Answer :

Introduction

U.S. Federal Health Care Agencies play the role of controlling health hazards especially for diseases which have newly emerged. Standards are created by the agencies for protection of the public health system. This paper highlights the role of a specific U.S. Federal Health Care Agency. Here the role of Centers for Disease Control and Prevention (CDC) has been discussed. Additionally the paper discusses how the National Academies of Sciences, Engineering and Medicine (IOM) core metrics for health and health care progress and public healthcare management approaches are related to the initiative. Along with this the barriers for the change implementation are also identified.

Part 1

Centers for Disease Control and Prevention (CDC) is a federal agency that is involved in conduction of health promotion with the aim of supporting prevention and preparedness activities that helps to improve the public health in the United States (CDC Works 24/7, 2018). The agency was developed in Atlanta, in the year 1946. This is managed by the Department of Health and Human Services (HHS) (HHS.gov, 2018). The CDC is involved in partnership with the other national and state level organizations to monitor as well as prevent situations related to outbreaks which includes bioterrorism. It also aims to prevent infectious and chronic diseases including the workplace hazards, injuries and threats of environmental health. CDC projects its focus majorly on five strategic areas which includes elevation the amount of support that is provided to the local and state health departments along with improvement of global health. Its objects also includes decrease of the leading causes of death. Additionally the focus is on strengthening surveillance along with reforming of health policies. Apart from these, the CDC plays multiple roles which includes coordination and technical support though which it tends to meet the health security goals. The goals comprises of prevention, detection and responding to the investments in global health (Johnson et al., 2014).

In the context of CDC, the health reforms were conducted in 2013, when president Obama signed the Patient Protection and Affordable Care Act. This law was known as PPACA (Arnett et al., 2014). This health reform legislation includes the development of the new programs of prevention and aims to monitor the public health workforce. These include the Patient Protection and Affordable Care Act, the HHS prevention and public health fund, the national public health improvement initiative (NPHII) and lastly the national prevention strategy (M, 2018).

The policies and regulations of CDC are governed by the Department of Health and Human Services (HHS). The HHS issue regulations are involved in implementation of laws that develops policies and provides guidance for the industries and the local and state governments. The page of the HHS Regulations covers the information on the strategies of health information technology along with the Health Insurance Portability and Accountability Act (HIPAA) (Croft & Parish, 2013). Additionally there is a mention of other laws and regulations. A recent vital hepatitis action plan has been proposed by CDC which will help to battle the viral hepatitis in United States between the year 2017 and 2020. The strategies included in the plan are given as four goals. The first goal is prevention of viral hepatitis infections that are new. The second goal state reduction of deaths and improvement of health of individuals suffering from viral hepatitis. The third goals mentions that there should be reduction of hepatitis health disparities and the final goal reflects that there should coordination and monitoring of the implementation of activities of viral hepatitis (Grol et al.,  2013)

CDC has been able to address the problems of health focused on the patient but also on the community as a whole. Interventions have been implemented in all conditions including the place where we live, learn and work. The social determinants of health (SDOH) have been focused upon by CDC in order to make healthy choices regarding the changes in community (Arnett et al., 2014).
Part 2

Quality initiatives have been taken by the centre for Clinical Standards & Quality (CMS). Highest priority is received by Medicare for Quality health care for people by the President along with the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS). In 2001, initiatives were taken HHS and CMS to begin the launching of Quality Initiatives. It assured the quality of health care service for all Americans by ensuring accountability, responsibility and public disclosure. One of the recent initiatives was the Request for Information (RFI) for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): Request for Information (RFI) Regarding Assessing Interoperability for MACRA; Corrections, 2018).

Public comment is invited for the section 101 of MACRA that is subjected to comment and notice rulemaking. It also includes the Merit-based Incentive Payment System (MIPS) directed for eligible professionals (EPs). Additionally the Section 101 of the MACRA is involved in promotion of the establishment of APMs through provision of incentive payments for EPs who are involved in APMs. This encourages the development of more Physician-Focused Payment Models (PFPMs) (HHS.gov, 2018).

Large scale information is required by the Center for Medicare & Medicaid Services (CMS) related to the clinician practices. This is required to attain the targets of advanced care and lower cost of better health. Practice Transformation reflects the process that results in changes of observable and measurable nature in terms of practice behaviour. Core competencies are a part of these behaviours. This can be described in terms of engaged leadership with improvement in quality empanelment and elevated outcomes of patient health along with business and economical acumen. There is a continuous healing that is generally team-based (Underwood & Waterson, 2014). It incorporates culture, beliefs and values along with structured and evidence-based care involving patient-centered interactions. There is a scope of enhanced access accompanied by progression towards a care management that is population based.

The barriers in overcoming the change in the healthcare system include the patient safety and clinical qualities are as follows:

Patient Safety and Clinical Quality

The focus on quality and safety of patient has not decreased since there has been release of the Institute of Medicine’s 1999 report that was related to the medical errors. Although recent reports have brought to limelight the fact that the “Swiss cheese” healthcare system has allowed an approximate of 200,000 people to die each year needlessly (Underwood & Waterson, 2014).

The Move Toward Digitization

Both improvements in terms of safety and efficiency, there is a need for push in order to adopt information technology (IT) systems. This will continue with the increase in the patient care settings which is becoming “filmless and paperless.”  In order to make the migration successful, process adaptation should be accompanied with altered management techniques that improve the acceptance rate among the health professionals and other staffs of the clinic.

Demographic Changes

With the converting demographics and an increase in aging population, there will continuation of the impact of healthcare in the United States. This is specifically for the service related to cardiovascular risk and other such specialities. As the U.S. healthcare workforce is aging, there is a presence of only 9.1% of all registered nurses (RNs) who fall under the age group of 30, with the average age 45.2 years (Antheunis, Tates & Nieboer, 2013).

Workforce Issues

There is a persistent workforce shortage, perceived especially in acute and certain regions or specialties. This continues to create a stress on the system. An article has stated that Healthcare Financial Management there is shortage of healthcare staffs, which includes the Registered Nurses along with the radiology technicians and several other professionals. They not only reduce the capability of the healthcare providers to respond to elevated rate of demand but also affect the ability of the providers for maintenance of the existing levels of service along with quality and profitability. There is a need for the hospitals to ensure that they are efficient in terms of operations and possess the ability to create a work environment that is optimum for attracting, developing and retaining the top talent.

Financial Challenges

There is an existence of financial pressures among the healthcare providers as they have to deal with the increasing demand. There is uncertainty in reimbursement along with revenue collection. Certain projects that address and identify the revenues and strategies of cost management. This will be important for maintaining quality services (M, 2018).

Conclusion

From the above discussion it can be concluded that the role of CDC is involved in conduction of health promotion with the aim of supporting prevention and preparedness activities that helps to improve the public health in the United States. The barriers are identified which help in overcoming the change in the healthcare system.