Discussion: Keeping Costs Under Control

Keep costs under control, reduce spending, and provide quality care: These could be the tenets for any healthcare provider. Oftentimes, when you discuss finances in a healthcare setting, you might focus on spending and keeping costs within your budget while putting quality in the backseat to other goals. Value-driven healthcare and quality measures in healthcare should not be conflicting ideas. The largest organizations responsible for paying providers for care are Medicare and Medicaid, and, like many other organizations, they want to spend less while still providing excellent care. This can be challenging as more and more emphasis is placed on spending.

While these two ideas are not in direct opposition, how decisions about spending are made based on these two perspectives can be very different. Value-driven healthcare strives to create a direct relationship of quality to reimbursement, while quality measurement in healthcare works to improve health through efficiency and utilization of resources. As a provider of healthcare, these two ideas drive financial decisions such as cost control and risk in relation to quality of care and quality measures.

In this week’s Discussion, choose one of the two perspectives to discuss. After posting on your perspective, you will respond to at least two colleagues, one of whom chose a different perspective.

To Prepare:

• Select one of two perspectives to address in this Discussion:
  • Value-driven healthcare
  • Measuring care for traditional fee-for-service
• Locate an organization that is implementing an initiative to address the perspective that you chose.
• Review the Resources for this week and consider the relationship between costs, patient outcomes, and care transitions as it relates to the perspective you chose.
• Reflect on how the perspective may impact cost reduction and the challenge for maintaining healthcare quality.

By Day 4

Post a comprehensive response to the following:

• Identify the perspective that you chose (either value-driven healthcare or measuring care for traditional fee-for-service in healthcare)
• Identify the organization that you found that is implementing an initiative relating to the selected perspective
• Summarize the initiative, including all policies and procedures that stem from it
• Explain how this initiative will impact cost control and quality of care within the organization
• Explain how risk and uncertainty should be factored into cost-control decisions in healthcare

include references.