13 May Week 6 Discussion 1: Cost Savings Resulting from Implementation of Quality Improvement Project
No one will argue the importance of quality, especially in health care, but the critical financial question is, what is the cost of added quality? If a hospital can take actions that will improve its quality score and realize an additional $1 million in payment, should it do so if it costs $2 million to realize those improvements? Some argue that quality improvements will actually reduce costs. However, quality enhancements often require additional resources once production efficiency has been reached.
Cost–benefit analysis is the process of analyzing healthcare resource expenditures relative to their possible benefit. This analysis can be helpful and necessary as a mechanism to setting priorities when choices must be made in the face of limited resources. This analysis is used to determine the degree of access to, or benefits of, health care to be provided. Clarity of the decision-making process demands that cost–benefit analysis be separated and differentiated from risk–benefit analysis as well as from determinations of efficient and cost-effective medical care during medical decision making. Those involved in the analysis must always keep quality and patient safety a priority in the final decisions.
With this understanding in mind, respond to the following questions:
If a fictional treatment costs a total of $45,000 at today’s value and increases a person’s quality of life from 0.5 to 0.6 for the remainder of the person’s life from age 70 onward, and the person’s expected life span increases from 73 to 75, what is the total gain in QALYs (Quality-adjusted Life Years), and what is the ICER (Incremental Cost-effectiveness Ratio = Costs/QALYs)?
Read the following in your Waxman textbook:
Chapter 9, “Ensuring Quality Care While Controlling Costs”
Read the following in your Buppert textbook:
Chapter 15, “Measuring Nurse Practitioner Performance”
4 RESOURCES
Include in-text citations from at least two course materials and two external scholarly resources.
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