Researchers have documented systematic variation in Medicare spending and health services utilization across various geographic regions for decades. The findings also evidence that high Medicare spending is unrelated to health outcomes. Policymakers have changed Medicare payment systems to promote high-value care. As key stakeholders in the health care delivery system, health care organizations and providers play an important role in health care spending.
You are taking on the role of a new CEO of a hospital that was identified as having high health care cost and utilization. In the first meeting with the board, you are tasked to reduce health care spending and utilization in your hospital. Your board provides a list of factors influencing health care spending and service uses. Your board asks you to prioritize the list and select one of the most critical determinants to implement a strategic plan.
Some categories of the factors influencing health care spending and service uses are the following:
- The operating cost regarding the supplies needed to care for patients.
- Diversity within patient populations, patients’ current state of health, access to care, insurance coverage, and patients’ preferences for their care.
- Physicians’ decisions on what care to give and the availability of reliable medical evidence to guide those decisions.
In the next meeting, you are required to present your strategic plan to your board. Be sure to include the appraised factors in the list that you deemed the most important. Justify your rationales for your selections.
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