According to the Centers for Disease Control and Prevention, more than 130 million Americans suffer from a chronic illness. In a 2013 study, the CDC found that one of every three Americans suffers from at least one chronic condition. More than two-thirds (69%) of the Medicare patients in the study suffered from two or more chronic conditions, and a third of all Medicare patients had four or more chronic conditions.
Due to the increasing number of multiple chronic conditions (MCC), healthcare expenditures develop exponentially as every additional chronic condition requires greater physician access and hospital admissions (Hajat, & Stein, 2018). Patients’ outcomes, in turn, worsen due to the deterioration of the quality of life, additional costs, out-of-pocket expenses, symptom control, and inability to work. Therefore, there is a growing need for health disparities reduction to improve patients’ outcomes and cut health care costs.
One may note that the prevention of chronic conditions should be placed at the heart of efforts that are needed to achieve the two above-mentioned goals. Provisions of the proposed strategy to reduce and eliminate health disparities should include several steps. Firstly, all preventative health care services should be provided with Medicaid and Medicare coverage (Cassidy, Trujillo, & Orleans, 2015). Secondly, community-based grants for chronic conditions prevention should be financed by the government.
Thirdly, beyond prevention, health care services should develop models of care that promote cross-condition management (Hajat & Stein, 2018). An example of such a model is symptom-based care guidelines for physicians. Fourthly, health risk disparities should be reduced by facilitating environmental changes to enhance nutrition and increase physical activity. Finally, it is recommended to establish a Health Promotion Public Health Council that would be responsible for setting and achieving goals associated with improving health through federal and state programs on health promotion.
Difficulties with forecasting health care delivery in the US are associated with dynamics that influence change. In particular, four key dynamic factors hinder predicting health care delivery. Firstly, a shift from a volume-oriented system to an outcomes-oriented system with the main outcome being good health (Knickman & Kovner, 2015). If some health care sectors choose to focus on producing high-quality services, other health care facilities may offer services that do not have a value.
Secondly, health care is becoming more cost-consuming with not only low-income but also middle-income people considering the majority of services to be unaffordable (Elmendorf, 2016). This unaffordability factor which shapes government decision on health care policy makes health care delivery difficult to predict. Thirdly, the dynamic of health care can hardly be tracked because health care is becoming politicized and there is much debate on how it should be financed and organized.
Fourthly, the way health care systems function differs from state to state. In particular, in 2014, more than 20 states refused to expand their Medicaid programs despite the Affordable Care Act (Knickman & Kovner, 2015, p. 335). Therefore, health care leaders in various states have different views on health care policies and strategies and shape their actions accordingly. As a result, such a variation does not allow for predicting health care delivery.
It should also be mentioned that it is unclear if all of the current efforts in health care will be integrated on a large scale and what the consequences will be. This leads to the assumption that it is difficult to predict health care delivery because there is a lack of quantitative variables and the lack of evidence that the current policies will have positive outcomes. Speaking of some practices that are being implemented, it is a question if they will become a norm. It is also unknown if the consolidation at which the US health care system is aimed will weaken competition and thus stimulate price growth.
References
Cassidy, E. F., Trujillo, M. D., & Orleans, C. T. (2015). Health and behavior. In J. R. Knickman & A. R. Kovner (Eds.), Jonas and Kovner’s health care delivery in the United States (11th ed., pp. 119-143). New York, NY: Springer.
Elmendorf, D. (2016). Recommendations for federal fiscal policy. Harvard Kennedy School. Web.
Hajat, C., & Stein, E. (2018). The global burden of multiple chronic conditions: A narrative review. Preventive Medicine Reports, 12, 284-293. Web.
Knickman, J. R., & Kovner, A. R. (2015). The future of health care delivery and health policy. In J. R. Knickman & A. R. Kovner (Eds.), Jonas and Kovner’s health care delivery in the United States (11th ed., pp. 333-341). New York, NY: Springer.