For the past few decades, quality of care has become a key topic of discussion by researchers and policy makers. There have been endless campaigns to promote quality of care when giving out services especially in health care centers (Amin, Das, & Goldstein, 2008). It is required that health care providers give the best health care services that meet the needs of each patient. However, researches have established that many patients die in medical centers, as a result of avoidable medical errors caused by health care provider. This has resulted in numerous studies on how health care services can be improved. Studies have depicted that if the healthcare providers are given the right incentives in their work and favorable working condition the quality of care can be improved. Therefore, it is recommended that one way of improve the quality of care in health care center is by ensuring health benefits contractors such as organizations who purchase medical plans for their employees and insurance companies providing medical covers to their customers increasing the health benefits of their employees. To ensure that the contractors provide the required health benefits to employees and their customers they should be regularly evaluated (Chopra, Munro, Lavis, Vist, & Bennett, 2008).
Evaluation Methods for the Quality of Care being delivered by Health Benefits Contractors to Employees
As a medical care administrator, I am responsible for overseeing the human resources benefits of employees are adequately serviced to ensure their satisfaction. To ensure this, I will analyze and evaluate the quality of care offered by the health benefits contractors to the employees. One of the evaluation methods that I will use in measuring the quality of care delivered by the contractors is collecting and analyzing performance related data. These will involve collecting data from health plans agreement, health care provider and the consumers or the patients. The data will consist of a patient’s demographics, health care processes and outcome, patient satisfaction and their experiences. This data will help in better understanding of practice pattern variation, the regional gap in health care quality, health care disparities and access to health care centers. The data will enable the health care center to negotiate a medical plan that will be appropriate to the employees as well as help in improving the quality of care (Chopra, Munro, Lavis, Vist, & Bennett, 2008).
The other method involves promoting adherence to clinical guidelines. Health benefits contractors should adhere to the clinical guidelines set by the medical center since this will help in decision making on the appropriate health care process for a specific condition. Hollingsworth (2008) depicted that, if the contractors adhere to the set clinical guidelines they make it easy for healthcare providers to assess the underlying issues and, as a result, there is improvement in quality of care. Non-adherence to these guidelines may affect the quality of care due to poor patient’s outcomes due to lack of appropriate resources in the medical care center or low practice level of health care providers.
Lastly, I will use public reporting on quality related information. In recent years, the public awareness has increased, and they report many incidences that are affecting their services. The medical center is encouraging patients to report and rate the level services they receive. This information will be helpful in evaluating the health benefits provided by health benefits contractors as well as promoting the quality of care in the medical centers. Studies show that public reporting can help to motivate changes in the health benefits contractor’s behavior to avoid a bad reputation. As a result, they will improve better services to their customers by ensuring they receive quality services from the medical care centers (Hollingsworth, 2008).
Plan that the Organization will use to assess the Quality of Care and Reduce Risk
It is evident that hospital administrators have recognized that poor quality health care services can affect an organization’s performance and lead to failure to integrate risk management strategy. The organization has designed a plan to access the quality of care in order to reduce risks to organizations. The plan includes the integration of performance based systems in the provision of health care system. Using this mechanism, the health care providers are paid bonuses incentives according to the outcome of the patients. By providing these incentives, health care providers make an extra effort in promoting the quality of services to achieve the desired outcome. The plan also includes rewards for health care givers who consistently produce high quality outcome in the hospital setting. According to this plan, payments f less performing medical practitioners can be withheld, of the poor outcome was, as a result, of preventable medical errors. This plan ensures that the contractors or health benefit purchasers reduce the risk of their investment due to poor quality services. The plan also integrates contract requirements that ensure reporting of performance data that is helpful in negotiating health plans. The data will also be useful in reducing the risk of both the medical care center and health benefits contractors (Cebul, Rebitzer, Taylor, & Votruba, 2008).
Amin, S., Das, J., & Goldstein, M. P. (Eds.). (2008). Are you being served?: new tools for
measuring service delivery. World Bank Publications.
Cebul, R. D., Rebitzer, J. B., Taylor, L. J., & Votruba, M. (2008). Organizational fragmentation
and care quality in the US health care system (No. w14212). National Bureau of Economic Research.
Chopra, M., Munro, S., Lavis, J. N., Vist, G., & Bennett, S. (2008). Effects of policy options for
human resources for health: an analysis of systematic reviews. The Lancet, 371(9613), 668-674.
Hollingsworth, B. (2008). The measurement of efficiency and productivity of health care
delivery. Health economics, 17(10), 1107-1128.