Healthcare why is it a problem

Affording healthcare is a top-of-mind issue for both insured and uninsured people, according to a Consumers Union study. Auerbach, David I. Emanuel, Ezekiel, and Victor R. Auguste, Byron G. PDF Download. The Healthcare Value Hub can help you find free, timely information about policies and practices to achieve health systems that are equitable, affordable, and focused on the goals and needs of the people the system is meant to serve.

About Contact Events Glossary. Why is this an Urgent Problem? In fact, there are several models of care delivery systems that range from practices that are not integrated to complete integration see below. At the other end of the continuum, there are larger, more coordinated and organized healthcare systems that have hospitals, doctors, and sometimes even health plans that all work together. On the other hand, healthcare systems that provide care coordination have shown success in reducing waste, increasing communication between providers, and coordinating medical services, all of which saves money, enhances quality, and creates value.

Realizing that more organized systems of care produce better quality medical outcomes, The Centers for Medicare and Medicaid Services is testing new forms of care delivery modeled after these kinds of systems, such as Accountable Care Organizations. What is an Accountable Care Organization? An Accountable Care Organization ACO is a partnership of healthcare providers who choose to work together in a way that will improve the quality, coordination and efficiency of the care they deliver to a defined group of patients.

The providers in this partnership can include primary care doctors, specialists, hospitals, therapists, and other medical professionals.

The goal of forming these kinds of relationships is to better organize the way care is delivered by removing the fragmentation and silos that exist between care providers. ACOs are now being formed around the country for people over 65 to meet the new care guidelines of Medicare, and for people who have insurance through their employers, like Blue Cross, United, Aetna, etc.

ACOs are also being formed to serve Medicaid patients in order to improve the coordination of care. The concept of ACOs was actually built on research conducted with CAPP medical groups and others that believe that organized systems of health care are better able to measure and monitor the care they deliver so that care can be continually improving and costs can be controlled.

The difference is that CAPP groups have been providing care in an organized accountable way for decades. Our organizations have pioneered this kind of medical care. Why are Accountable Care Organizations important to achieve improved cost and quality? The belief is that, if well conceived and implemented, ACOs can achieve both cost and quality improvements because the coordinated and collaborative nature of the delivery system itself is paid for and rewarded for its outcomes, not for its volume of services.

Therefore, the structure of an ACO becomes important: experts believe that ACOs must be physician-led, primary care-centered, and patient-focused systems of care.

Currently, there are many health care systems of physicians and hospitals that function like ACOs, and the research conducted on these entities support the prevailing notion. By encouraging the evolution and growth of ACOs through payment incentives and a favorable regulatory climate, ACOs may be the most promising mechanism to control costs and improve quality and access in the American healthcare system.

The ACO concept is one that has been widely discussed among health researchers and pundits. According to the Commonwealth Fund, 54 percent of health care opinion leaders believe that ACOs are an effective model for moving the U. Note that while the government focus on ACOs is within the context of Medicare, the concept applies to all patients covered by private-sector insurers that are also sponsoring such efforts.

ACOs actually contract with health plans and Medicare by agreeing to measure and report on the quality of the health care delivered. High cost is the primary reason that prevents Americans from accessing health care services. Americans with below-average incomes are much more affected, since visiting a physician when sick, getting a recommended test, or follow-up care has become unaffordable.

These patients have acknowledged the difficulty in paying medical bills and other expenditures. According to U. The availability of more expensive, state-of-the-art medical technologies and prescription drugs generate demand for more intense, costly services even if they are not necessarily cost-effective. The increased costs of medical services occur due to the rise of chronic diseases, including obesity.

Nationally, chronic illnesses contribute huge proportions to healthcare costs, particularly during end-of-life care. The National Academy of Sciences found that the U. Therefore, medical experts focus more on preventative care to improve health and reduce the financial burdens associated with chronic disease. High administrative costs are a contributing factor to the inflated costs of U.

The government outsources some of its administrative needs to private firms. The aim is to improve administrative efficiency and provide healthcare quality to the citizens.

Lack of Insurance Coverage The majority of U. In addition, average annual premiums for family coverage have increased, outpacing inflation and workers' earnings. The lack of health insurance coverage has severe consequences for the U. The Center for American Progress estimated that the lack of health insurance in the U. In addition, shortened lifespans and the loss of productivity are observed due to the reduced health of the uninsured.

Health insurance coverage is uneven; minorities and deprived families lack insurance coverage. As a result, they face more health hardships than insured Americans. Moreover, the uninsured may not seek medical care due to high costs and avoid regular health screenings. Hence, they are also likely to access preventive health services as well.

The United States Census Bureau annually reports that around