HEALTHCARE COSTS AND QUALITY CARE 5
involves paying for treatment atan affordable rate for the quality health care. It entails not overspending money on unnecessary treatments or tests for the benefit ofhealth facilities but fair medical costs that are not overly priced.Health care costs and quality of care remain a controversial issue asthe cost of health care at times does not match the quality of healthcare given. Young and Kikham (2013) reported that when a patientwalks into New Jersey’s Bayonne Hospital center requiring arespiratory ailment treatment also referred to as COPD (chronicobstructive pulmonary disease) they face an official price charge of$99,690. A few miles from New Jersey is the Lincoln medical andmental health facility that charges $7,044 for a similar COPDtreatment. The reports compiled by the federal database for nationalhealth care costs are a reflection of what happens in New Jersey.
There is a need to investigate the roles of private and publicagencies in addressing cost and the quality of healthcare, following the escalating health care costs which contrast with the quality ofcare . Health care agencies play an imperative role in controllingthe costs of health as well as improving the quality of care so thatpatients pay for treatment that they deserve fairly.
Health care differs in private and public agencies. The roles andmajor activities in public and private agencies in terms of how theyaddress cost and health care is a result of various factors. Twoagencies will be compared to shed light on addressing cost and healthcare in New Jersey. New Jersey Family care and New Jersey home healthcare agencies are two different health care provider agencies thatare involved in major activities of addressing quality and cost inhealth care. NJFC is a state funded health insurance agency thathelps uninsured children have affordable health coverage (NJFC,2015). It is a public agency that supports hardworking families whoare unable to afford privately paid high costs of health insurance.The eligibility for NJFC public agency cover for a family’s healthneeds are family size and the monthly income. Home health careClifton New Jersey is a private agency providing home care,preventive, rehabilitative and therapeutic services (Home health careagencies, 2015). Its private home care duties include personal careand helping with activities like skilled nursing, physical oroccupational therapy.
Current and projected initiatives to improve quality whilesimultaneously controlling costs in the public initiatives like NJFChave been offering a comprehensive health insurance that providesmany children with health care needs. Their services includepreventive health care, emergency care, physician services, inpatientand outpatient services, lab services, eyeglasses, dental services,mental health services and prescription of drugs amongst other needsthat children need. The charges for this agency range from ahousehold size of one to eight with charges per annum from $40,845 to$140,135 for eight (NJFC, 2015). According to Genworth financialcosts of 2012, the average hourly rate for New Jersey health carewere $19.5. This rate is said to be lower than the neighboringstates. They provide all home care services including nursing, homehealth-aide and physical therapy. The public and private agencydiffer in terms of cost and services.
Implications for staff, nurses and advanced practice nursesincluding evidence-based practice relative to cost and quality arelisted as crucial for cost reduction in health care. According toDeNisco and Barker (2013), advancedpractice nursing is the intervention by any form of nursinginfluencing health care outcomes for individuals such as patients orthe management of care, administration of health organizations andthe implementation of health policy.Reducing the costs of health care and improving the quality ofcare requires coordinated efforts from the public and privateagencies. Cost cutting efforts on the federal or public level havebeen evident through the Patient protection act of 2010, the largestattempt to reform healthcare since 1965(DeNisco & Barker, 2013). .This law put the federal government at the center of cost cuttingtrying to compare expensive treatment and the quality of caredelivered. The implementation of health insurance private agencies isanother strategy of cutting costs in health care through loweringexpenses and premiums. The lowering of premiums reduces expensesthrough accessibility, promoting transparency, accountability,competition and giving the government oversight. New Jersey andNevada are restructuring their health care costs through Medicaid toreduce costs and channeling medical treatment into more costefficient care programs.
Private sectors have the greatest potential to cut down health carecosts. They can implement strategies like computerizing patientinformation to decrease redundant and unnecessary tests assertsMcClellan and Rivlin (2013). Such strategies are useful in minimizingerrors and decreasing pharmacy mistakes as well as reducing thenumber of patient visits to the hospital. Evidence based protocolsthat avoid unnecessary treatments, testing, procedures and diagnostictesting are also crucial in improving health care costs. Privateagencies can ensure that physicians receive a fixed salary to reduceexpenses like fee for service incentive and order more tests andprocedures. They can also choose to focus on preventive services forpatients as it cuts down expenses largely. Insurance companies lowercosts through focusing on primary care and ensuring that preventiveservices are provided. Such services decrease unnecessary readmissionrates, days spent in hospital and unnecessary trips to the hospital.
DeNisco, S., & Barker, A. M.(2013). Advancedpractice nursing: Evolving roles for the transformation of theprofession. Burlington,Mass: Jones & Bartlett Learning
McClellan, M. and Rivlin, A. (2013). Improving health whilereducing cost growth: What is possible? The future of US Healthcare spending conference, Health care reform at Brookings, Engelberg center Washington DC Retrieved from http://www.brookings.edu/~/media/events/2014/04/11-health-care- spending/improving_health_reducing_cost_growth_mcclellan_rivlin.pdf
NJFC. (2015).New Jersey Family Care, benefits.gov retrievedfrom http://www.benefits.gov/benefits/benefit-details/1315
New Jersey home health care agencies. (2015). Home health careagency, retrieved from http://www.homehealthcareagencies.com/directory/nj/
Young, J. &Kirkham, C.(2013). Hospital prices no longersecret…Huffpost Business, edition US fromhttp://www.huffingtonpost.com/2013/05/08/hospital-prices-cost- differences_n_3232678.html