Case Analysis : The Service Services Provided By American Well And The Potential Of A New Product

Many selections of healthcare plans are available for consumers to choose from to match their own personal needs, preferences and budget. The health care system is most often complex, inconsistent and costly. To maintain and improve the business, healthcare organizations are continuously innovative and evolving to meet the demands of consumers. The purpose of this paper is to discuss a case study of UnitedHealthcare Group, what they are about, their network and resource management, their view on nursing and how they satisfy their patients.

More and more people with medical insurance are relying on the health care system as new technologies and treatments become available. This leads to a grater number of claims for payment by insurance companies, the costs of which are passed back to health care consumers. The baby-boom generation is entering its peak health-care using period. Over eighty million Americans will turn 50 in the next 10 years. The cost of providing heath care for these individuals will be staggering

The U.S. health care system faces challenges that indicate that the people urgently need to be reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps even for those with access to insurance coverage.

Health care is growing and demand on our health care system is rising. According to the Administration on Aging of the U.S. Department of Health and Human Services, people 65+ represented roughly 13% of the population in 2011, but are expected to be 21% of the population by 2040. The aging population, as well as increasing technological advances, and improved access to health care reinforce why reimbursement optimization is now essential to cost control and maintaining the quality of our health care system.

One dominant economic feature of the healthcare industry is the growing need for both basic and specialized healthcare due to the continued aging of the “Baby Boomer” generation. This generation consists of over 79,000,000 individuals born in the US between 1946 and 1964. As this generation has aged, the need for healthcare has increased dramatically. Let us take a look at some statistics:

In the past several years, there have been several changes in economic policy at federal and state levels. The two economic policies that present to be the most precedent for healthcare leaders with concern to facility reimbursement are the Affordable Care Act (ACA) and the switch from volume to value reimbursement. First, there is the ACA policy, which have affected healthcare facilities and their reimbursement methods. In fact, ever since this policy was implemented, provider reimbursement has started to decrease in terms of fee-for-service payments (The Common-Wealth Fund, 2015). In other words, the intention of this policy was to provide budget relief to the government payers as well as giving providers an incentive to provider patients with great quality of care.

However, prior to the existence of the ACA, the American healthcare system left a lot to be desired and still today leaves room for improvement. The basic issues underlying efforts to improve the United States (US) health care system remain, as they have for decades, concerns for costs, access, and quality (Sultz, 2006). Even though knowledge, technology, and

The increase of expenses - As politicians continue their dissension amongst each other, the situation is worsening in our healthcare system. According to the World Health Organization, to achieve universal health coverage, countries need a financial system that enables people access to all types of health services without incurring financial hardship (Carrin, Mathauer, Xu, & Evans, 2011). This idea would be the foundation of innovative ideas that the U.S. could reform its healthcare system, but too many ideas are sabotaging any valid efforts. In the mean time, the U.S. healthcare system continues to deal with issues such as the increasing uninsured Americans (over 49 million), expensive administrative procedures and the inability to measure the accuracy of quality of care, access of care, and the increasing healthcare spending and financing that limit our ability to efficient utilize resources.

Healthcare in the United States has reached a level of complexity which has perplexed Presidents, Congressional members and private industry for over a century (Palmer, 1999). While the healthcare system has evolved over the last century, policy decisions which have attempted to effectuate changes to cost, quality and access have been

With the passage of the Affordable Care Act (ACA) in 2010 there have been significant changes in the healthcare environment in the United States. The ACA has a goal of increasing access to health care services while also reducing costs. Today’s “triple aim” of healthcare includes improved population health, better patient satisfaction, and lower patient costs.

Health care in the United States (U.S.) is driven by a makeshift of services and financing. Americans access health care services in diverse ways, from private doctors’ offices, to hospitals, and to insurance providers. The effects of the ACA will have numerous changes impacting hospitals and physicians practices. One of the main goals of healthcare reform is to reduce Medicare expenses by combining payment for services provided by hospitals, doctors, and nursing homes into one lump sum, which will effect

This exercise point out some very important factors with regard to health care cost.  nursing homes and other health care delivery systems are faced with significant shortfalls in reimbursement for various reasons.  Medicare reimbursement often does not cover the full extent of treatment of individuals.  McPike (2008) notes that, “The insurance and hospital industries released a study today showing that underpayment by Medicare and Medicaid costs consumers and employers $88 billion more a year for health care as providers attempt to make up the difference.” Today with continue cutbacks in medicare reimbursement this number is significantly higher.  In an attempt to reclaim these losses, both self pay and privately insured patients are charge

Lakeland Regional Health was number one in America for the most Emergency Room visits March 2015-2016, even so they re-direct on average 260 uninsured and Medicaid patients a month to their Family Health Clinic for non-emergent care. The Affordable Care Act, though providing insurance benefits to many who could not afford insurance in the past, has not changed the quantity of patients utilizing the emergency room for primary care mostly due to the overwhelming need for more clinics that accept Medicaid, Share of Cost, and the uninsured.(2) Patients have often commented that it is cheaper to pay the penalty on their taxes each year over applying for the ACA insurance. The deductible and out-of-pocket for the insurance generally matches but the limits are often well above what the patient can afford to pay, and insurance does not pay until they have met that deductible amount. The question is not about providing care to the patients that arrive in the emergency room, but to offer a screening process to ensure that the emergency room is available for true emergencies, and that the safety of patients are considered and the delay of care is as short as possible.

Even although, the cost of the health care system and the care it offers my not allow the national debt to decline to a level that will or would enhance the economy forward the cost of running a system that is backed by the government is too costly, and it will not help the deficit. , the legal responsibility of the organization is that every patron should have the same treatment for the same ailment. There are no predetermined dispositions; everyone is eligible as a government-backed facility. The funds are to assure those who have no insurance are covered. The accountable care

AMERICAN WELL NEW MARKET OPPORTUNITIES The various market opportunities for American well are listed as per the priority  Online Kiosk: The patients can enter their preliminary information on the Hospitals Kiosks instead of waiting idle. The information that shared can be useful to the doctors on narrowing down the symptoms and treatment. There by increasing the efficiency of the physician and better treatment for patients  International Expansion: American well can expand the concept of E care over the horizon there by providing healthcare facilities to remote destinations and catering to international markets. Since healthcare industry is most prominent throughout the world Expanding would better investments  Online Pharmacy: The digitalizing pharmacy is trivial as many will have questions on how to take medicines its side effects due to the social stigma associated most of them just keep quiet to take the prescribed medicine and then come