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Present-day Concerns In Healthcare Industry

Concerns In Healthcare and lifestyle are interconnected aspects of our lives that are essential to our overall well-being. However, as our society evolves and progresses, new challenges and issues continue to arise.

Over the past twenty years, the Concerns In Healthcare industry has undergone major changes, and leaders in both politics and the industry have had to tackle several issues that affect the quality, accessibility, and cost of healthcare.

The COVID-19 pandemic further emphasized these challenges, with hospitals struggling to cope with the influx of patients and public health officials attempting to curb the spread of the virus.

Concerns In Healthcare are complicated and multifaceted, as evidenced by the pandemic. Those interested in resolving these issues through healthcare administration may pursue graduate studies. Let us discuss some of the current issues in the healthcare industry, its impact on individuals and society, and potential solutions.

High Healthcare Costs

The current most crucial Concerns In Healthcare is the exorbitant cost of care. According to a survey by the Kaiser Family Foundation, over 45% of American adults find it challenging to afford healthcare, and more than 40% are burdened with medical debt.

The high cost of healthcare is causing individuals to alter their behavior, with many avoiding doctor visits when they feel unwell or completely neglecting preventive health checkups.

Additionally, 25% of Americans cannot afford necessary medication, leading to skipped doses or non-compliance with prescription instructions. These behaviors can result in severe health complications, leading to even higher healthcare expenses in the future.

Why is the cost of healthcare so high?

Adopting electronic health records (EHRs) and electronic medical records (EMRs) in healthcare has brought significant benefits, including increased efficiency, improved patient safety, and enhanced clinical decision-making. However, implementing and managing these systems comes at a considerable cost.

The need for resources to train and manage personnel and the cost of operations has significantly increased. The complexity of EHRs and EMRs requires a skilled workforce to operate and maintain them, adding to the financial burden of healthcare organizations.

As a result, healthcare providers face a challenging balancing act of investing in these systems while ensuring they remain financially sustainable.

Healthcare Disparities

Healthcare disparities refer to the differences in healthcare access, quality, and outcomes among different populations. These disparities can arise due to factors such as race, ethnicity, socioeconomic status, geography, and age. For example, low-income or rural people may not have access to quality healthcare services.

The healthcare industry has acknowledged the substantial disparities in health outcomes among various populations, which are not solely related to income and healthcare expenses. Social determinants of health, including an individual’s ZIP code, race and ethnicity, air and water quality, and access to education, housing, transportation, and nutritious food, considerably influence health and wellness.

Moreover, long-standing racial and social inequities have resulted in generations of poor health in certain communities. These factors collectively impact a person’s access to medical care and overall health. Treating underserved individuals during a health crisis is usually more costly, often requiring hospitalization or emergency room visits.

Preventable Medical Errors

Historically, healthcare providers in the United States have employed a fee-for-service (FFS) model. This implies that medical practitioners use established billing codes to bill for each service provided. The more services a physician offers, the more they receive compensation, which some critics argue leads to unnecessary tests and treatments.

A transition to a value-based care (VBC) system is currently underway. In VBC, Medicare and insurers compensate providers based on outcomes.

For instance, hospitals are incentivized to decrease their readmission rates, which means they focus on eliminating medical and surgical errors. Industry leaders anticipate that VBC will enhance the overall wellness of the population and reduce hospitalizations and illnesses. However, proper billing for treatment is no longer as straightforward.

To address these issues, healthcare organizations and governments focus on preventive measures, such as promoting healthy eating habits, regular physical activity, and smoking cessation. Additionally, healthcare providers are incorporating technology such as wearable fitness devices, telehealth, and digital health apps to help people manage chronic diseases.

Managing Data In Healthcare

Healthcare’s increasing dependence on data presents significant opportunities, but proper management is crucial to avoid potential issues.

According to a report in Frontiers in ICT, providers and healthcare systems generated about 80MB of data per patient annually, even before the pandemic. This data includes information from electronic health records (EHRs) and administrative data such as demographic data, addresses, insurance policy and claims data, payment records, and appointment scheduling.

One solution to this challenge is the use of artificial intelligence (AI), which is having a growing impact on healthcare delivery and administration. Artificial intelligence and machine learning can streamline simple, repetitive tasks such as patient intake and scheduling, enabling staff to focus on more complex issues and save time and money.

AI can also help anticipate staffing needs, making scheduling easier for administrators. Furthermore, doctors can use artificial intelligence to complete administrative tasks, freeing them to focus on patient care. Lastly, administrators and health insurers use big data analytics and AI to predict health risks and track and analyze disease outbreaks like COVID-19.

Lack Of Transparency

The healthcare industry in the United States is plagued by fraud and cover-ups, with upcoding being a major problem.

Providers engage in upcoding by using billing codes that suggest a more expensive procedure was performed than what was actually done, resulting in higher reimbursements from insurance companies. This practice creates a tug-of-war between providers and insurance companies, with policyholders caught in the middle.

While providers benefit from increased payments, insurance companies may charge higher premiums to employers, and consumers ultimately bear the brunt of the financial burden. This system disadvantages consumers, with little control over healthcare outcomes and pricing. Efforts to combat upcoding and fraud are crucial for improving the integrity of the US healthcare system.

Conclusion

The healthcare industry faces numerous challenges that require innovative solutions to ensure accessible, affordable and high-quality care for all.

Healthcare providers and policymakers must prioritize addressing the current issues in healthcare to enhance health outcomes and promote well-being. Acknowledging and tackling these challenges can create a healthier society for future generations.

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