NHS FPX 6008 Assessment 3 Business Case for Change
Phillip September 30, 2023 No Comments

NHS FPX 6008 Assessment 3 Business Case for Change

NHS FPX 6008 Assessment 3 Business Case for Change

Student Name

Capella University

NHS-FPX 6008 Economics and Decision Making in Health Care

Prof. Name

Date

The Problem and the Potential Impact of the Healthcare Economic Issue

The healthcare economic issue is a pressing concern that affects all, including healthcare providers, organizations, and communities. From individuals to organizations, and even the larger community, the lack of affordable healthcare insurance can have a significant impact on their lives. It is not just about the rising healthcare costs or the financial burden on individuals but also the larger implications of this issue on their overall health and productivity (McKinsey, 2022).

As an individual, I face the risk of financial strain and limited access to healthcare services without proper insurance coverage. For organizations, it can lead to increased healthcare costs and decreased productivity, with patients missing care due to illness or seeking costly emergency care. Meanwhile, due to a lack of preventive care, the community may experience the spread of infectious diseases, reduced economic productivity, and increased healthcare costs.

As an individual, not having proper insurance coverage can lead to financial strain and limited access to healthcare services in a few ways (Peng & Zhu, 2021). For example, without insurance coverage, individuals may have to pay for healthcare services out of their own pocket. This can be costly, especially for those who require ongoing care or have a chronic condition. As a result, individuals may delay or skip necessary medical care, which can lead to more serious health problems down the line (Peng & Zhu, 2021). 

NHS FPX 6008 Assessment 3 Business Case for Change

Organizations may have to bear the cost of providing healthcare services to uninsured individuals, which can be expensive. This can increase healthcare costs for the organization and may result in higher employee insurance premiums (Karpman et al., 2021). 

Decreased productivity: Employees who do not have insurance coverage may be more likely to miss work due to illness or to seek costly emergency care. This can lead to decreased productivity and increased absenteeism, which can have a negative impact on the organization’s bottom line.

According to the Economic and Social Impacts and Benefits of Health Systems Report by the World Health Organization (WHO), the impact of the healthcare economic issue is undeniable, and addressing it is crucial to ensure the well-being of everyone in society. The health organization can improve access to essential healthcare services, reduce healthcare costs, and boost productivity by providing affordable healthcare insurance. It is time to take action and ensure everyone can access affordable healthcare coverage, regardless of income or social status (WHO, 2019). So, let us keep listening and exploring ways to tackle this issue head-on as we work towards building a healthier and more equitable society for all.

Feasibility and Cost-Benefit Analysis

The healthcare economic issue of accessing affordable healthcare insurance is a complex challenge that requires careful consideration of feasibility and cost-benefit analysis.

Feasibility considerations: The feasibility of implementing affordable healthcare insurance depends on various factors, such as the current political climate, economic conditions, and the availability of resources (Illinois Government, 2021). For example, the Affordable Care Act (ACA) was designed to address this issue by expanding access to healthcare insurance, but its implementation faced significant political opposition and implementation challenges in some states (Campbell & Shore-Sheppard, 2020).

Cost-benefit considerations: Implementing affordable healthcare insurance requires a significant investment of resources, but the long-term benefits of reducing healthcare costs and improving health outcomes are substantial (King, 2020). A study shows that the aggregate annual cost of uncompensated care provided to uninsured individuals dropped by a third following implementation of the ACA’s coverage provisions, from an average of $62.8 billion per year in 2011-2013 to $42.4 billion in 2015-2017. The cost of implicitly subsidized uncompensated care or care with no payment source, including a non-health insurance source, dropped from $21.6 billion to $15.1 billion per year on average before and after the ACA, respectively (Karpman et al., 2021). The study also found that the ACA led to increased preventive care services, which can result in long-term cost savings by reducing the need for expensive medical treatments.

Mitigating Risks to Financial Security

To mitigate risks to the financial security of healthcare organizations or settings, below are three potential strategies to adopt:

Improve cost management: Healthcare organizations can implement strategies to manage costs more effectively, such as negotiating lower prices for medical services and supplies or increasing efficiency in healthcare delivery. This can help reduce financial strain and improve the organization’s sustainability (Sturmberg & Bircher, 2019).

Diversify revenue streams: Healthcare organizations can explore alternative sources of revenue, such as grants or partnerships with other healthcare providers. This can provide a more stable financial base and reduce reliance on fee-for-service models (Kosala & Heengama, 2019).

Implement risk management strategies: Healthcare organizations can develop and implement risk management strategies to identify and address potential financial risks (Auditboard, 2021). For example, developing contingency plans for unexpected events such as pandemics or natural disasters can help organizations manage financial risks more effectively.

Evidence-Based Research to Support Strategies

Evidence-based research and scholarly sources support the proposed strategies. For example, a study published in the Journal of Healthcare Finance found that cost management strategies, such as supply chain optimization, can help improve financial performance in healthcare organizations (Truong, 2022). Another Journal of Healthcare Management study found that diversifying revenue streams can help reduce financial vulnerability and improve financial sustainability (Carney, 2020). Finally, a report by the Agency for Healthcare Research and Quality (2022) provides guidance on developing and implementing risk management strategies in healthcare organizations (Sturmberg & Bircher, 2019).

In conclusion, addressing the healthcare economic issue of accessing affordable healthcare insurance requires careful consideration of feasibility and cost-benefit analysis. Implementing affordable healthcare insurance can have significant long-term benefits, but mitigating financial risks requires improving cost management, diversifying revenue streams, and implementing risk management strategies. Evidence-based research and scholarly sources provide valuable insights to inform these strategies.

Affordable Healthcare Insurance Solution

Several changes and solutions can be implemented to address the economic issue of accessing affordable healthcare insurance.

Expanding Medicaid: Expanding Medicaid to cover individuals and families who are not eligible. Expanding Medicaid has improved access to healthcare services, reduced healthcare costs, and improved health outcomes for low-income individuals and families. According to a study published in the New England Journal of Medicine, states that expanded Medicaid saw a significant reduction in uninsured rates and improved access to care for low-income populations (Graves et al., 2020).

Implementing a Public Option: A public option for healthcare insurance is another solution allowing individuals to purchase affordable insurance plans through a government-run program. A public option can potentially increase competition in the healthcare insurance market, improve access to affordable insurance, and reduce healthcare costs (Rapfogel & Calsyn, 2021).

Addressing Prescription Drug Costs: Addressing the high cost of prescription drugs is another solution that can help reduce healthcare costs and improve access to essential medications. This can be done by implementing price transparency measures, allowing for importing lower-cost drugs from other countries, and regulating pharmaceutical companies to prevent price gouging. According to a report by the Kaiser Family Foundation (KFF) (2019), high prescription drug costs are a significant burden on patients and healthcare systems, and addressing this issue can lead to significant cost savings.

Implementation of the Provided Solution and Potential Benefits

Implementing these solutions can significantly benefit organizations, colleagues, and the community. For organizations, implementing these solutions can help reduce healthcare costs, improve the health and productivity of employees, and improve financial stability. Implementing these solutions for colleagues and the community can improve access to essential healthcare services, reduce financial strain, and improve overall health outcomes.

In conclusion, implementing solutions such as expanding Medicaid, implementing a public option, and addressing prescription drug costs can help address the economic issue of accessing affordable healthcare insurance. These solutions can potentially benefit organizations, colleagues, and the community by reducing healthcare costs, improving access to essential healthcare services, and improving overall health outcomes. Evidence-based research and scholarly sources provide valuable insights to inform these solutions.

Solutions Addressing Cultural and Ethical Considerations

When proposing a solution to address the economic issue of accessing affordable healthcare insurance, it is essential to ensure that the solution is culturally sensitive, ethical, and equitable within the context of the community and healthcare setting in which it will be implemented.

Firstly, cultural sensitivity is important because healthcare practices and beliefs can vary significantly across different cultures and communities. The proposed solution should be developed with an understanding of the cultural values and beliefs of the community it will serve (Georgetown University, 2019). For example, when implementing a public option for healthcare insurance, it is important to consider how the program will be marketed and communicated to the community to ensure that it is accessible and culturally appropriate.

Secondly, ethical considerations are critical when implementing any healthcare solution. The proposed solution should not unfairly burden or disadvantage any specific groups within the community. For example, when expanding Medicaid, it is important to consider how it will impact vulnerable populations, such as those with disabilities or chronic health conditions. Ethical considerations will also be applied to patient privacy and confidentiality, informed consent, and patient autonomy.

NHS FPX 6008 Assessment 3 Business Case for Change

Finally, ensuring that both access and cost are equitable across all groups in the community is essential for promoting health equity (Nall, 2020). The proposed solution will ensure that everyone in the community has access to essential healthcare services and that healthcare costs are not prohibitively expensive. For example, when implementing a public option for healthcare insurance, it will be ensured that the premiums and deductibles are affordable for low-income families and individuals.

In conclusion, ensuring that the proposed solution to address the economic issue of accessing affordable healthcare insurance is culturally sensitive, ethical, and equitable within the context of the community and healthcare setting in which it will be implemented is important. This means considering cultural values and beliefs, ensuring ethical considerations are met, and ensuring that access and cost are equitable across all groups in the community. By doing so, we can promote health equity and improve access to essential healthcare services for all community members.

Conclusion

The economic issue of accessing affordable healthcare insurance is a complex and multifaceted problem that has far-reaching impacts on individuals, organizations, and communities at large. To address this issue, it is essential to consider a range of factors, including the feasibility and cost-benefit considerations of potential solutions, the potential benefits of implementation, and the cultural, ethical, and equitable implications of any proposed changes. By taking a comprehensive and evidence-based approach to addressing this issue, we can promote health equity and improve access to essential healthcare services for all community members.

References

Agency for Healthcare Research and Quality. (2021). Developing and implementing a risk management plan: AHRQ patient safety network. AHRQ.gov. https://psnet.ahrq.gov/primer/developing-and-implementing-risk-management-plan 

Auditboard. (2021, February 18). 10 Types of risk management strategies to follow in 2021. Www.auditboard.com. https://www.auditboard.com/blog/10-risk-management-strategies-2021/ 

Campbell, A. L., & Shore-Sheppard, L. (2020). The social, political, and economic effects of the Affordable Care Act: Introduction to the issue. RSF: The Russell Sage Foundation Journal of the Social Sciences, 6(2), 1–40. https://www.jstor.org/stable/10.7758/rsf.2020.6.2.01

Carney, K. J. L. (2020). Practitioner application. Journal of healthcare management, 65(1), 71–72. https://doi.org/10.1097/jhm-d-19-00237 

Georgetown University. (2019). Cultural competence in health care: Is it important for people with chronic conditions? – Health Policy Institute. Health Policy Institute; GeorgeTown University. https://hpi.georgetown.edu/cultural/ 

Graves, J. A., Hatfield, L. A., Blot, W., Keating, N. L., & McWilliams, J. M. (2020). Medicaid expansion slowed rates of health decline for low-income adults in Southern States. Health affairs, 39(1), 67–76. https://doi.org/10.1377/hlthaff.2019.00929 

NHS FPX 6008 Assessment 3 Business Case for Change

Illinois Government. (2021). Feasibility report for coverage affordability initiatives in Illinois. Illinois.gov. https://www2.illinois.gov/hfs/SiteCollectionDocuments/04022021FeasibilityStudyReportFinal.pdf 

Karpman, M., Coughlin, T. A., & 2021. (2021, April 6). Declines in uncompensated care costs for the uninsured under the ACA and implications of recent growth in the uninsured rate. KFF. https://www.kff.org/uninsured/issue-brief/declines-in-uncompensated-care-costs-for-the-uninsured-under-the-aca-and-implications-of-recent-growth-in-the-uninsured-rate/ 

KFF. (2019, March 15). KFF Health Tracking Poll – February 2019: Prescription Drugs. The Henry J. Kaiser Family Foundation. https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-february-2019-prescription-drugs/ 

King, J. S. (2020). Covid-19 and the need for health care reform. New England Journal of Medicine, 382(26). https://doi.org/10.1056/nejmp2000821 

Kosala, G., & Heengama, B. (2019). Scholar works revenue diversification to improve and maintain service offerings of nonprofit organizations part of the finance and financial management commons, and the organizational behavior and theory commons. Walden University. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=8509&context=dissertations 

McKinsey. (2022). Transformative impact of inflation on the healthcare sector | McKinsey. Www.mckinsey.com. https://www.mckinsey.com/industries/healthcare/our-insights/the-gathering-storm-the-transformative-impact-of-inflation-on-the-healthcare-sector

Nall, R. (2020, September 8). Health equity: Definition, examples, and action. Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/health-equity

Peng, Z., & Zhu, L. (2021). The impacts of health insurance on financial strain for people with chronic diseases. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11075-2

Rapfogel, N., & Calsyn, M. (2021, May 5). Public options will improve health equity across the country. Center for American Progress. https://www.americanprogress.org/article/public-options-will-improve-health-equity-across-country/ 

NHS FPX 6008 Assessment 3 Business Case for Change

Sturmberg, J. P., & Bircher, J. (2019). Better and fulfilling healthcare at lower costs: The need to manage health systems as complex adaptive systems. F1000Research, 8, 789. https://doi.org/10.12688/f1000research.19414.1 

Truong, H., Yee, T., & Tu, D. (2022). The impact of cost management strategies on financial performance in healthcare organizations. Journal of Healthcare Finance, 49(2), 1-15. https://journals.lww.com/journalhealthcarefinance/Abstract/2022/03000/The_Impact_of_Cost_Management_Strategies_on.2.aspx 

WHO. (2019). Economic and social impacts and benefits of health systems report. Who.int. https://apps.who.int/iris/bitstream/handle/10665/329683/9789289053952-eng.pdf 

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