Health Care Reform: A Case Study

With so many changes in healthcare and the call to attention to reduce costs hospitals have been at the center of discussion in regards to health care reform. Many hospitals have gone out of business while others have simply gotten bigger and merged due to the complex and fundamental changes in deliveries care. Despite a history of strength and stature in America, the hospital institution is in the midst of massive and disruptive change (Houle and Fleece, 2012). One of the single biggest changes to the growth of hospitals as well as to the decline of hospitals has been the increasing use of pay for performance models or value based purchasing strategies by both private health plans and government agencies. The objective of pay-for-performance initiatives is to link reimbursement quality and efficiency as an incentive to improve the quality of healthcare, as well as reduce systemwide costs. Government agencies and private health plans are continuously establishing programs that encourage hospitals, physicians, and other providers to meet quality standards providers who can demonstrate improvement in care and more efficient performance stand to reap financial rewards with approximately

In return, they agreed to provide a reasonable volume of services to persons unable to pay and to make their services available to all persons residing in the facility’s area (http://www.hrsa.gov/gethealthcare/affordable/hillburton). Since the passage of that act, it helped further expand that number of hospitals to 7,200 by 1970. By the early 1990s that number steadily grew. But the demand for inpatient services sharply declined in the late 1990s with the introduction of managed care, the expansion of outpatient services, and the high costs of a hospital stay. During that time period, some hospitals were forced to merge or shut