As of 2016, the percentage of the Gross Domestic Product in the USA spent on healthcare was appropriately 17.9 %. Healthcare expense grew 4.3% or around $10,348 per person (National Health Expenditures Data) Our healthcare costs are higher than those found in other higher income countries such as Great Britain (9.7%), Netherlands (10.5%) Germany (11.3%), France (11%), and Denmark (10.8%). (Health Care Spending in the United States and Other High-Income Countries)
Health outcomes regarding average life expectancy in Hawaii, Minnesota, Connecticut are similar to those in Sweden, Germany, Great Britain, and Denmark. Dr. Ashish Jha of the Harvard T.H. Chan School of Public Health and senior author in his study Health Care Spending in the United States and Other High-Income Countries study indicates that many healthcare outcomes comparison in some states to these countries is similar. Many of these countries have similar populations as some of these states. The USA is much larger and more diverse nation than those to whom our healthcare system is often compared. It seems once a person gets into the healthcare system they do well as those in other high-income countries. Health Care Spending in the United States and Other High-Income Countries
Utilization of services in the USA as reported by the Organisation for Economic Co-Operation and Development data. The USA does not appear much different than other high incomes countries regarding structural capacity, access, and quality, and healthcare utilization. Dr. Ashish found utilization of healthcare services in the USA was not different than that in Denmark, Netherlands, Germany, France, and the UK.Health Care Spending in the United States and Other High-Income Countries - Video
The primary contributors to higher costs are administrative costs, healthcare professional labor, and pharmaceutical. Administrative costs in the USA average 8% compared to other countries 1% to 3%. Medicare while many opponents of government managed care administrative costs are around 2% (Medicare is More Efficient Than Private Insurance). Physician and nurses salaries are also higher in the USA than in most other countries. Primary care physician average $218,173 while in other high-income countries salaries are $86,607 to $154,126. The USA medical education system is more costly and more prolonged than those in other countries. Regarding pharmaceuticals in different counties, the average cost ranges between $466 to $939 while in the USA is $1,443. Health Care Spending in the United States and Other High-Income Countries
In the past several years the Congress, as well as the President, have failed to find solutions to address this issues at least from a Federal level. There has been some progress made at the State level by some to create an expansion of Medicaid, require individual mandatory insurance purchases thus lowering the costs of premiums, and well as provide insurance companies “safety” coverage in case of unexpected losses. Read more about this at 4 States Are Restoring the Individual Mandate to Buy Health Insurance with 9 states considering individual mandate rules: report
Maybe change will only come when the private sector takes ownership of creating health policy and innovations to reduce the costs of healthcare. Amazon, Berkshire Hathaway, and JP Morgan Chase have announced Atula Gawande a well-known surgeon and best selling author to be the lead in a new company formed by this partnership with an aim to reduced healthcare costs. With the combined companies having over one million employees the deep pockets of Jeffrey Bezos of Amazon, Warren Buffett of Berkshire Hathaway, and Jamie Dimon of JP Morgan Chase just might interrupt the healthcare system that is often inefficient and absorbed by seeking financial incentives that may or may not relate to improving quality. Clearly, Congress and the healthcare industry has been unable to accomplish this task Washington Post June 20, 2018
Dr. Bob
Wednesday, November 28, 2018
Wednesday, November 21, 2018
For-Profit Nursing Schools – Creating Success
Nursing schools owned by a profit-oriented organization are often stigmatized as not “being good enough” to educate nurses. This source of stigma is hard to pinpoint as to the etiology. Perhaps it stems from a historical perspective at least in the past where education was provided by government-sponsored programs. With this model, the taxpayers funded the schools. This paradigm has changed significantly in the past 20 years because of the decrease in state funding and schools are expected to raise tuition in part to support student education. As a result, in many states, the costs of attending public sector or private non-project schools have “skyrocketed” as schools must act as a “for profit” enterprise to support their operations.
The shortage of nurses created an opportunity for alternative educational modules given the public sector simple was not able to be adapted to meeting the needs of the healthcare industry for nurses. The inability to the public and to a lesser extent non-profit schools to be more entrepreneurial often because of state regulatory prohibitions created an opportunity for private for-profit schools to emerge. The trend for profit was non-only isolated to nursing as other professions, as well as occupational majors, saw new educational opportunities appear.
The Obama administration who tended to lack an understanding of for-profit schools through the Department of Education decided (because of some outliers who were gaming the system) created new regulatory oversight which for the most part created significant closures of these schools. Thus at least in nursing while attempting to provide more funding to public sector nursing programs through the Division of Nursing within the Health and Human Resources Administration restricted growth or made doing building nursing programs impossible. The action contributed to the shortage of nurses and in some way continues today even though the Trump administration has lifted some of the restrictions.
As in any business venture particularly something as complex as nursing being able to provide a high-quality program can be very challenging. Given the stigma mentioned earlier often nurse educators are hesitant to move to the for-profit sector. The workload expectations are also different in that having a tenure-track position and focus on the creation of research agendas is mostly missing in the for-profit sector. The focus is on teaching and the scholarship of such. Faculty appointments are full time with no time off in the summers other than accumulated vacation time. Thus, finding nursing educators and administrators willing to give up these “perks” can be challenging.
Many of the for-profit schools have managed to address these issues adequately and as a result, provide a high-quality education. Notable are some of the Fortis schools including the Denver College of Nursing who have some quality program. Others such as publicly traded Chamberlain and Walden Universities are known for the quality of their graduates.
The variability in student outcomes and educational experience is directly related to several variables. From my perspective, the primary driver of quality is the ability of nursing administrators and faculty to create a successful learning experience. Often for-profits have limited experience under their belt in regards to nursing education. To develop successful programs can be very challenging. Success, while not guaranteed, can be fostered by using nursing consultants experienced with the for-profit sector. RL Anders and Associates given our extensive experience in both public sector and the for-profit schools can be a cost-effective resource to foster faculty development, student retention, satisfaction, and success on the NCLEX®.
Our clients are willing to share with you their experience and how together improvements and successful outcomes have been achieved. Our cost-effective consultant services which often can be done virtually thus saving traveling costs may make the difference in your NCLEX® results and EBITDA.
Check out these videos regarding how to achieve NCLEX® success.
Nursing schools owned by a profit-oriented organization are often stigmatized as not “being good enough” to educate nurses. This source of stigma is hard to pinpoint as to the etiology. Perhaps it stems from a historical perspective at least in the past where education was provided by government-sponsored programs. With this model, the taxpayers funded the schools. This paradigm has changed significantly in the past 20 years because of the decrease in state funding and schools are expected to raise tuition in part to support student education. As a result, in many states, the costs of attending public sector or private non-project schools have “skyrocketed” as schools must act as a “for profit” enterprise to support their operations.
The shortage of nurses created an opportunity for alternative educational modules given the public sector simple was not able to be adapted to meeting the needs of the healthcare industry for nurses. The inability to the public and to a lesser extent non-profit schools to be more entrepreneurial often because of state regulatory prohibitions created an opportunity for private for-profit schools to emerge. The trend for profit was non-only isolated to nursing as other professions, as well as occupational majors, saw new educational opportunities appear.
The Obama administration who tended to lack an understanding of for-profit schools through the Department of Education decided (because of some outliers who were gaming the system) created new regulatory oversight which for the most part created significant closures of these schools. Thus at least in nursing while attempting to provide more funding to public sector nursing programs through the Division of Nursing within the Health and Human Resources Administration restricted growth or made doing building nursing programs impossible. The action contributed to the shortage of nurses and in some way continues today even though the Trump administration has lifted some of the restrictions.
As in any business venture particularly something as complex as nursing being able to provide a high-quality program can be very challenging. Given the stigma mentioned earlier often nurse educators are hesitant to move to the for-profit sector. The workload expectations are also different in that having a tenure-track position and focus on the creation of research agendas is mostly missing in the for-profit sector. The focus is on teaching and the scholarship of such. Faculty appointments are full time with no time off in the summers other than accumulated vacation time. Thus, finding nursing educators and administrators willing to give up these “perks” can be challenging.
Many of the for-profit schools have managed to address these issues adequately and as a result, provide a high-quality education. Notable are some of the Fortis schools including the Denver College of Nursing who have some quality program. Others such as publicly traded Chamberlain and Walden Universities are known for the quality of their graduates.
The variability in student outcomes and educational experience is directly related to several variables. From my perspective, the primary driver of quality is the ability of nursing administrators and faculty to create a successful learning experience. Often for-profits have limited experience under their belt in regards to nursing education. To develop successful programs can be very challenging. Success, while not guaranteed, can be fostered by using nursing consultants experienced with the for-profit sector. RL Anders and Associates given our extensive experience in both public sector and the for-profit schools can be a cost-effective resource to foster faculty development, student retention, satisfaction, and success on the NCLEX®.
Our clients are willing to share with you their experience and how together improvements and successful outcomes have been achieved. Our cost-effective consultant services which often can be done virtually thus saving traveling costs may make the difference in your NCLEX® results and EBITDA.
Check out these videos regarding how to achieve NCLEX® success.
The success of for-profit programs and achievement of your
EBITDA is possible once the foundation for success is in place. Given us a call at 915-383-1653 or send an
email to rlanders10@gmail.com
Our webpage is https://www.rlaassociates.com/
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