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Winter 2024 - Critical Care

Overcoming Challenges of Delivering Quality Healthcare

Better health for all is on the horizon thanks to those who are implementing new strategies to improve care.

As the U.S. population increases and ages, the rate of illness and disease escalates too, so it is vitally important that providers are equipped to deliver quality healthcare. But both long-standing and new challenges make delivering quality healthcare difficult, and these challenges will undoubtedly continue into the future as well.

However, there is hope: Several healthcare associations have identified many of these challenges and are working toward implementing solutions that will make better healthcare available to populations that need it.

American Hospital Association

The American Hospital Association (AHA) represents nearly 5,000 hospitals, healthcare providers, networks and their patients and provides information on healthcare issues and trends. AHA is “committed to providing patients with high-quality, equitable, safe and person-centered care.”

AHA has identified several challenges to providing quality healthcare, including historic workforce shortages, soaring costs, broken supply chains, severe payer underpayment and an overwhelming regulatory burden. They are implementing the following strategies to address these challenges:

AHA 2023 Advocacy Agenda. This agenda is focused on quality, equity and transformation. AHA believes everyone deserves access to high-quality care, regardless of personal or community characteristics or geographic location, so strategic partnerships and solutions are being established to coordinate care across the continuum. AHA is also urging the government to support policies to support this effort, as well as improve maternal and child health outcomes with a particular focus on eliminating racial and ethnic inequities.1

Health Research and Education Trust Hospital Improvement Innovation Network 2.0. Valuable best practices from this two-year contract awarded by the Centers of Medicare and Medicaid Services helped reduce all-cause inpatient harm by 20 percent and readmissions by 12 percent by 2019.

Age-Friendly Health Systems. The number of Americans at or above 65 years of age (55 million) is projected to double by 2060. The goal of this program is to rapidly spread the 4Ms Framework to 20 percent of hospitals and medical practices by 2020.

Better Health for Mothers and Babies. AHA collaborates with Alliance for Innovation on Maternal Health to safeguard mothers and babies by reducing maternal morbidity, especially in the hospital.

AHA Joint Initiative with Center to Advance Palliative Care. Palliative care reduces symptom distress by 66 percent, with improvements often lasting months. This initiative reexamines palliative care, identifies patients needing additional support and builds a care plan centered on the whole patient.2

Quest for Quality Prize. AHA recognizes hospitals and health systems that provide access to exceptional quality care that is Safe, Timely, Effective, Efficient, Equitable and Patient and family-centered (STEEP) with this yearly award.3

American Medical Association

The American Medical Association (AMA) represents physicians at the federal and state levels to help them remove obstacles that interfere with patient care and access to quality healthcare. AMA is currently leading the charge for Medicare payment reform to address long-standing and current patient care and access to quality healthcare issues that affect more than 50 million Americans:

On July 13, 2023, a proposed Medicare physician payment schedule was released that will see a new rule bring another downward adjustment of 3.36 percent in 2024 (on top of the 2.0 percent payment reduction in 2023). The payment schedule estimates the Medicare Economic Index increase at 4.5 percent for 2024, the highest this century and in addition to last year’s 3.8 percent in 2023.

According to AMA, “When adjusted for inflation, Medicare physician payment has effectively declined 26 percent from 2001 to 2023. These increasingly thin or negative operating margins disproportionately affect small, independent and rural physician practices, as well as those treating low-income or other historically minoritized or marginalized patient communities.”4

In response, AMA and the Federation of Medicine developed a set of principles known as Characteristics of a Rational Medicare Payment System to guide efforts on Medicare physician payment reform. This is part of AMA’s Recovery Plan for America’s Physicians and represents its ongoing work.5

“Cuts, temporary measures and partial fixes to the Medicare physician payment system are not sustainable,” explains AMA. “They hinder physicians’ ability to adequately pay staff, purchase new equipment and invest in their practices. Without long-term reform, physicians could be forced to close their doors for good, leaving Medicare patients without access to high-quality care. Overall, a rational Medicare payment system would ensure financial stability and predictability, promote value-based care and safeguard access to high-quality care.”6

According to AMA, providing and protecting high-quality care can be achieved by 1) advancing health equity and reducing disparities by risk-adjusting payment model innovations and recognizing physicians’ contributions to reducing health disparities and 2) supporting clinical practices where they already are by recognizing that high-value care is provided by both small practices and large systems, and in both rural and urban settings.7 Physicians need support as they care for historically marginalized, higher-risk, hard-to-reach or sicker populations.

American Nurses Association

The American Nurses Association (ANA) represents more than four million nurses and offers many opportunities for its members to foster excellence in patient care. ANA has developed three practice areas that help nurses address the challenges they have in providing quality healthcare:

1) Support nurses to manage the complexities of modern healthcare and deliver consistently excellent care. From ethical dilemmas to healthcare reform, ANA works to ensure that no matter what the challenge, nursing continues to improve healthcare for all.8

2) Emphasize advocacy as a pillar of nursing. Advocacy for patients in the workplace, community and government is important to advance the nursing profession and, ultimately, quality healthcare.9

3) Encourage use of digital health. Telehealth applications that include live (synchronous) video conferencing, remote patient monitoring and mobile health all help nurses overcome the challenges of delivering quality healthcare to patients who are not able to visit a doctor’s office or a hospital in person; who need regular monitoring that does not require an office or hospital visit; or who live in remote locations where no doctor’s offices or hospitals exist.10

In addition to these, ANA’s American Nurses Credentialing Center’s (ANCC) Pathway to Excellence Program is the premier designation for healthy work environments. It recognizes healthcare organizations that demonstrate a commitment to establishing the foundation of a healthy workplace for nurses. The professional development program fosters satisfied nurses by ensuring they are competent to provide care; it also provides mentoring, support and opportunities for lifelong learning. ANCC says that communities want satisfied nurses because they are better equipped to deliver higher-quality care, and with fulfilled staff, come higher standards of care and patient outcomes.11

From Adversity to Improvement

With adversity comes an opportunity for improvement. Though challenges remain, healthcare associations are actively attempting to address them. Thanks to their efforts, better access to and delivery of improved patient care is on the horizon.


  1. American Hospital Association. AHA Advocacy Agenda 2023. Accessed at
  2. American Hospital Association. Quality and Patient Safety. Accessed at
  3. American Hospital Association. AHA Quest for Quality Prize. Accessed at
  4. American Medical Association. Nation’s Physicians to Develop Action Plan to Reform Medicare, June 12, 2023. Accessed at
  5. American Medical Association. Medicare Physician Payment Proposal a Wake-Up Call for Congress, July 13, 2023. Accessed at
  6. American Medical Association. Fix Medicare Now. Accessed at
  7. American Medical Association. Characteristics of a Rational Medicare Payment System. Accessed at
  8. American Nurses Association. Nursing Excellence. Accessed at
  9. American Nurses Association. Federal Advocacy. Accessed at
  10. American Nurses Association. Telehealth. Accessed at
  11. American Nurses Association. About Pathway. Accessed at
Diane L.M. Cook
Diane L.M. Cook, BComm, is a freelance trade magazine writer based in Canada.