NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change

NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change

School of Nursing and Health Sciences, Capella University

NURS-FPX6218 Leading the Future of Health Care

Proposing Evidence-Based Change

Change Proposal Summary Report

Executive Summary

The USA health care system has significant failures that are worsening over time. About 47 million Americans do not have health care coverage, and 21% have difficulty paying for health care needs. On average, the USA pays higher price per unit of health care services when compared to other developed countries. Comparisons with UK and Sweden reveal that although the USA system spends more on health care, the UK and Sweden that spend less report better health outcomes. This is blamed on the fragmented investor-driven health care system that is faulted for making health care inaccessible and lacking control over costs. it includes profit-driven middlemen who negotiate for prices and add to the public health bill. A single-payer system is proposed as better for the USA as it would reduce health care costs and improve public health outcomes through sustainable cost control and improve accessibility through universal coverage.

Proposed Change

Despite spending higher on average than other developed countries, the USA health care system has failed to provide coverage for all residents. This is a crisis that is worsening as the economy slows down. About 47 million Americans do not have health care coverage, and 33% of Americans younger than 65 years of age are without insurance coverage. In addition, 21% of Americans have difficulty paying for health care needs. The issue is exacerbated by the fact that the economy is growing at a slower rate that the rate at which health care expenditure is increasing. This state of affairs is blamed on the fragmented investor-driven health care system applied in the USA. This has resulting in higher price per unit of health care services when compared to other developed countries. This makes it clear that the US health care system is faulty because it is not available to all Americans and there is no system in place to control costs (Rice et al., 2021).

Most other developed countries have some government involvement in health care delivery to ensure that costs are controlled and coverage is universal. Compared to the USA, these countries spend less and have better coverage. Also, they have better outcomes when compared to the USA. The fragmented investor-driven US public health system must be reformed if costs are to be controlled and outcomes improved. The US system has commercial, profit driven providers providing care and this sees costs rising (Thomas, 2021). The proposed change is to apply a single-payer public health system that leverages the power of the government to negotiate affordable prices thereby control costs. This would make health care more accessible and help in improving public health outcomes.

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Desired Outcomes

As earlier indicated, the fragment investor-driven US public health system is ineffective and inefficient as it is unable to control costs. The system has been able to realize savings from improving quality of care and health status. However, these savings are diverted to charging higher prices for health services and products, higher profits, and higher administrative costs. A single-payer system helps to address this problem by reforming the financial system and ensuring that the government pays directly for all health care costs. All Americans would be automatically eligible for coverage as a condition of this single-payer system. In essence, the proposed change is expected to successfully achieve sustainable cost control and universal coverage (Shi & Singh, 2022).

The proposed single-payer system leverages the power of the government to negotiate affordable prices with the pharmaceutical industry and health care providers. In fact, it eliminates the need for middlemen who have been pushing health care prices up through administrative costs. Some of the eliminated middlemen include private health insurers. With this change, the administrative costs of health care would also reduce. In this respect, the proposed change from fragmented investor-driven public health system to single-payer system is expected to reduce health care costs and improve public health outcomes through sustainable cost control and improve accessibility through universal coverage (Sabrin, 2021) NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change.

Health Care System Comparative Analysis

A comparison between the US health care system and United Kingdom (UK) and Sweden’s health care systems reveals significant shortcomings in the US system. The average annual health care expenditure per person in the US is at least double what is spent in each of the two countries. The US figure is estimated at $12,530, a figure that is significantly higher than Sweden’s system at $5,819 and UK system at $4,400. Despite spending more than double what residents in other countries spend, the US reports less favorable health outcomes. First, the US reports higher mortality from preventable causes when compared to the UK and Sweden. The US reports a figure of 175 per 100,000 population, a figure that is higher than UK at 119 per 100,000 population, and Sweden at 93 per 100,000 population. Second, the US reports higher mortality from treatable causes when compared to the UK and Sweden. The US reports a figure of 88 per 100,000 population, a figure that is higher than UK at 69 per 100,000 population, and Sweden at 51 per 100,000 population. Third, the US reports higher infant mortality rate when compared to the UK and Sweden. The US reports a figure of 5.8 deaths per 1,000 live births, a figure that is higher than UK at 3.9 deaths per 1,000 live births, and Sweden at 2.4 deaths per 1,000 live births. Fourth, the US reports higher obesity prevalence when compared to the UK and Sweden. The US reports a figure of 30.9% of adults are obese, a figure that is higher than UK at 20.1%, and Sweden at 13.1%. Fifth, the US reports lower life expectancy at birth when compared to the UK and Sweden. The US reports a life expectancy figure of 78.6 years, a figure that is lower than UK at 81.3 years, and Sweden at 82.5 years. Finally, the use has lower health care spending efficiency when compared to the UK and Sweden. The USA spends 19.7% of the GDP on health, a higher figure when compared to the UK at 10.43% and Sweden at 10.9% (see Table 1). Based on this comparative analysis, it is clear that although the USA system spends more on health care, the UK and Sweden that spend less have better health outcomes.

Rationale for the Proposed Change

The proposal is to apply a single-payer system in the USA. Currently, the USA applies a fragmented investor-driven public health system. This has been faulted for being ineffective in providing universal care, and being inefficient in controlling costs. The system has been able to improve quality of care and health status while saving costs. However, the savings are diverted to charging higher prices for health services and products, higher profits, and higher administrative costs. The result is that health care is not accessible to all Americans and is very costly. As such, there is a need to improve health care access while controlling and reducing costs. Towards this end, a single-payer public health system has been proposed. This system leverages the governments financial power to negotiate affordable health care costs for the public with the pharmaceutical industry and health care providers. Also, it reduces the unnecessary administrative costs by eliminating the middlemen, such as public health insurers. In this respect, the change from fragmented investor-driven public health system to single-payer system is expected to reduce health care costs and improve public health outcomes through sustainable cost control and improve accessibility through universal coverage (Heitkamp, 2019).

Financial and Health Implications

The fragmented investor-driven public health system lacks coordination and incentives are misaligned, resulting in inefficient allocation of resources, especially when it comes to cost savings. The fragmented system has saved on costs through improving health care quality and health status. However, it has many unnecessary ‘players’ so that any savings made are spent on the ‘players’. To be more precise, the fragmented system has many unnecessary middlemen who target the cost savings to increase their financial take through higher prices for health services and products, higher profits, and higher administrative costs. The result is that the USA spends a lot on health care but reports less favorable outcomes and low access. In continuing to use the fragmented investor-driven public health system, the USA should expect the health care costs to grow while accessibility reduces (Rice et al., 2021).

The fragmented investor-driven public health system should be replaced with a single-payer system. NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change This approach leverages the government’s financial power to negotiate affordable prices with the pharmaceutical industry and health care providers. It allows the government to directly negotiate for lower prices while reducing the costs incurred from engaging middlemen such as private health insurers. This helps in achieving sustainable cost controls to improve public health outcomes, and universal coverage to improve accessibility (Sabrin, 2021).

Conclusion

The purpose of this paper was to explore the faults in the fragmented investor-driven US public health system, and propose a solution. Based on the analysis, it is clear that the USA pays higher price per unit of health care services when compared to other developed countries. Despite paying a higher price, it reports lower health outcomes. The comparison between performance in USA, UK and Canada reveals that although the USA system spends more on health care, the UK and Sweden that spend less have better health outcomes. The US system has commercial, profit driven providers providing care and this sees costs rising. Also, the system has middlemen who add to the costs. The proposal is to replace the fragmented investor-driven US public health system with a single-payer system. A single-payer system is preferable because it eliminates middlemen and unnecessary administrative costs, while leveraging the government’s financial power to negotiate affordable health care costs with the savings used to improve access. in this respect, the proposal is to apply single-payer system in order to reduce costs and improve access.

Appendix

Table 1: Health Care System Comparative Analysis (source: Organization for Economic Co-operation and Development, 2022)

Public Health Outcomes

United Kingdom Health Care System

Sweden Health Care System

US Health Care System

Average annual health care expenditure per person

$4,400

$5,819

$12,531

Mortality from preventable causes (age standardized rate per 100,000 population)

119

93

175

Mortality from treatable causes (age standardized rate per 100,000 population)

69

51

88

Infant mortality rate (deaths per 1,000 live births)

3.9

2.4

5.8

Obesity prevalence (percentage of adults)

20.1

13.1

30.9

Life expectancy at birth (years)

81.3

82.5

78.6

Efficiency (total national spending on health as % of GDP)

10.43%

10.9%

19.7%

 

References

Heitkamp, K. L. (Ed.) (2019).
Universal Health Care
. Greenhaven Publishing LLC.

Organization for Economic Co-operation and Development (2022).
OECD Health Statistics 2021
.
https://www.oecd.org/els/health-systems/health-data.htm

Rice, T., Rosenau, P., Unruh, L. Y., & Barnes, A. J. (2021).
Health Systems in Transition: USA
(2
nd
ed.). University of Toronto Press.

Sabrin, M. (2021).
Universal Medical Care from Conception to End of Life: The Case for a Single-Payer System
. Page Publishing, Inc.

Shi, L., & Singh, D. A. (2022).
Delivering Health Care in America: A Systems Approach
(8
th
ed.). Jones & Bartlett Learning, LLC.

Thomas, R. K. (2021).
Health Services Planning
(3
rd
ed.). Springer.

 

NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change

Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 5 page report.

Introduction

Note: Complete the assessments in the order in which they are presented.

Health care systems around the world provide useful models for analysis. Familiarity with different models and approaches to health care enables leaders to identify what works and what does not, as the basis for proposing a change. As we continue to evaluate the complex and fragmented system in the United States, it is important for nurse leaders to become familiar with the programs and systems that provide evidence-based quality care that is affordable and focused on continual improvement.

This assessment provides an opportunity to examine a local or regional health care issue from a global perspective.

Preparation

Your organization, in collaboration with the key stakeholders from the community, is funding an initiative to investigate potential improvements in the local or regional health care system. As a nurse leader attuned to the effects of health care policy and finance on the provision of affordable, high-quality care, you have been asked to join the task force conducting the study.

You know that an examination of other countries’ health care systems can provide a solid, evidence-based foundation for evaluating outcomes and identifying benchmarks. Consequently, you have decided to undertake an analysis of selected, non-U.S. health care systems and compare them to each other and to the existing local or regional U.S. system to help inform decision making as the task force considers proposed changes NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change.

In this assessment, you will propose a change to one aspect of your local or regional health care system or program. Conduct a comparative analysis of different health care systems and summarize your proposed change and findings from your analysis in a report to executive leaders. To prepare for your assessment, you are encouraged to begin thinking about the non-U.S. health care systems you might like to examine. In addition, you may wish to:

Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.

Review Guiding Questions: Proposing Evidence-Based Change [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment.

Note: Remember that you can submit all or a portion of your draft report to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

MSN PROGRAM JOURNEY

The following is a useful map that will guide you as you continue your MSN program. This map gives you an overview of all the steps required to prepare for your practicum and to complete your degree. It also outlines the support that will be available to you along the way.

MSN Program Journey.

TEMPLATES

Use this template for your summary report.

Summary Report Template [DOCX].

Requirements

Complete this assessment in three steps:

Propose a change to one aspect of your local or regional health care system or program that would improve outcomes.

Conduct a comparative analysis of different health care systems, focusing on one aspect of the system you are proposing to change.

Summarize your proposed change and the results of your comparative analysis in a report to executive leaders.

The summary report requirements outlined below, correspond to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Proposing Evidence-Based Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

Identify an aspect of a local or regional health care system or program that should be a focus for change.

Define desirable outcomes, including who will pay for care and factors limiting the achievement of those outcomes.

Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.

Choose one of the following options for selecting the two systems or programs:

Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.

Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.

Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.

Explain why specific changes will lead to improved outcomes.

Determine the financial and health implications associated with the proposed changes.

Address the implications of making the changes NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change.

Address the implications of not making the changes.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Document Format and Length

Use the Summary Report Template. This APA Style Paper Tutorial [DOCX] can help you in writing and formatting your assessment. If you would like to use a different worksheet for your community health assessment, obtain prior approval from faculty.

Your summary report should be 5 pages in length, not including the title page and references page.

Be sure to apply correct APA formatting to all source citations and references.

Supporting Evidence

Cite 5 credible sources from peer-reviewed journals or professional industry publications to support your comparative analysis.

Additional Requirements

Be sure to delete all directions from the template before submitting your summary report. In addition, proofread your report to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.

Portfolio Prompt: You may choose to save your summary report to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Identify the challenges and opportunities facing health care.

Identify an aspect of a local or regional health care system or program that should be a focus for change.

Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.

Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.

Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.

Competency 3: Evaluate the positive and negative influences of leaders on health care processes and outcomes.

Determine the financial and health implications of making—and not making—proposed changes to a health care system or program.

Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.

Explain why specific changes will lead to improved outcomes.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

All of the following must be included:

1. Identifies an aspect of a local or regional health care system or program that should be a focus for change. Provides clear expectations for improvements substantiated by credible evidence.

2. Defines desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes. Provides well-reasoned justification for the definition and exhibits insight into optimal health care solutions.

3. Explains why specific changes will lead to improved outcomes. Draws well-substantiated conclusions that are in line with reasonable expectations.

4. Analyzes two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States. Articulates insightful lessons learned from the analysis that have clear implications for U.S. health care.

5. Determines the financial and health implications of making—and not making—proposed changes to a health care system or program. Draws insightful, well-reasoned conclusions based on credible evidence.

6. Writes clearly and concisely in a logically coherent and appropriate form and style. Main points, ideas, arguments, or propositions are well-developed and engaging. Adheres to all applicable disciplinary and scholarly writing standards and conventions.

7. Supports assertions, arguments, propositions, and conclusions with relevant, credible, and convincing evidence. Skillfully combines error-free source citations with a perceptive and accurate synthesis of the evidence.

Guiding Questions for Assessment 1

Proposing Evidence-Based Change

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Proposing Evidence-Based Change assignment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assignment. This document is a resource to help you complete the assignment. Do not turn in this document as your assignment submission.

Executive Summary

Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of different health care systems, focusing on the aspect of the system you are proposing to change, and summarize the results in a summary report.

Identify an aspect of a local or regional health care system or program that should be a focus for change.

• Why did you decide on this particular change?

• What improvements do you expect as a result of the change?

• What evidence supports your position?

Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.

• What is your rationale for this definition?

• What sources can you cite that support your definition?

• What are the two limiting factors?

Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.

• Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change or select two systems that both produce positive outcomes but take unique or innovative approaches to the problem. Then, compare the outcomes in each non-U.S. system with each other and with present outcomes in your community.

o How do the two health care systems or programs address the issue?

o What lessons are you able to draw from each example that you could apply in your system?

Explain why specific changes will lead to improved outcomes.

• What are the expected improvements in outcomes?

• What evidence can you use to justify your conclusions?

• Are your expectations reasonable within the existing health care system?

Determine the financial and health implications associated with the proposed changes.

• Address the implications of making the changes.

• Address the implications of not making the changes.

o What are the likely costs and benefits for individuals and the community at large?

o What are the potential short- and long-term effects?

o What evidence do you have that supports your conclusions?

Write clearly and concisely in a logically coherent and appropriate form and style.

• Write with a specific purpose and audience in mind.

• Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

• Integrate relevant and credible evidence from 3–5 peer-reviewed journals or professional industry publications.

• Is your supporting evidence clear and explicit?

o How or why does particular evidence support a claim?

o Will your reader see the connection? NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change

• Did you summarize, paraphrase, and quote your sources appropriately?

Submission Reminders

• Have you identified an aspect of your local or regional health care system or program as the focus for change, with supporting evidence?

• Have you clearly defined desirable outcomes and provided supporting evidence?

• Have you completed your examination of two non-U.S. health care systems or programs with respect to the issue reflected in your proposed change?

• Have you adequately explained why specific changes will lead to improved outcomes and provided supporting evidence?

• Have you determined the financial and health implications both of making and not making your proposed changes and provided supporting evidence?

• Is your report well supported by 5 sources of relevant and credible evidence?

• Is your report 5 pages in length, not including the title page and references page?

• Did you proofread your writing and delete all directions from the template?

 

Below is the template for assessment it must be used:

Change Proposal Summary Report

Your Full Name (no credentials)

School of Nursing and Health Sciences, Capella University

NURS-FPX6218 Leading the Future of Health Care

Proposing Evidence-Based Change

Instructor’s Name

Month, Year

Change Proposal Summary Report

Note: Delete this note and all instructions from the template before submitting your report. Use headings to organize your text, rather than bullets.

Executive Summary

Proposed Change

Identify an aspect of a local or regional health care system or program that should be a focus for change.

Desired Outcomes

Define each desirable outcome you wish to examine, including who will pay for care and factors limiting achievement of those outcomes.

Health Care System Comparative Analysis

Use Table 1, in the appendix, for your comparative analysis of the specific outcomes you wish to examine.

Analyze outcomes in two non-U.S. health care systems that offer insight into your proposed change.

• Choose one of the following options for selecting the two systems:

o Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.

o Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.

• Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.

Rationale for the Proposed Change NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change

Explain why specific changes will lead to improved outcomes.

Financial and Health Implications

Determine the financial and health implications associated with the proposed changes.

• Address the implications of making the changes.

• Address the implications of not making the changes.

Conclusion

Summarize your analysis and provide your rationale for the proposed change.

Appendix

Table 1: Health Care System Comparative Analysis

Table directions:

1. Add the names of the two non-U.S. health care systems and the local or regional U.S. health care system to the applicable column headings.

2. In the first column, list each outcome. Add rows to your table, as needed.

3. Add the relevant information pertaining to each outcome for each health care system in the second, third, and fourth columns.

Outcomes [Health Care System 1] [Health Care System 2] [U.S. Health Care System]

List outcome 1 here.

List outcome 2 here.

List outcome 3 here.

Place in-text citations here, along with any other information not included in the table itself.

References

List your APA-formatted references here NURS-FPX6218 Leading the Future of Health Care Proposing Evidence-Based Change