Review - Health and Human Services Strategic Plan for Fiscal Years 2010-2015

Reviewing the U.S. Department of Health and Human Services Strategic Plan for Fiscal Years 2010-2015 helped me gain a better understanding of how the plan was implemented and what the main foci of attention were. It was written with five strategic goals in mind: 1. Transform Health Care 2. Advance Scientific Knowledge and Innovation, 3. Advance the Health, Safety and Well-Being of the American People, 4. Increase Efficiency, Transparency, and Accountability of HHS Programs, 5. Strengthen the Nation’s Health and Human Service Infrastructure and Workforce. Although being broken into five separate entities there is a lot of overlap in between each goal which should be expected. It is very well written document, but as we stand in 2016, it seems as though it fell short on different areas of the plan that were crucial to its overall success. We are going to dive a little bit deeper into Strategic Goal #1 which was written to improve the overall strength of healthcare.

The changes that were proposed to the healthcare system were to improve patient outcomes, promote efficiency and accountability, ensure patient safety, encourage shared responsibility and work toward a high-value healthcare system. A strong healthcare system enhances the ability of our Nation to provide extra medical care when it is needed to both individuals and community. When the plan was written over 45 million Americans lacked health insurance. That number has fallen to now less than 15 % of the United States populations (less than 29 million). The overall Strategic Goal 1 is broken down into six distinct objectives. To get a better understanding of the whole goal it is best to break down each objective and take a look at why they have or have not been successful from an implementation perspective.

The first overall objective is to ensure that coverage was more secure for those already having insurance and to extend affordable care to those who do not. The main piece of this was to ensure that those with coverage do not have any gaps for pre-existing conditions and to make sure if they were about to lose coverage that they were able to still receive healthcare. It was also to cover those individuals that could not afford healthcare benefits to receive them as part of the Affordable Care Act. I believe that part of this worked, but part of the goal was to make sure that increasing premiums and medical costs would not drive some to bankruptcy or force those with insurance to make a decision such as healthcare or food on the table. I do not believe they were successful with this as high deductibles and copays have forced those with insurance to either see the physician or give up something in its place. This actually affects people like you and me as each family member within my insurance has a $300 deductible. Just a routine yearly check-up for my kids is basically $600. This hinders the true idea behind the plan. I am in agreement that it did meet other goals as Medicaid coverage has been expanded and the number of uninsured has decreased dramatically. I hesitate to commit to an agreement on the State-based exchanges as it seems as though they are decreasing at a pretty alarming rate

The second overall objective is to improve healthcare quality and safety. There seems to be a gap in between the care that is considered best practice versus what is delivered. However, I do agree that there has been a better emphasis placed on patient safety and patient outcomes. Unfortunately hospitals are not rewarded by bettering their numbers in this area, but the reimbursements are cut so it is seen more of a penalty. I think if there was a standard across the board, a national average, then those that exceed it should be awarded and those that do not just receive reimbursement for the care provided. There has also been a better focus on healthcare-associated infections or conditions (HACS). Again, the issue here is the hospital gets monetarily punished for having a HAC, but we do nothing to reward those that do not. This overall reimbursement penalization only hurts the system more. In addition, more monies should be given to organizations to make their hospitals safer. Whether it is technology upgrades or something simple as enhancing falls preventions programs we can do better in this area.

The third overall objective is to put a focus on disease prevention, especially in the community setting. We are making some very good strides in this area. There seems to be a push to outpatient clinics for anticoagulation and diabetes management. There also seems to be a newfound focus on disease state prevention and healthy living. Education provided at physician offices is often discussed with the patient so they understand the preventive measures they can take from a lot of different disease states. There is