Hill Physicians Executive Summary

The U.S. Health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance.” (WHO, 2000, p. 1) Progression in the United States has not kept up with the advances in other wealthy nations dealing with the population health. Disease and chronic disability report almost 50% of America health problem (JAMA, 2013).

The health care system must change to improve our nation’s health and takes strong steps to address the unsustainable growth of health care costs in America. We still have a long way to go before our health system become effective. We still have population that do not have insurance, have difficulties accessing their health care, or their needs are not met within the healthcare system. It is an investment in prevention and wellness and increasing access to primary care physician.

Globally, the United States has one of the largest and most convoluted healthcare systems, whereas universal healthcare coverage seems extremely farfetched. Annually, the US spends over $3 trillion on healthcare. Nevertheless, we have the worst health outcomes when compared to other industrialized countries. As stated by Anja Rudiger (2008), “Recent data suggest that around 101,000 deaths a year can be attributed to the underperformance of the US healthcare system.” Thus, the United States’ healthcare system greatly relies on revenue. Both funding and the distribution of services are commercially structured and held accountable by investors to increase financial gains. According to Andrew Jameton and Jessica Pierce (1997), “the US healthcare system increasing appears to have

T.R. Reid uses cost, quality, and choice to fully evaluate healthcare systems all around the world. As an American citizen, I have always thought our system was unfair. The poor suffer more than the rich for going to see a doctor for the same reason. In chapter one of The healing of America, T.R. Reid comments on how many Americans have also started to notice that the American healthcare system is not as great as we once thought. Not only is it unfair, but it is also expensive and unsuccessful (9). By looking at all the other countries’ healthcare systems, Reid would then be able to better pinpoint how America can better its health care system by taking portions of those health systems.

According to the Garber & Skinner (2008), the United States spends more on health care than other nations but continues to score below other nations in numerous areas of measurement. These scores in, consideration with amount spent, suggest that healthcare is the United States is inefficient. Additionally, the United States has a significantly large portion of under

Though the spending has lessened in recent years ,when compared with other economically developed countries the cost of the health care in U.S is much higher and ranks poorly on quality indicators (Burke & Ryan, 2014).Evidence suggest that patient quality outcomes not generally correlated with variation spending .Beneficiaries are expected and deserved for high quality care within affordable

How can ideas such as the Triple Aim initiative and patient centeredness help to improve performance in the U.S. health system?

The effectiveness of the health care we provide at Salina Family Health Care is measured routinely. For example, there is a “health care plan” that encompasses 16 different aspects of health care that we’ve determined to be important to our patient population. For these 16 “goals” we have 34 specific interventions we’ve implemented to help us achieve these goals. We receive a monthly report of our progress toward meeting these goals which might include getting blood pressure readings below 140/90, catching women up who need a pap smear or encouraging smoking cessation in persons who smoke. This health care plan drives our practice and the feedback we receive for our efforts guide our practice daily.

Hospitals are viewed unfavorably by most patients for the elevated (and often surprise) costs, care quality, and their lack of follow up to the provided care. “Who could feel sympathy for a billion-dollar corporation?” (Gunderman, 2013). Our payor-driven (as opposed to consumer-driven) health system has resulted in inflated costs, increased waste, and a race where executives continuously search for ways to increase their revenue share to stay relevant in market size, instead of improving patient care quality. Unfortunately, the increased level utilization linked payment system discourages investment in the most basic mantra: health quality.

Carson Snowder is a member of the St. Luke’s Magic Valley quality department. He completed a Masters in Public Health from the University of Arizona and is currently working towards becoming a certified professional in healthcare quality (CPHQ). He joined our team in April, 2015 as a continuous improvement coach. Since that time he has been heavily involved in performance improvement projects centered on our Healthgrades ratings. Through which he has helped to reduce surgical complications and mortalities within the orthopedic and cardiology service lines respectively. When not in the office, Carson likes to hunt, fish and garden.

The American medicinal services framework has major issues with quality and wellbeing. One viable approach to assault these issues is through the strategies for quality change (QI). The term QI alludes to exercises that utilization information based strategies—some created in assembling enterprises—to realize prompt changes in human services conveyance. Change has dependably been an inborn piece of therapeutic practice, as clinicians and chiefs adjust to new medicinal information, new innovation, and new examples of ailment. QI techniques empower them to roll out improvement deliberately, measuring and evaluating the impacts of a change, bolstering the data again into the clinical setting, and making modifications until the point that they

Over the years the U.S. have implemented various health plans, the Value-Based system is geared towards delivery efficiency and effectiveness. “The Department of Health & Human Services implemented a budget program in 2015 to provide a non-biased payment structure for the Value-Based system”.

Based on my findings and the studies mentioned above, there are some variations in achieving better outcomes by age, gender, and race. This could affect my future practice, because I could be evaluated by my patients’ outcomes. Yet, quality healthcare outcomes depend upon patients' adherence to the recommended preventive services, lifestyle modifications, and treatment. So, my future practice is contingent upon my future patient population.

“Although outcomes research has identified many useful strategies for improving the quality and value of care, it must be kept in mind that such strategies are only as good as their translation into practice” (Merrill, 2017, p. 238).

• Foster innovative and sustainable activities and interventions that improve the quality and value of health care.