Healthcare Quality and Cost Containment

The quality of medical care is the degree to which medical services provided to individuals and groups of the population increase the likelihood of achieving desired health outcomes and correspond to evidence-based professional knowledge. This definition of the quality of medical care extends to health promotion, prevention, treatment, rehabilitation, and palliative care and proceeds from the fact that the quality of medical care can be measured and continuously improved. Quality health services are the result of both the broader context of health systems and the actions of care providers and individuals working in the system (Leger & Dunham-Taylor, 2018). The key participants, including regulators, citizens, patients, physicians, and others should work together to achieve the goal of providing quality health services on the ground.

Primarily, consumers are the major stakeholders in improving care quality and its costs. They play a critical role in the formation of the patient-centered approach, thereby contributing to the increase in the value of health services. Additionally, they help medical personnel make vital decisions regarding care (Leger & Dunham-Taylor, 2018). When dwelling on prices retention, the mechanism of supply-demand comes into action. The more the demand is, the higher the prices are. However, consumers are barely impactful in containing the costs because the major drivers, including the economy and politics, are out of their control. Moreover, their buying power remains the same, and they have to either use health coverage or cut expenses.

Healthcare providers have a supportive function in the medical field. It presumes that they assist patients throughout their stay in the hospital by providing needed services. In general, they ensure the proper treatment and procedures are performed in a timely manner to maintain one’s well-being. Improving healthcare quality is one of the most significant opportunities suggested to the providers. These professionals may create organizations and committees to advocate for policy promotion, disease prevention, and other relevant issues. Physicians and other specialists may contribute to the spread of telemedicine, the technology allowing for online diagnostics (Martinelli, 2022). This step can prevent numerous hospital admissions since the patients could be diagnosed via an Internet connection.

The next stakeholders are payers, people, or organizations that negotiate or set tariffs for the supplier’s services and collect revenue. In terms of healthcare, it is the government that stimulates the boost of its quality (Martinelli, 2022). It ensures that all services are provided according to the standards, and insurance is accessible and affordable to different layers of the population. It controls its financial operations to monitor if the money is spent on developmental activities. The cost containment activities are incorporated into the range of governmental duties (Martinelli, 2022). For example, it controls the health coverage programs and their tariffs. Additionally, it may introduce disease prevention programs such as diabetes or obesity control initiatives to promote self-management strategies. Such an approach prevents severe health outcomes and saves money on unnecessary treatment.

Suppliers play a strategic role in the field of healthcare since they supply, obtain, and allocate all the required resources. Their major role in boosting the quality of medical services is the timely provision of medicines and equipment to the provider or a customer. By ensuring all the provision operations are done smoothly, the supplies contribute to the development of higher quality care (Leger & Dunham-Taylor, 2018). They can also take part in the cost containment procedures by optimizing the supply chain management. It is possible by building warehouses and expanding the number of transports which creates improved performance. The suppliers can also unite to reduce the bureaucratic red tape.

Finally, the regulatory bodies in healthcare develop health prevention measures, identify potential risks, improve public health, and ensure specialists work in a safe environment. The regulators can increase healthcare quality by setting new standards. In addition, they inform the government about the potential changes and set high safety guidelines to provide secure conditions for both patients and workers. Their other role is to standardize processes and achieve predictable outcomes, aiming to boost healthcare quality (DeNisco, 2019). The regulators also control the high prices in healthcare by sustaining the level of insurance tariffs. Furthermore, they may cut expenses by developing more relevant and high-quality guidelines that do not have to be revised miscellaneously, which would require additional fees. Therefore, all mentioned stakeholders are vital for developing and functioning healthcare services, their accessibility, and affordability.

To my mind, the Affordable Care Act (ACA) has impacted the formation of the American health system. It was introduced in 2010 under the governance of President Obama (Kenter et al., 2019). The new law authorized the reform of the health care system in the United States, which many presidents had previously tried to implement. He made significant changes to the U.S. medical system between 2011 and 2014 (Kenter et al., 2019). The provisions included in the healthcare reform and patient protection were aimed at expanding access to medical care, strengthening consumer protection, as well as drawing special attention to disease prevention. The main goal of Obamacare is mandatory health insurance for 32 million Americans who do not have health insurance (Kenter et al., 2019). First of all, these are middle-class Americans who are unable to purchase expensive commercial insurance. Still, at the same time, their incomes do not allow them to take advantage of the state Medicaid subsidy program for low-income citizens. Therefore, the ACA has resolved the insurance issue and improved public health.

The medical organization should ensure each patient is treated equally and adequately. Hence, there is necessary to sustain the minimum staffing ratio so that nurses can provide reasonable care to everyone (DeNisco, 2019). The minimum balance is advantageous in that there is no overcrowding in the hospital, creating a safer environment. Additionally, it helps for more adequate resource allocation that in case with overstaffing. On the other hand, understaffing leads to adverse health outcomes by creating long wait lists, which is inadmissible in terms of a normative economic dichotomy (DeNisco, 2019). Moreover, it may cause the inability to provide high-quality services. Overall, it is indispensable to sustain the mandatory level to keep the hospital environment balanced.

In conclusion, healthcare quality improvement and cons containment are two issues in the medical system of the U.S. While it is vital to spend much on developing care services, it is also indispensable to retain prices. Five major groups of stakeholders are capable of solving these problems and bringing public health to a new level. One of the most impactful policies was the ACA which introduced the possibility of acquiring health coverage for minority groups. Additionally, the mandatory patient-nurse ratio is crucial to maintain in order to avoid adverse health outcomes that take a tool of the nation’s well-being.


DeNisco, S. M. (2019). Advanced practice nursing: Essential knowledge for the profession. Jones & Bartlett Learning.

Kenter, R. C., Mayer, M. K., Morris, J. C., & Lucero, L. M. (2019). State politics and the Affordable Care Act: Choices and decisions. Taylor & Francis.

Leger, M. & Dunham-Taylor, J. (2018). Health care financial management for nurse managers: Merging the heart with the dollar (4th ed.). Jones & Bartlett.

Martinelli, L. A. (2022). Stakeholders and ethics in healthcare: Ethical accountability for organizations. Taylor & Francis.

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