Rise In Healthcare Cost Review

Rise In Health Care Costreview The N

Review the national healthcare issue/stressor you examined in your Assignment for Module 1, (PLEASE USE THIS TOPIC-RISE IN HEALTH CARE COST). Review the analysis of the healthcare issue/stressor you selected. Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor. Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs. The Assignment (4-5 pages): Developing Organizational Policies and Practices. Add a section to the paper you submitted in Module 1. The new section should address the following: Identify and describe at least two competing needs impacting your selected healthcare issue/stressor. Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor. (PLEASE USE THIS TOPIC-RISE IN HEALTH CARE COST). Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics. Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples. Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

Paper For Above instruction

The escalating rise in healthcare costs has emerged as one of the most pressing and complex issues facing the United States' healthcare system. Addressing this issue requires a comprehensive understanding of the various factors influencing healthcare expenditures, the ethical considerations involved in policy formulation, and strategies to balance competing needs such as resource allocation, provider sustainability, and patient access to quality care. This paper reviews relevant scholarly resources and organizational policies concerning the rising healthcare costs, critically analyzes the ethical implications, and proposes actionable policy recommendations to mitigate costs while maintaining ethical integrity.

In examining the rise in healthcare costs, two dominant competing needs confront policymakers and healthcare organizations: the need to contain costs to ensure broad access and sustainability, and the necessity to provide high-quality, equitable patient care. Cost containment strategies often involve reducing expenditures, which can sometimes compromise patient outcomes or healthcare provider well-being. Conversely, prioritizing high-quality care and patient safety may lead to increased costs, challenging organizations to balance fiscal responsibility with ethical care delivery (Kelly & Porr, 2018). These competing needs underpin the ethical dilemmas faced by healthcare administrators and professionals in policy development and implementation.

To address these issues, evidence-based policies focus on efficiency and quality improvement. For instance, value-based care models incentivize providers to deliver services that improve patient outcomes while controlling costs, aligning economic incentives with ethical obligations of beneficence and non-maleficence (American Nurses Association, 2015). Another policy involves implementing health information technology systems that promote care coordination and reduce redundant testing, which can decrease unnecessary costs and improve patient safety (Milliken, 2018). Both policies exemplify efforts to reconcile cost reduction with ethical practice, emphasizing patient-centeredness, safety, and fairness.

Within organizational settings, a relevant policy impacting healthcare costs and ethical considerations is the implementation of strict utilization review protocols. These policies aim to ensure resource efficiency by evaluating the necessity of medical procedures and services (Kelly & Porr, 2018). However, ethical critiques of such policies highlight potential conflicts with patient advocacy and autonomy if used excessively to deny care. The ethical strengths of utilization review include promoting fairness and preventing unnecessary interventions, but challenges involve the risk of infringing on individual patient needs and provider judgment, raising concerns about the potential for implicit biases or cost-driven decision-making overriding clinical appropriateness.

Critiquing this policy through an ethical lens, based on the ANA Code of Ethics (American Nurses Association, 2015), reveals the importance of balancing resource stewardship with respect for patient dignity and individualized care. Provision 6 emphasizes the nurse’s role in maintaining ethical integrity when advocating for patients, even within cost constraints. Thus, policies that overly emphasize cost containment without regard for ethical principles risk undermining trust, autonomy, and beneficence. Strengthening the policy involves integrating ethical decision-making frameworks that prioritize patient-centered outcomes and transparency in resource allocation decisions.

To enhance organizational policies, I recommend adopting a balanced approach that incorporates shared decision-making with patients, transparent criteria for resource utilization, and ongoing staff training on ethical considerations in cost-related policies. For example, establishing multidisciplinary committees that review cases with high-cost interventions can ensure that ethical principles guide resource decisions, fostering equity and respect for patient preferences. Additionally, leveraging health technology assessments can identify cost-effective interventions aligned with patients' values, ensuring that cost-saving measures do not compromise quality or ethical standards. Evidence suggests that such strategies improve compliance, patient satisfaction, and ethical integrity (Milliken, 2018; Kelly & Porr, 2018).

References

  • American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/
  • Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06
  • Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01
  • Porter, M. E. (2010). What is value in health care? New England Journal of Medicine, 363(26), 2477-2481. doi:10.1056/NEJMp1011024
  • Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. JAMA, 307(14), 1513-1516. doi:10.1001/jama.2012.0469
  • Øvretveit, J. (2010). Does improving quality save money? A review of evidence of which improvements are most cost-effective. Health Economics, Policy and Law, 5(2), 269–283. doi:10.1017/S1744133109990309
  • Leatt, P., & O’Neill, D. (2009). Organizational ethics and health policy. Health Care Analysis, 17(4), 312-324. doi:10.1007/s10728-009-0098-8
  • Rajkomar, A., et al. (2019). Machine learning in medicine. New England Journal of Medicine, 380(14), 1347-1358. doi:10.1056/NEJMra1814259
  • Sullivan, T. (2017). Ethical considerations in healthcare cost containment. Journal of Healthcare Management, 62(1), 12-20. doi:10.1097/JHM-D-16-00052
  • Gostin, L. O., & Wiley, L. F. (2016). Public health law: Power, duty, restraint. University of California Press.

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