes, private and public health systems work in tandem to reduce the burden of disease and increase quality, while managing costs. They do this through programs such as Vaccines for Children (VFC) and Women, Infants, and Children (WIC), the Substance Abuse and Mental Health Services Administration (SAMHSA), Healthy People (1990–2030), Program of All-inclusive Care for the Elderly (PACE), and many more. Moana’s director shares with her that all of these private–public health programs and initiatives, in addition to the significant advancements in medical education, research, and technologies, have led to one of the most highly regulated industries in the United States and the world today.
In this assessment, you will review the private and public health legislation, regulatory agencies, and quality initiatives that have catapulted the United States into the quality revolution that we are experiencing today. As this quality revolution continues, health care professionals can expect to see more innovations contributing to individual patient and population health quality initiatives, with many more regulations to come.
Scenario
You are a health care educator for a large integrated accountable care organization (ACO). You are tasked to work with a group of hospital executives to identify milestone events for three eras, the 1800s, 1900s, and 2000s, and identify trends from those events that impacted the health care industry. The trend analysis will consist of three critical measures: access, quality, and costs. Milestone events and trends identified for these three measures over time should include legislation, regulatory agencies, and quality initiatives in the various time periods. The final paper will be used in an annual strategic planning session attended by the ACO and hospital executives to demonstrate how the quality movement has evolved into a quality revolution.
Instructions
Write a 2–3 page paper in which you explain and analyze health care regulations and medical practice evolutionary changes for access, quality, and cost, including the significant milestone events from different time periods.
Complete the following:
Additional Requirements
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Use the scoring guide to understand how your assessment will be evaluated.
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