External Forces and Their Impact on Health Care

External Forces and Their Impact On Health Care


Health care quality and safety are not solely dependent on the actions of individual providers and institutions. A host of external forces exert a profound influence on what happens within any single organization or the behavior of any individual provider. These external forces include accreditation bodies, regulators, legislatures, insurers, and many other entities. Sociopolitical forces, including the economy and public opinion, also play a role in how and how well health care is provided.


To prepare for this Discussion Question:


· Review this week’s Learning Resources.


· Choose a specific example of an external force that influences health care and safety, as discussed in Chapter 2 of your Course Text.


Then, analyze how it influences health care quality management. (The external force can have minimal or extensive impact on quality.) Finally, evaluate whether the impact on health care is positive or negative, providing evidence to support your position.






The predominant model for the delivery of health care in the United States and other parts of the world is fee-for-service. A new model gaining in popularity is known as pay-for-performance, or P4P. In the P4P model, providers are paid for how well they provide care, not how much care they provide. There are rewards for high quality, efficient and effective care and penalties for wastefulness and medical errors. Whether or not P4P can raise the standards of care and/or lower its cost is a matter of some disagreement.


To prepare for this Application Assignment:


Review the Learning Resources for this week that discuss pay-for for-performance.

Find two additional reputable sources (i.e., news sources, accreditation and health care agencies, peer-reviewed journal articles, etc.) that address the challenges of adopting a pay-for-performance approach for ensuring quality and safety in health care.


To complete this Application Assignment, write a 3-page paper that addresses the following:

Summarize and analyze the challenges discussed in the two sources you selected.

Select the two most significant challenges to the successful adoption of a P4P approach, and explain why.

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