Quality, Cost, and Outcomes Introduction Cost, access, and quality are the cornerstones of health care delivery, and these issues are the focus of the ongoing debate regarding health care in the United States. We continue to try to find ways to control costs of health care through cost containment initiatives by the government, third-party payers, and employers, and we continue to try to expand access to services.
The 3 components of the triangle are access, cost, and quality. One of my professors in medical school used this concept to illustrate the inherent trade-offs in health care systems.
His point was that at any time, you can improve 1 or perhaps even 2 of these things, but it had to come at the expense of the third. I can make the health care system cheaper improve costbut that can happen only if I reduce access in some way or reduce quality.
I can improve quality, but that will either result in increased costs or reduced access. And of course, I can increase access—as the Affordable Care Act ACA does—but that will either cost a lot of money it does or result in reduced quality. Anyone who tells you that he or she can make the health care system more universal, improve quality, and also reduce costs is in denial or misleading you.
When it comes to election season, those people are often politicians. The lesson of the iron triangle is that there are inherent trade-offs in health policy.
If we wanted to conduct the debates honestly, we would acknowledge these and allow the public to decide what they really want—and what they are willing to sacrifice to get it. Fear of Hard Truths But politicians often seem to fear telling hard truths.
They are afraid of the consequences of acknowledging reality.
Take Plan B, a drug to prevent pregnancy after unprotected sex. SincePlan B has been available over-the-counter in the United States to women who are 17 years old or older. Those aged 16 years or younger need a prescription. But plenty of adolescents younger than 17 years were still having sex and becoming pregnant.
This, of course, was a difficult political decision. But the Obama administration had argued that they would approach this from a scientific standpoint.
Rather than discuss the trade-offs and admit which side they preferred, they started to make no sense. And in trying to please everyone, they wound up pleasing no one. Many people oppose abortion in this country.
In the end, by avoiding the discussion, Akin brought on himself a load of negative publicity. Willful Avoidance Most significantly, this willful avoidance of trade-off discussions has rendered much of the discussion of health care reform nonsensical.
The ACA starts from a place of wanting to make sure that all individuals can obtain affordable insurance, even if they have a prior medical condition. And if you demand that people buy insurance, then you have to make sure they can afford it.
The plus is that many more people get access. The negative is that it costs people and the government money. Governor Romney used to recognize these. That is, of course, nonsense.
You have to take the bad with the good. If you want to save money, you have to cut spending. When you do, there will be consequences. If you want to set up groups like the Independent Payment Advisory Board to recommend spending reductions to Medicare, they will have to recommend either that benefits get cut or that reimbursements get cut.
Someone is going to be unhappy. We can make the system cheaper. We can make it more expansive. We can make it higher in quality. We have to choose.high access cost caching and prefetching cost depends on previous access careful block placement and scheduling.
stored High Cost Fund Eligibility Application Instructions -Texas education agency division of idea coordination august For example, a policy that increases access to health services would lower quality of health care and/or increase cost.
The desired state of the triangle, high access and quality with low cost represents value in a health care system. In truth, access, quality, and cost already drive our practice lives. JOP aspires to enlighten the ongoing dialogue with colleagues, patients, and their communities as we face changes in these areas.
The editors are seeking ideas and commentary on these issues. The cost and quality of health care varies from state to state. These states ranked highest for access, outcomes, and cost.
The cost and quality of health care varies from state to state. These. Quality, Cost, and Value Page Content Our goal: Encourage, empower, and enable health care delivery systems to provide truly value-based care that ensures the best health care.
Mar 09, · A brief presentation by Dr. David San Filippo on the impact of the triad of Access, Quality, and Cost.