...Cost shifting when hospitals or healthcare provider’s charges insured patients more than the uninsured for the same services. Hospitals and health care providers used this mechanism to make up for the loss make by providing services to uninsured. Likewise uncompensated care is when hospitals or health care provider’s loss money for charity care and or due to the fact that patients who get treatment are unable or unwilling to pay for the healthcare services the received. (Shi, Singh pg238). Hospitals cost shifting are becoming more of trend for example hospitals attract both patients and physicians with more expensive technologies and treatments. According Christopher W. Baugh and Jeremiah D. Schuur (2013) when observation is used as a billing status in inpatient areas without changes in care delivery, it’s largely a cost-shifting exercise — relieving the hospital of the risk of adverse action by the RAC but increasing the patient’s financial burden.(p303)...
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...attacks and strokes. There are also some programs that are taking it a step further by imposing charges or penalties to employees if they do not participate or as an example try to lose weight or quit smoking. Some employees argue that they are infringing on basic human rights or even sighting the Americans with Disability Act law. RELATIONSHIP TO COURSE MATERIAL This article relates to our lessons for the week because it reports about Consumer driven heath care, the costs associated with providing one and the impact to the employee and employer. Rising healthcare costs are eating away the profits from companies and also the high deductibles from employees. There are a number of ways to control costs including lifestyle changes, and this is exactly what the company is trying to assert to its employees. HEALTH CARE ISSUE 3 While healthcare costs are increasing, and the healthcare system that is charged with keeping employees and their families healthy is strained, the overall health of Americans is declining. Furthermore, the indirect costs to employers of workers with...
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...in 2002 a. Technological change: + Genomics and healthcare information technology such as Digital Imaging, Electronic Patient Records and Disease Management Systems make personalized medicine and personalized diagnostics possible. Moreover, healthcare practice move from cure to prevention. These changes require expertise in biomedical sciences rather than in engineering and physics; and also investment, collaboration with pharmaceutical companies which facilitate the creation of imaging equipment necessity to alter GEMS business model which is away from engineering heritage toward bio-chemistry and develop drug based on genetic code for specific individual, or small group rather than entire population. b. Demographic change: + Population were aging in advanced nation, implied fewer working-age people to pay for more intense care while the emerging middle-classes if Asia, Eastern Europe and Latin America were increasingly aware of, and needed, better healthcare. This requires the shift in distribution of healthcare equipment in these countries (more for Asia, Eastern and Latin America) and the change in market segment of healthcare equipment. + Global information flows made healthcare disparities between developed and developing nations more stark and unacceptable. Thus, concentrating more on developing world needs great effort investment and customization. c. Fierce competition: + Siemens is leading in healthcare IT, which is a great advantage for them to thrive in...
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...the organization’s disposal and the internal and external environmental factors under which the company exists and competes with other companies (Cole, 1997). For the healthcare providers that are facing financial challenges in the sector, consolidation and cooperation seems to the new way out. Various healthcare providers throughout New Yolk city are merging with other healthcare providers so as to ensure that they survive the harsh economic times. However consolidation was not only for the hospitals but physicians and other groups within the healthcare sector were also expected to merge in order to survive ('market overview', 2013). Others are also opting for other means to ensure accountability in the sector. These measures include bundled payment programs and patient-centered medical homes. Other large healthcare facilities are also shifting from inpatient health services to ambulatory care facilities so as to diversify their services and stay ahead of competition. Due to the introduction of New Yolk state’s health insurance exchange, approximately 1 million state residents were expected to enroll. However by early December 2013 approximately 90,000 residents had enrolled. This was a clear indication of the positivity healthy insurance plan had been received by the state residents. Employers were now shifting he cost of health insurance to workers with additional implementation of high deductible health plans. This move was predicted to have a decrease in the refilling of prescription...
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...Task 3 Jennifer Gentry Western Governors University A1. Country to compare and A2. Access The country I chose to compare with the United States healthcare system is Japan. Access to healthcare in Japan is fairly easy. Every individual, including the unemployed, children and retirees, is covered by signing up for a health insurance policy. They can obtain insurance either through their work or through a community based insurance. For those Japanese citizens that are too poor to afford health insurance, the government supplies their insurance through a social insurance. If a Japanese citizen loses his/her job and becomes unemployed, the individual will just switch to a community based insurance rather than a work insurance (Reid, 2008). In contrast, in the United States, if you become unemployed, you lose your health insurance. An individual can, however, obtain insurance through a private source but it is often more expensive. In 2010, The Patient Protection and Affordable Care Act was signed into law in the United States. The PPAAC was designed to enhance coverage for uninsured or low-income Americans. This was met with much controversy since a large number of Americans felt like it was unconstitutional for the government to mandate that American citizens who were not insured by another source purchase this healthcare or otherwise have to pay a fine based on percent of income through yearly taxes. There are numerous insurance avenues for children, unemployed and...
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...Health Care This paper is an overview of the present healthcare system in United States as well as a presentation of a new, future healthcare system that differs substantially from what we have today. For many years, politicians and insurance companies proclaimed that US had the best healthcare system in the world, but as its major shortcomings become more visible, Americans are finding it harder to accept this assertion. There is growing recognition that the growing problems of rising costs and lack of access constitute a real crisis. The total spending on health care in 2007 was $2.3 Trillion or $7,600 per person. As shown in figure 1 this represents over 16% of gross domestic product and is expected to increase at similar levels for the next decade reaching $4.2 trillion or 20% of GDP in 2016 (Poisal, 2007). Health care spending is 4.3 times the amount spent on national defense (CHCF, 2005). Employers are also struggling with record health care costs-which have climbed at several times the rate of inflation and wages for the past decade. The annual cost of an average family health plan rose to $12,680 this year, more than double the $5,791 it cost in 1999, according to the Kaiser survey . Workers' annual contributions to those premiums have also more than doubled, to $3,354 in 2008 from $1,543 in 1999 (Claxton et al., 2008). The rise in health insurance gravely endangers U.S competitiveness. For example, General Motors spends about $1600 per car on health care- there...
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...ABSTRACT Consumer satisfaction with healthcare has, in recent years, gained widespread recognition as a measure of quality. Conventional healthcare in India is doctor-centric rather than patient-centric. As the patient/customer is not the centre of the services, the experience provided to his/her is suboptimal. There is little effort in making health services a positive experience for the patient in most healthcare centers. However, the trend of positive patient experience is setting in. With patients becoming 'educated customers' and participating in decision-making of their health care, the focus is shifting towards making healthcare more patient-friendly. There are a lot of healthcare providers in India each of them offering a wide variety of healthcare services to the people. Each of them have their own core competencies which makes them different from the other service providers. In a rush to make their own mark in the society each of them are missing out some of the key issues that form the basis of their existence. For any business, customer is the most important asset. In the same way, healthcare is also a business the most important asset is the patient. In healthcare industry the word of mouth publicity is the most trusted thing. It is believed that a satisfied customer shares his/her experience with a few people but a dissatisfied customer shares his/her experience with quiet a large number of people. So if the customer has a good experience with a service provider...
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...Many healthcare administrator believe in the concept of healthcare promotion services which to increase the effectiveness of recovery and reduce the number of repeat episode of illness. Nurse have long been recognized for their expertise in patient education , counseling and case management skills. The national health agenda addresses several problem in the national healthcare such as ensuring that all American have access to care, and not just emergency care but prevention services and care for chronic conditions, bringing cost under control, and maintaining or improving quality of care. In 2010, Unites States spent 17% of the national economy on healthcare compared to 9.5% on average across the 34 member countries of the International organization for economic development. U Healthcare can be reduced by increase in utilization of Nurse practitioner(NP). NP services cost 40% less than Physician services and are cost effective in preventive services. Research has showed that NP can manage 80-90% of what physician do without the need for consultation. The department of human services reports a comparebvle office visit can range from 10%-40% less in favor of NP without compromising patient satisfaction and quality of care. Recent literature has found that employing NP fully could save the 20% cost of primary care . It is estimated that US may be spending 8.7 billion that could be saved by utilizing NP. Tbe US healthcare is challenged...
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...PUBLIC AND THE HEALTHCARE DELIVERY SYSTEM The Public and the Healthcare Delivery System September 11, 2009 The Public and the Healthcare Delivery System Thesis: Discuss the current American health care delivery system and provide recommended improvements. I. Discuss current healthcare delivery system A. Define concept of healthcare delivery system B. General public opinion regarding our current delivery system II. Examine the cost for the current healthcare delivery system A. Primary methods for funding B. Reforming cost III. What is the current role of the U.S. government in the healthcare delivery system? A. Medicare coverage B. Veteran’s hospitals IV. Insurance coverage for U.S. citizens A. Total number of U.S. citizens with no insurance coverage B. Reforming Insurance coverage for U.S. citizens V. Discuss changes we need to make in the healthcare delivery system A. Public option B. Offer low cost-coverage to individuals with pre-existing medical conditions VI. Who will absorb the cost for the changes needed in healthcare delivery? A. Insurance companies B. U.S. citizens References Bohmer, R. M., & Lee, T. H. (2009). The Shifting Mission of Health Care Delivery Organizations. The New England Journal of Medicine. Retrieved September 11, 2009. Retrieved from http://healthcarereform.nejm.org/?p=1347 Dove, J. T., Weaver, W. D., & Lewin, J. (2009). Healthcare Delivery System...
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...Healthcare Industry Paper HCS/449 November 9, 2015 Hello, how is everyone this evening? My name is and I was picked to come here to be a guest speaker to discuss the healthcare industry’s evolution from the past, now, and what is left to come. I will discuss what healthcare industry is, the evolution of technology, financial, and the economic perspective from the past, present, and what we can expect in the future. What is healthcare industry? The healthcare industry is a set of comprises of providing diagnostic, preventive, remedial, and therapeutic services (like physician, nurses, hospitals, etc.). And to include medical equipment, health insurance forums, and pharmaceutical manufactures. The Past Since 2005, the healthcare industry has created to where patients are able to get to their records easier and faster through an electronic health record (EHR). Not only do patients get their medical information faster, but so do physicians, nurses, and medical facilities. In 2009, only sixteen percent of United States hospitals had EHRs and by 2013, it jumped up to eighty percent of all United States’ hospitals invested in EHRs (Jayanthi, 2014). This allowed a more structured platform, a more integrated and efficient care for patients. EHRs can be used as a data and population health tool for the future. If a patient is required to wear a cardiac monitor their heart beats, then they will have a sensor or wearable technology...
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...America's Medicaid program provides medical assistance for individuals and families with low incomes and/or few resources. The program began in 1965 and is now the largest source of funding for medical and health-related services for people with limited income. Today, the program covers 53 million people, nearly one in every six Americans, and costs $300 billion a year in federal and state funds. In fact, Medicaid in some states accounts for more than one-third of the overall budget (Galt, 2005, 1). The program undoubtedly has a major impact on America, but overall it is more damaging to patients and medical providers than it is beneficial. Yes, medical assistance for those with limited incomes is important; however, Medicaid is not effectively providing medical assistance where it is absolutely essential. The Medicaid program can, at times, significantly help individuals in need of medical assistance. With medications often costing upwards of one hundred dollars for a single months supply, Medicaid's maximum co-payment of three dollars can literally be a lifesaver to those without a job and/or insurance. Unfortunately, it can also be as a means to obtain unnecessary medication at taxpayer's expense. More often than not, people being placed on Medicaid greatly increase their number of monthly prescriptions (Galt, 2005, 1). In a recent glimpse of five randomly selected patients, four added three or more medications per month when they began their coverage. By working as a pharmacy...
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...Healthcare Reform Melissa Benavides GE175 – American Government June 29, 2011 Mr. M. Sedam Healthcare Reform Healthcare reform has been an issue in the United States for quite some time. A number of citizens believe the government should pay for our healthcare. Others believe the government should not have any say in our healthcare and it should be paid for by private insurance companies or out of the individual’s pocket. While others still argue that medical costs are on the rise and it is becoming impossible to afford while the economy is folding in on itself. As an unmarried individual, healthcare can get quite costly for me. For those who are unemployed healthcare is most likely a pipe dream and they suffer through sickness or aches and pains. On March 23, 2010 the Affordable Health Care Act became a law. This meant that insurance companies would no longer stand between consumers and their healthcare providers. They could no longer dictate what services would be limited, and the need for seeking approval before receiving emergency care at a facility outside the plan’s network. This new law also enabled people under the age of 26 to stay on their parent’s health plan where as before, the cap age was 21. New regulations require insurance companies to cover children with pre-existing medical conditions. Lifetime limits have been abolished and companies have been made to use 80-85% of the consumer’s money they pay into the insurance for their healthcare...
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...Altruistic Care Management- company description Gerri Dean Business 319-13644 Marketing Devry University Professor Teague Altruistic Care Management-company description Altruistic Care Management is a new company that provides expert solutions for consumer’s healthcare issues; my ultimate goal is address healthcare issues on a global basis. Altruistic Care Management was founded as a result of the many horror stories experienced by friends and family dealing with the healthcare industry. In my twenty-nine years of healthcare experience in the areas of administration and customer relations; I have seen firsthand abuses i.e. in billing practices, treatment/procedure denials, and unethical termination of member policies, unsatisfactory customer service, and insurance companies’ refusal to provide clear and detailed reason(s) for their decisions. The company’s name “Altruistic” was chosen because it is synonymous with humane, unselfish, noble, and philanthropic caring and giving. ACM will be structured as a Limited Liability Company. Limited Liability guarantees protection against personal assets also with LLCs I have the option to be taxed as a partnership or as a corporation. LLC offers a flexible ownership in that I do not have to comply with ownership restrictions; I have the opportunity to file as a person, partnership or corporation. Next, the flexible distribution of profits and losses is the best choice for me in that profits and losses do not have to be...
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...The roles of speech-language pathologists seem to be shifting and expanding as the 21st century presents society with continuous technological transformations, rising costs of healthcare services, increasing demand for services as the population ages, rising numbers of Autism diagnoses, and the growing diversity of the United States population. Thus, the role of speech-language pathologists within a healthcare setting will depend upon several factors and new models of service delivery will likely be necessary to achieve client success within the ever-changing society of the 21st century. The increasing costs of healthcare services not only affects where speech-language pathologists provide treatment, but also who can receive treatment....
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...business that has no power to influence the prices set by the marketplace. Within a hospital setting must take the prices set in the marketplace and have little influence over reimbursement rates. Because of competition and insurance company dominance most healthcare providers are price takers. Price takers typically will take the price as a given and focus on management to ensure profitability of healthcare services. If a provider dominates the market with differentiated services such as outcomes, convenience then the provider can set market prices on services or are price setters. In the healthcare arena, the status between price setter and taker can change quickly or can be a price setter in one area e.g. cardiac surgery, but a price taker in others depending upon the marketplace. 7.2 a (no b?) a. Full cost pricing for price setters sets prices that recover all costs of a particular service direct fixed and variable costs, overhead plus a profit component. Marginal costs prices cover incremental costs which typically refers to recovering only direct variable costs. 7.4 a. Cross subsidization or cost shifting refers to overcharging some insurers as compared for full costs while others are undercharged. Today cost shifting often covers governmental payers like Medicaid, Medicare. Payers faced with increased cost are demanding prices cover only true costs. 7.5 a. Target costing is a management strategy used by price takers in which revenue is projected assuming prices as...
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