Access, Cost, and Quality of Quality Environments and Initiatives for APNs

Access, Cost, and Quality for APNs
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Access, Cost, and Quality for APNs
Introduction
Several factors drive healthcare transformation in the United States (U.S.), including access problems, fragmentation, unsustainable costs, disparities, and suboptimal outcomes. Health care quality requirements and cost issues coupled with the ever-evolving social and illness-type demographics create the need for urgent changes. Other significant concerns in the healthcare system include caring for and reimbursing for medical treatments for clients with chronic illnesses. Obamacare (the Affordable Care Act) introduced programs via the Centers for Medicare and Medicaid Services to control costs and enhance quality. This paper discusses the access, cost, and quality of quality environments and recent quality initiatives in the U.S. healthcare system. In addition, the report reflects on the connection between quality measures, evaluation, and role development, including potential changes in the role of Advanced Practice Nurses (APNs) when the system lacks effective quality measures.
Access, Cost, Quality of Quality Environments, and Recent Quality Initiatives
Healthcare access is the ease with which an individual can obtain necessary healthcare. It is conceptualized as an individual’s opportunity to utilize proper services commensurate to medical care needs. An opportunity to obtain health care exists in the availability of services. However, such opportunities are constrained by other factors such as cultural, organizational, financial, and social issues. In this vein, the access levels impact the utilization of health care services and, thus, the population or individual’s health status. Even before the Covid-19 pandemic, access was a significant issue in the U.S. health care system. Today, evidence indicates that socioeconomic and racial disparities within the populations impacted by Covid-19 significantly contribute to reduced access and utilization of medical care services (Núñez, Sreeganga, & Ramaprasad, 2021). Consequently, inaccessible or inadequate access to medical care services exacerbates the existing structural disadvantages, exerting more pressure on the system.
Healthcare costs in the U.S have drastically increased over the past six decades to 2020. Regrettably, U.S. healthcare costs constitute one of the highest globally. The U.S. healthcare expenditure reached $4.1 trillion in 2020, averaging more than $12,500 per individual. The average healthcare cost per person in the Organization for Economic Co-operation and Development (OECD) is approximately one-third of the U.S. The constant rise in healthcare spending can be conceptualized as a utilization function (the volume of healthcare services used) and price (dollars paid for such services). The most notable underlying factors that augment utilization and price include healthcare prices and the aging population. The aforementioned factors boost healthcare expenditure (Peter G. Peterson Foundation, 2022). The cost of medical care services grows typically faster compared to the cost of other services in the economy, thus making price a signific...