Introduction
It is hard to disagree that the American healthcare system is not perfect and requires specific improvements in order to adequately respond to the needs of diverse patients. Not all Americans succeed when accessing high-quality medical services, and minority and poor patients face many inequalities and disparities. For example, if they lack money or insurance, have reduced mobility, or are not welcomed by culturally untrained medical workers, nationwide patient outcomes decrease greatly. The purpose of this paper is to assess the efficacy of healthcare interventions performed in 2011 and earlier. While healthcare reforms, including health information technology (HIT), changing payment models, and shifts in care delivery, have indeed improved equity, they have also raised new barriers.
Healthcare Reforms Efficacy
Unequal or challenged access to high-quality medical services is one of the most severe issues that U.S. citizens face. Unfortunately, to address this concern and improve healthcare equity, it is not enough to only eliminate one or two obstacles (Fiscella, 2011). A comprehensive approach that simultaneously solves numerous issues is required, and it is also crucial not to add new problems when reducing the existing ones.
In general, healthcare reforms can be considered quite effective because they have enhanced access to medical services, which is one of the key elements of equity. For instance, ACA provisions expanded insurance coverage to approximately 32 million uninsured individuals and improved “access to behavioral care for poor and minority patients” (Fiscella, 2011, p. 80). Differences between medical and behavioral care costs were minimized, and “patient cost sharing for evidence-based preventive services covered by Medicare and Medicaid” were eliminated (Fiscella, 2011, p. 80). When addressing primary care disparities, ACA took more modest steps but achieved enhanced workforce support, training of cultural competence, and introduction of new care models, among other important interventions (Fiscella, 2011). Overall, the situation has become more positive, and the number of patients receiving quality services has risen.
Health Information Technology
Healthcare equality and equity cannot be improved without ensuring the adequacy of health information technology. Fiscella (2011) noted a growing adoption of electronic health records (EHRs) by U.S. office physicians in 2009. One of the objectives of the 2009 American Recovery Reinvestment Act was to provide physicians and hospitals with financial support so that they could engage in federally approved EHRs. In general, the adoption of health information technology proved to eliminate health disparities by decreasing the risks of decision-making bias and medical errors and enhancing population management, tracking, and standardization of care (Fiscella, 2011). At the same time, these significant improvements in relation to equity have also brought new challenges that promoted healthcare disparities. For instance, since practices that served minority patients did not receive immediate access to HIT, “inequalities in resources between providers” grew (Fiscella, 2011, p. 81). What is more, many low-income patients who did not have the opportunity or knowledge to use technology failed to take advantage of HIT’s benefits.
Changing Payment Models
To meet the needs of minorities and poor persons, new payment models were introduced. Healthcare reforms made sure to foster the value of care and offer multiple positive options to providers, including cost savings. Further, with the introduction of bundled payments, underserved patients’ greater medical needs were taken into account, and resources were redirected to population health and care value (Fiscella, 2011). The latter contributed significantly to enhancing equity, but, like with any reform, changing payment models has also created new obstacles. Thus, bundled payments additionally reduced some low-income patients’ access to quality care because providers feared potentially higher costs associated with these individuals’ diseases (Fiscella, 2011). Additionally, this payment model deprived some small private practices that offered services precisely to underserved patients of their sustainability.
Shifts in Care Delivery
Finally, it is essential to assess whether the mentioned reforms managed to bring positive and efficient shifts in care delivery. In general, whether aimed to promote HIT, raise access to care, or create new payment methods, all these efforts should have eventually made changes in the way medical support is delivered. As stated earlier in the paper, ACA paid specific attention to offering training programs to the healthcare workforce (Fiscella, 2011). As a consequence, those who received additional education managed to transform their practice and better adapt to the needs of patients. Cultural competency and other vital skills strengthened, and care delivery improved. Some other solutions resulted in fostering “innovative, community-wide solutions for care for underserved patients, including promotion of patient capability” (Fiscella, 2011, p. 81). Therefore, the overall attempt to enhance underserved patients’ access to quality care can be considered successful.
Conclusion
To draw a conclusion, one may say that almost every process of refining or upgrading major systems can introduce additional concerns and barriers. There is no doubt that recent healthcare reforms have made nationwide access to medical services more equal, eliminating numerous disparities and discriminating factors. Poor and minority patients became more welcomed, and their needs were emphasized. Those new challenges created by HIT and payment models can be eliminated in the future.
Reference
Fiscella, K. (2011). Health care reform and equity: Promise, pitfalls, and prescriptions. Annals of Family Medicine, 9(1), 78-84.