Healthcare Regulation Influences On Healthcare Organizations

Copyright (c) 2012 Morgan D

The health care sector has on many occasions come under scrutiny raised by the concerns that the sector faces in terms of political threats, resources or the ever increasing service demands being a consequence of increasing numbers of underinsured and uninsured individuals. Many studies have been conducted to address the financial and safety viability of the health care sector but none has addressed the organizational strategic decisions that are inevitable in the ever-increasing difficult environments in terms of finances (Baxter, 2004). Compared to other industries, the health sector is overly affected by regulations and laws where some laws such as those relating to social systems of insurance and malpractices affects ways in which the sector operates. It is vital for health administrators and practitioners to be aware of these dynamic and complex legal fields. To be at par with the requirements needed in the sector, professionals in this field must be keen in monitoring and evaluating the trends that facilitate the establishments of strategic ways to counter the regulations and laws affecting the sector to enhance its overall survival (Brennan, Gutterman, & Zuckerman, 2001).

The scope of this study will outline the different ways that the sector can adopt to enhance its survival with regard to strategic planning and decision-making. The approach of the study will generally analyze the results obtained from different case studies where methods applied in these studies will provide a dynamic understanding of the sector’s changes owing to the numerous viewpoints provided by many stakeholders. In-depth qualitative and quantitative information obtained from the case studies will only display the generalized statistics from the small samples that translate to the much larger populations (Sofaer, 1999). The study maps the health care sector based on types of organizations and the kind of services they offer such as areas affected and diversity of provided services (Sofaer, 1999). The service areas will be selected based on organizations in the field of family planning clinic, public health departments, hospitals and community-based clinics. Secondary and primary procedures of data collection will be utilized that address the research question that shed some light on the threats health organizations face, possible responses in terms of strategies to counter the threats, organizational change opportunities and relevant recommendations to stakeholders in the policy making process. The analysis of data collected cut across the different themes that have been revised to compare, contrast and identify the relevant information spanning across the health care organizations

Different agencies have been established that regulate the health care sector extensively. Governments, to enhance control, usually create the agencies that do not render any goods or services but in some ways increases the costs of Medicare through complex forces combinations such as technology advancement, medical specialty advancements and country’s expansion of the hospital systems that have made the health care costs to rise. Attempts to regulate the costs without affecting the access and quality have always been a major concern. The competition in this case has become devoid as more provider of services increase. The care delivery structures have long been changed owing to the regulations where insurers together with the government have affected the supply of money in the sector and provider organizations have been forced to operate on less cash than they expect (Keane, Marx & Ricci, 2002). The advent of managed care gatekeepers has proliferated and referral costs has risen since the sector has seen an increased number of specialties following regulations by the government. This has made the organizations to be overly vulnerable to instances of litigations where contractual associations are present. The increased regulation by the government has led to centralized practices in terms of administration that have lowered the efficiency in resource streamlining, marketing intensification and public relations. The regulations have prompted closure of many community-based care centers due to their inaccessibility owing to higher operating inefficiencies. Social and ethical instances have also increased as genetic researches intensify where more regulations have been advocated for that have brought with them the a fresh analysis of enduring concerns implemented through legislative mandates for example the Patient Self-Determination Act in the USA. This has increased the overall sensitivity of patients’ records that require attention with regard to ethical and social issues .

Growth and survival of an organization is an implicit objective that calls for investments in terms of resources and energy. This can only be achieved only when higher managerial levels are given the required attention. Through bureaucratic imperialism, an organization develops specific goals that serve specific groups hence making it create its own territory. The organization becomes imperialistic due to underlying competitions and power struggles that ensue when organizations seek to work with same members, jurisdiction area and clients. This enhances professional licensure that annexes a territorial domain for a given group of professional.

Organizations can also co-opt to ensure it adapts to changes where it shares powers through absorbing new elements. This can be done through formal or informal co-optations where the former allows the sharing of organizational burden where power is not transferred (Taylor, 2004). Adaptation and hibernation of a care organization can help in the maintenance of equilibrium with regard to changing organizational inputs. Cutting cost, in this case becomes a sensible choice where processes such as retrenchment are applied. Expansion, multiplication and goals succession attracts materials, personnel and money in the case of organizations that have multiple groups of clients.

This helps the managers to expand or modify the original goals of the organization in a positive manner. Additionally, organizational changes can be enhanced through restructuring of its life cycle that is assessed chronologically in phases of development and growth (Taylor, 2004). However, not every organization reflects the details that every phase entails and emphasis is predominantly directed at characteristics of the organization’s clusters that are dominant at specific times. Due to increased competition and the rise of new providers of health care, mergers and affiliations are vital where the restructuring efforts associated with such exercises precede a mutual diligence where financial, legal and operational issues are evaluated.

Owing to the increasing dependency on markets to dispense resources in the healthcare sector, enforced policies should seek to enhance the efficiency of these markets. Enforcements of regulations and laws are essential to avoid monopoly but they should allow to a greater extent the growth of efficient and new forms of health care ventures. However, the drawing of a line between arrangements and practices that are efficient overly and that posses market strengths has become a difficult task owing to the industry’s rapid changes.