Healthcare Risk Management in US

This assignment provides a comprehensive overview of healthcare risk management in the US, discussing current trends, future perspectives from both administrative and patient viewpoints. It highlights the importance of reasonable health services, expanding Medicaid programs, and providing actual worth to invested money. The administrator's perspective emphasizes creating awareness about rare diseases, conducting educational programs, and serving high-value care to prevent disease transmission risks.

Running Head: Current and Future State of Health Care Legislation Analysis
Current and Future State of Health Care Legislation Analysis
Student name:
Email Id:

Current and Future State of Health Care Legislation Analysis 1
Describe the current health care environment in the United States from the perspective
of the health care administrator and the patient?
It is very necessary for a country to have an effective and efficient Health care environment.
In this section, The Health Care Environment of US is to be discussed. It can be explained
more clearly by the perspective of health care administrators and patients:
Health care administrators:
The health care administrators plays very important role in health care environment of the
US. The administrators of health care also called the mangers of health services that manages
and regulates the management in hospitals, health systems and related organisations. They are
responsible for facilities, services, programs, staff, budgets, relations with other organizations
and other related functions. They don’t handle the patients on day to day basis like clinicians.
Rather they do work to make policies and procedures to improvise the health care system of
individual patients. They also face some challenges while dealing with the patients and the
related companies such as lack of integrity and ethical issues (Drummond, Sculpher, Claxton,
Stoddart & Torrance, 2015).
 Lack of integrity: Some of the companies often go for some additional requirements
at the time of admitting the patients even in their worst conditions such as filling
forms, submitting the amount of the treatment before accessing any health services.
For such companies earning profit is the major priority instead of the patients (Jester,
2017).
 Ethical issues: Some of the patients refuse to follow the orders of their doctor and
demand to provide extensive care even at the time of terminal sickness.
Patients
Perspective of most of the adults towards the health care environment in the US is good.
They are really convinced by the reasonable cost of their health care system. However it
depends on the areas of facility as the people who use mini-clinics are more likely to consider
their health care expenses rational (Robert Wood Johnson Foundation, 2016). The
consequences of the survey imply that the health care expenses refer to serious financial
issues for more than one fourth of Americans. In total, 40% of people admit that they are
spending more than half or their earning on their medical bills. It is to be noted that out of
five there are four people who believe that they are not getting the actual worth of their

Current and Future State of Health Care Legislation Analysis 2
spending on health services and most of the people also reported that they are struggling to
afford the medical prescription (American Society for Healthcare Risk Management, 2009).
Describe some recent changes in the health care legislation of US?
There were 4 big changes in the latest GOP bill of health care in US to amend the affordable
care act. An amendment was introduced in 2017 which makes the coverage of insurance
unaffordable for people those who already have health issues. Under these changes the
government is likely to reduce its health care spending and decrease the insurance premiums
for healthy and young people. Before this Affordable Care Act Medicaid was not insurance
for poor people but it was the insurance for some of the poor people who comes in particular
criteria set by the government. According to the new amendments in the act, the program of
Medicaid being expand covered below 138% of the federal poverty line. These amendments
also include the down prices of the insurance for some people but the lower income group of
people would spend more than they were spending previously. Insurance plans could cover
less of financial benefits after the amendments (Stanhope & Lancaster, 2015).
How does this change influence the way that an administrator would operate within the
health care system?
Administrators are those people who actually encourage everyone to follow the amendments
done by the government. The administrators play a very important role in the recent changes.
After repealing the ACA act under the health care system of US, the population of US is still
facing issues in availing the health care services (Young & Kroth, 2017). The health care
administrators are facing many challenges that even on daily basis, to strategize and address
these issues. They are facing many difficulties to provide the adequate care to the people in
the US. The reasons behind these difficulties are the implementation of new legislation which
includes many new changes and the shift in demand of the patients to specialized providers.
Therefore it became too difficult for the administrators to handle the issues faced by the
patients.
What are current trends emerging in health care?
The emerging trends in health care can be explained as follows:
Repealing the ACA: Under this act the coverage of insurance is unaffordable for people
those who already have health issues. According to the new amendments in the act, the

Current and Future State of Health Care Legislation Analysis 3
program of Medicaid being expand covered below 138% of the federal poverty line. These
amendments also include the down prices of the insurance for some people but the lower
income group of people would spend more than they were spending previously. Insurance
plans could cover less of financial benefits after the amendments. (Santilli & Vogenberg,
2017).
Rare diseases: The president of US Donald Trump, thinking to have the existing provisions
included in the act ACA related to pre-existing medical conditions (Santilli & Vogenberg,
2017). The president also likely to increase the orphan drugs for the adults to cure the rare
diseases and soon he will acknowledge the health coverage affect to progress to market the
many drugs that are in the final stages of development
High-value care: The market of common health insurance has been facing a coverage policy
change to alternate sites of care which will enhance in 2017. The alternate sites of care
implies providing the kind of health care which is different and reasonable than a room of a
hospital, centre of outpatients, convenience care, urgent care clinics and independent medical
clinics. In 2017 they focussed on determining higher-value care sites (Santilli & Vogenberg,
2017).
Using the current trends, speculate on future of health care risk management from both
the perspective of the health care administrator and patient?
From the perspective of patients
As per the current health care system of US, the patients would like to have the greater health
care system which provides reasonable services to them. They would expect administrators to
make the favourable policies for the low income group of people under which the treatment is
to be provided on a very low cost (Bowling, 2014). They also expect the enough availability
of nurses and doctors to solve their problems. They also expect from administrators to expand
Medicaid programs. To improvise the health care system and the life expectancy rate in US,
health services should be provided on a very low cost. As per the current health care trends,
patients expect to have the actual worth of the money invested in health care services
(National Center for Health Statistics, 2014).
From the perspective of health care administrators

Current and Future State of Health Care Legislation Analysis 4
As per the current trends of health care system of US, the administrators would like to
improvise the health care system which can satisfy the needs of the patients. In the current
scenario of health care system the administrator faces many challenges such as lack of
integrity and ethical issues while dealing with patients and health related organization (Saint
Joseph University, 2018). In future they want to conduct the educational programmes
regarding rare diseases to create the awareness among people and to manage the future risk
regarding health. They want to serve the high-value care to the patients to prevent the high
risk of disease which can be easily transferred.

Current and Future State of Health Care Legislation Analysis 5
References:
American Society for Healthcare Risk Management. (2009). Risk management handbook for
health care organizations (Vol. 30). John Wiley & Sons.
Bowling, A. (2014). Research methods in health: investigating health and health services.
McGraw-Hill Education (UK).
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015).
Methods for the economic evaluation of health care programmes. Oxford university
press.
Jester, B.M.A. (2017). The 4 Big Changes To Health Care In The Latest GOP Bill. Retrieved
6th March 2018. Available at: https://fivethirtyeight.com/features/the-4-big-changes-
to-health-care-in-the-latest-gop-bill/
National Center for Health Statistics (US. (2014). Health, United States, 2013: With special
feature on prescription drugs.
Robert Wood Johnson Foundation. (2016). PATIENTS’ PERSPECTIVES ON HEALTH
CARE IN THE UNITED STATES. Retrieved 6th March 2018. Available at:
https://www.npr.org/assets/img/2016/02/26/PatientPerspectives.pdf
Saint Joseph University. (2018). Health Care Challenges Facing Administrators Today.
Retrieved 6th March 2018. Available at: https://online.sju.edu/graduate/masters-
health-administration/resources/articles/health-care-challenges-facing-administrators-
today
Santilli, J. & Vogenberg, R.F. (2017). Top 10 Healthcare Market Trends in 2017. Retrieved
6th March 2018. Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394543/
Stanhope, M., & Lancaster, J. (2015). Public Health Nursing-E-Book: Population-Centered
Health Care in the Community. Elsevier Health Sciences.
Young, K. M., & Kroth, P. J. (2017). Sultz & Young's Health Care USA. Jones & Bartlett
Learning.

Current and Future State of Health Care Legislation Analysis 6