The health care organizations are constantly looking for strategies to address and prevent the challenges confronting the health care reforms. Managed care is health insurance that contracts with particular healthcare providers to reduce the costs of services to the members who are the patients. In essence, the health insurance company and the providers such as nurses and specialists formulate a legal document that the provider accepts to provide specific services to the patients at a reduced cost (Mohammed et al., 2016). The key reform factors that I believe will need to be addressed by future health care leaders and workers are the cost of care and hospital readmission rates. The cost of care in the U.S health system is rising. The increase in healthcare costs is attributed to the advancement in technology, U.S aging population, and low number of general physicians as the number of specialties increase hence inadequate primary care providers. They need to focus on cost-containment measures such as integration of health information technology in health care. Another key reform factor is prevention of hospital readmission rates. The reasons hospital and health system leaders should be concerned with driving down preventable readmissions are clear (Zuckerman et al., 2016). Under healthcare reform, healthcare providers with high levels of preventable readmissions face the potential of losing a portion of their federal payments. It is critical hospitals identify which patient populations are at increased risk of hospital readmissions to target specific patients (Ody et al., 2019). This will help in initiative strategic measures for preventing hospital readmissions.
Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., & Murad, M. H. (2016). Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. American Journal of Medical Quality, 31(1), 12-21.
Ody, C., Msall, L., Dafny, L. S., Grabowski, D. C., & Cutler, D. M. (2019). Decreases in readmissions credited to Medicare’s program to reduce hospital readmissions have been overstated. Health Affairs, 38(1), 36-43.
Zuckerman, R. B., Sheingold, S. H., Orav, E. J., Ruhter, J., & Epstein, A. M. (2016). Readmissions, observation, and the hospital readmissions