Abstract
The healthcare environment is characterized by various dramatic as well as rapid changes whereby this is usually leads to various difficulties especially in regard to effective change management. In regard to this, the various stakeholders involved in the management of healthcare organizations should effectively monitor change in order to anticipate the effects of these changes and come up with the appropriate measures to effectively deal with the challenges presented by the changes.
As such, it is crucial and necessary to effectively understand the continuing trends that include; changes in managed care, client characteristics and pay-for-quality so as to effectively deal with the difficulties associated with the aforementioned changes. More importantly, it is crucial to effectively understand the implications associated with healthcare changes so as to ensure that implementation of these changes is beneficial to the healthcare workers, clients and the entire healthcare system.
Introduction
Essentially, the healthcare environment is usually characterized by various facilitators for change that include; increased utilization, state as well as federal regulations, patients’ expectations, advancements in technology and competition (Sommers et al., 2014). As such, effective change management is among the main concerns especially in regard to optimal management of healthcare whereby healthcare professionals are required to acquire the necessary competencies as well as maintain the required expertise so as to effectively undertake their specific roles. In the light of this, the pace at which changes occur within the healthcare environment has dramatically increased creating serious concerns in the healthcare sector due the difficulties and challenges associated with the adoption of these changes all the stakeholders in the healthcare industry. Effective change is usually characterized by the unfreezing of the old behaviors, introduction of new behaviors and subsequently re-freezing these introduced behaviors.
However, adoption to changes usually results to internal pressure especially among the healthcare professionals as well as healthcare organizations mainly due to the challenges that result from dealing with these changes. Moreover, change management involves handling the various complexities associated with change processes whereby this requires evaluating, planning as well as implementing various strategies, operations and tactics so as to ensure that these changes are relevant, applicable and worthwhile. Nonetheless, change management is a dynamic and complex process that usually associated with various difficulties (Lewis & Brown, 2012). Inherently, most individuals are opposed to change, particularly when things are deemed to have been working in the right manner over the years since changes usually affect the routine tasks as well as the normal procedures and the healthcare environment is no different. In addition, changes in healthcare occur more rapidly and are dramatic compared to the various other aspects of the modern society whereby this creates various challenges especially among the providers of healthcare. As such, the purpose of this paper is to discuss the difficulties associated with changes in the healthcare environment mainly by focusing on the changes in the client characteristics, managed care and pay for quality.
Changes in client characteristics
Over the years, various changes have been witnessed in regard to the characteristics of clients whereby this presents significant difficulties especially among the healthcare workers. In the light of this, the demographic characteristics of the entire population usually has a significant impact on the healthcare environment (Sommers et al., 2014). As such, increase in the age expectancy had led to a subsequent increase in the elderly population whereby this presents various challenges to the healthcare professional as well as the healthcare organizations. For instance, increase in the older population requires specialized skills and more facilities as well as resources such as home care agencies and skilled care so as to provide optimal care to this population. In addition, the health conditions that are related to aging usually result to the development of various specialty programs that include; stroke rehabilitation, memory care, wellness programs as well as palliative care so as to foster healthy aging among this population. On the other hand, increase attention in regard to neonatal care, preventive care and healthy growth as well as development is associated with various challenges since the provision of optimal care to the neonates requires specialized competencies and additional time. The increase in illnesses and diseases is associated with various challenges in regard to the interventions required to mitigate the effects as well as control these diseases (Sommers et al., 2014). In relation to this, some of this diseases such as tuberculosis and smallpox require timely interventions that include immunizations in order to effectively control and manage these diseases.
Furthermore, lifestyle changes such as the adoption of sedentary lifestyle and consumption of unhealthy foods is associated with various diseases such as diabetes, cardiovascular diseases and hypertension that require the incorporation of tailored interventions so as to effectively manage these illnesses. Subsequently, this necessitates the need for healthcare professionals to engage in continued research so as to come up with research-based information and knowledge that can be used to develop suitable interventions to effectively manage these diseases. In regard to this, research projects and disease management requires allocation of extra resources and commitment of the healthcare professionals whereby this is associated with various difficulties such as lack of commitment among the care professionals and inadequate resources. The emergence of new health conditions especially among specific age groups such as autism and childhood obesity necessitates the need for the development of new approaches so as to effectively manage these conditions. Thus, this underscores the need for healthcare professionals to engage in continued research and effectively collaborate amongst themselves whereby this is associated with various challenges especially since it requires working for additional hours and increased workload. Subsequently, this results to burnout, fatigue and stress whereby this leads to job dissatisfaction and high turnover rates thereby creating a huge problem to the entire healthcare system. More importantly, changes in the clients’ preferences and demands due to various aspects that include; ethnic, cultural and religious affiliations whereby this requires incorporation of various skills and knowledge so as to provide competent and customized care to effectively meet the unique needs of the clients.
Changes in managed care
The regulations and laws that have enforced in the healthcare industry pertaining to healthcare delivery are associated with various changes especially among the healthcare professionals as well as the healthcare organizations. The key example that stand out in regard to these regulations as well as laws include; “the patient protection and affordable care act” and the ARRA (American Recovery and Reinvestment Act) (Sommers et al., 2014). The aforementioned laws involved new provisions pertaining to the access rights, healthcare delivery and healthcare information security as well as privacy. In the light of this, the various changes pertaining to managed healthcare especially following the implementation of the Affordable Care Act of 2010 is associated with numerous challenges among the healthcare organizations as well as the healthcare workers.
The alignment between hospital systems and clinicians as well as the new insurance systems have changed the face of healthcare delivery over the recent years. In relation to this, the open enrollment pertaining to health insurance as well as subsidizations granted by the federal government have made it considerably affordable has increased the accessibility of healthcare. Subsequently, this has presented various difficulties to the healthcare professionals as well as healthcare organizations since increased accessibility to healthcare services is associated with a subsequent increase in patient. As such, this results to an increased workload that is associated with delivering quality care to these patients as well as overutilization of the healthcare resources. For instance, following the enforcement of the affordable care act a significant number of American insured under the new act will gain access to the healthcare services especially from Medicaid thereby creating a huge workload to the healthcare workers whereby this results to burnout leading to higher turnover rates among the care providers (Lewis & Brown, 2012).
Measuring and reviewing the practices pertaining to patient care and the standardization of these practices are among the main components involving managed care. In regard to this, effective monitoring as well as tracking of the quality metrics is associated with various difficulties among the healthcare professionals since they are required to provide quality healthcare services. In relation to this, the care professionals encounter various problems dealing with the increased patient population and lack of adequate resources though they are required to comply with the standardizations required in care practices. On the other hand, the income limitations that have imposed on the healthcare organizations coupled with the limited supply pertaining to the money for healthcare services from insurers and the government has inevitably forced various healthcare providers to operate on minimal costs than they require. Subsequently, this compromises the quality as well as safety of care rendered to patients. More importantly, various limitations placed in regard to the payment and reimbursement for services and the instance whereby these services would be accessed. Plans for managed care have led to a significant reduction in the premium costs for health insurance among subscribers as well as employers thereby creating a huge pressure to healthcare organizations since they are forced to operate with limited financial resources. For instance, healthcare organizations are encouraged to minimize the length of hospital stay and cater for more patients whereby this usually lower the level of care quality rendered to patients (Sommers et al., 2014).
Changes in pay for quality
Although, the health plans relating to pay-for-quality are basically designed to increase the operating efficiency of healthcare provides as well as enhance the quality of healthcare. Pay-for-quality is usually associated with various difficulties especially among the healthcare professionals. Essentially, the pay-for-quality health plan involves paying clinicians based on the quality, outcomes and efficiency in regard to care delivery and holding the healthcare professionals accountable for the healthcare costs (Panzer et al., 2013). As such, this payment plan has elicited mixed reactions among the healthcare professionals with most of them criticizing the payment. In regard to this, most healthcare professionals argue that the payment mode does not consider various aspects involved in care delivery that foster optimal patient outcomes. For instance, some of the healthcare professionals lack the required resources that can be used to promote optimal outcomes. Thus, most clinicians argue that the payment mode does not provide a level playing ground for all the healthcare professionals. Moreover, the payment mode is associated with various difficulties since it is quite difficult to measure as well as quantify some of the quality metrics such as the quality of life as well as functioning improvement. Additionally, it is difficult to quantify some of the care aspects such as clinician-patient discussions (Panzer et al., 2013).
Furthermore, penalize healthcare professionals for increased costs, poor outcomes as well as medical errors usually demotivates the care professionals and leads to job dissatisfaction whereby this increases the turnover rates of the healthcare workers. Subsequently, could result to shortage in healthcare workers thereby creating a huge problem within the entire healthcare system.
Conclusion
The various changes witnessed in the healthcare environment especially in the recent years especially due to enforcement of new regulations and laws are associated with various difficulties among the healthcare providers and the entire healthcare environment. As such, this underscored the need to develop appropriate measures to effectively deal with the challenges associated with these changes so as to promote optimal delivery of the healthcare services and improve the clients’ outcomes.
References
Lewis, M. A., & Brown, A. D. (2012). How different is professional service operations management?. Journal of Operations Management, 30(1), 1-11.
Panzer, R. J., Gitomer, R. S., Greene, W. H., Webster, P. R., Landry, K. R., & Riccobono, C. A. (2013). Increasing demands for quality measurement.JAMA, 310(18), 1971-1980.
Sommers, B. D., Graves, J. A., Swartz, K., & Rosenbaum, S. (2014). Medicaid and marketplace eligibility changes will occur often in all states; policy options can ease impact. Health Affairs, 10-1377.
