Expert answer:Discussion Responses

  

Solved by verified expert:Please respond to student #1 and student #2 discussion post. You can do either the following below.
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Student #1
One of the most significant purposes of the ACA is to reduce healthcare costs and
increase quality of care provided to patients. Scott Knoer (2015) discusses the pressure
the ACA placed on pharmaceutical companies with regard to the increase of costly
specialty drugs, rise is pricing for sole-source drugs and the increase in pricing for
generic drugs. He also states that one way companies are attempting to mitigate the
turbulence is to partner with outside entities like chain pharmacies. (Knoer, 2015, p. 5)
Strategic planning on the part of pharmaceutical companies include planning for changes
in delivery and financing, population management, new drug development, the
pharmaceutical marketplace, technology, the work force, patient accountability, and
ethics. And, common barriers are identified as lack of time and resources for analyzing
external environmental forces. (Zellmer, 2016, p.2) The fundamentals of strategic
planning calls for management to steer the direction of an entity and plan for change to
occur. Furthermore, strategic planning is much more than gearing up for competition, it
is about adapting to changes that occur in external environments. (Moseley, 2018, p.5).
So, in the context of the pharmaceutical industry, a mistake could have been the lack of
planning and evaluation surrounding the external environmental forces that became
factors with the implementation of the ACA.
Student #2
Fundamentally, pay-for-performance has some major flaws when it comes to planning
and implementation. Paying for quality over quantity seems like a no-brainer, however,
moving toward pay-for-performance is met with resistance by some providers who do not
want to change the way they practice medicine. A main reason paying for quality is
problematic, is because there is no definitive way quality is defined. There have been
studies that pay-for performance does not incentivize provider behavior, or even patient
outcomes (Carroll, 2014). Arguably, some healthcare facilities are at a disadvantage
when it comes to quality and meeting performance measures simply because of the
patient population they serve, an issue yet to be acknowledged by the ACA (Carroll,
2014). Pharmaceuticals play a role in pay-for-performance involving hospitals and
managed care organizations that employ physicians. They incorporate generic drug and
follow-on biologic prescribing as a measure in their pay-for-performance schemes and
are not prohibited from accepting prescribing bonuses from private health plans
(Sarpatwari, Choudhry, Avorn, & Kesselheim, 2015).
Changing physician behavior can be a huge challenge when implementing such
practices. The basis of pay-for performance is to extrinsically reward physicians, which
undermines the intrinsic motivation of helping others, a main reason why physicians
decide to practice in the first place (Carroll, 2014). This can be overcome by proper
strategic planning and implementation in a healthcare organization. There is great
pressure on administrators and managers to maintain adaptability to keep up with ever
changing structure and cost issues associated with the ACA and pay-for-performance. A
strong strategic plan that incorporates pay-for performance compensation schemes
includes established internal metrics which can be used to plot organizational and
employee progress (Moseley, 2018). This process will assist organizations in providing
value to their patients and improve operational effectiveness. The challenge lies in
breaking physician habit to get them to perform activities differently than they may have
in the past.

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