Case Study: Current Generation Opportunities In The Healthcare Industry

Recently healthcare along with other services sectors have been growing at a fast rate and opportunities to

For contract pharmacies, the 340B guidelines state the following: “The guidelines provide that the covered entity will verify, using the contractor’s (readily retrievable) customary business records, that a tracking system exists which will ensure that drugs purchased under the Act are not diverted to individuals who are not patients of the covered entity. These records will be maintained for the period of time required by the State law and regulations.” Entities are advised that in many instances, other insurance programs require much longer maintenance of records (i.e., Medicaid/Medicare).

Health information technology or HIT is a huge part of the dashing changes in how medications are prescribed, dispensed, and administered by using technologies electronic devices to share and manage patient information, instead of doing it the old fashion way which was over the phone, having all patients’ records and files on paper, and using the old fax method. Everything is computerized, from managing the

To add to the dilemma, the rising cost of healthcare will not adequately be addressed by any new healthcare system. The costs of healthcare in America are staggering and currently represent over 17% of our national GDP with the expectation of that number rising to 20% in less than 5 years. These costs are direct hits on the revenues received by hospital which affect their ability to remain operational. As the hospital’s revenues and profit margin decrease, so does the expected longevity of the hospital.

The Triple Aim is large, and the obstacles are frightening. Supply-driven demand, new technologies, and physician-centric care are said to be among the biggest barriers. With little or no foreign competition to spur domestic change, physician-centric care is negatively affected. New technologies may have limited impact on outcomes. Despite these obstacles, a handful of healthcare leaders is challenging the U.S. health care market. According to Health Affair, innovations in primary care such as the medical home, as well as “Minute Clinics” and other retail health care providers are challenging the prevailing approach

The health care industry is the fastest growing field. As the years go by, more and more discoveries will be made. This paper will discuss the changes from the past 10 years, what I believe will be the biggest change in the next 10 years, my role in the industry, adapting my skills to grow with the change, my perception towards the changes, technologies role, and financial and economical issues.

Both health care organization and individuals, who purchase and consume prescription drugs can play a great role in reducing the nation’s total prescription drug expenditures as well as individual expenses. Since 2004, one out of every ten dollars on health care has been spent on prescription drugs since 2004 follow-on a sharp increase in 12.2 percent in 2014 (Kennedy & Morgan, 2009). This figure indicates that while the U.S. health care gets the best technology and infrastructures in treating its nations, there is an undeniable increase in health care cost, especially, in prescription drugs.

Three general hospitals and two other cardiac hospitals serve the metropolitan area’s 620,000 people from a ten-county area. One of the main issues continuing to consider include factors that influence costs including outputs, input costs, technology, efficiency, and variable and fixed costs. Cost management’s important in healthcare, as organizations start to adopt the cost-reducing technology, substitute high cost for low-cost production techniques, purchase goods and services more conservatively, and rethink what they

One of the biggest industries in the United States is healthcare industry, which accounts for over 17.5 percent of the Gross Domestic Product (GDP) of the country. This big representation of the nation’s economic activities impacts the overall economy. In other ways, it’s also impacted by the general economy. While the health care industry continues to grow, transformational changes also continue to enforce change in its organizational structure. Change in organizational structure enables health care providers to make arrangement for the change. In this case, the overall health care providers’ advance in new medical technology (to provide the best quality services), financial system, and the entire health care service structure, rules, and regulations are changed. Hence, a health care industry is fronting a noteworthy pressure to reduce health care cost, to prepare for an influential change in how health care is provided, financed and consumed while delivering the quality care (Hicks & Jacobs, 2014, pp. 385-402).

Hospitals and health care systems take strategies to update their infrastructure like technological upgradation, operating room services etc. in contrary due to the concept of supply and demand and less competition in specialty services force the physicians to pursue further.

This Issue Brief examines issues related to managed competition and the use of a health insurance exchange for the purpose of addressing cost, quality, and access to health care services. It discusses issue that must be addressed when designing an exchange in order to reform the health insurance market and also examines state efforts at health reform that use an exchange. The basic component of managed competition is the creation an organized marketplace that brings together health insurers and consumers (either as individuals or through their employers).The sponsor of the exchange would set "rules of engagement" for participating insurers and offer consumers a menu of choices among different plans. Ultimately, the goal of a health insurance exchange is to shift the market from competition based on risk to competition based on price and quality.Among the issues that need to be addressed if an exchange that uses managed competition has a realistic chance of reducing costs, improving quality, and expanding coverage:

A substantial piece of the U.S market in the health sector is run by the prescription drugs and, therefore, making the U.S the global largest market of pharmaceuticals accounting for more than a third of the world’s expenditure on drugs. It is estimated that in 2014 slightly over $300 billion were spent on prescription drugs which accounts for roughly 10 cents of every dollar in the U.S healthcare market. The U.S expenditure on prescription drugs has been growing at an annual rate of 11% for the last 27 years between 1980 and 2007. But the expenditure has slowed between 2008 and 2013 to about 2% annual average which has been occasioned by several reasons including the 2008 financial quagmire which was also responsible for the reduction in the overall U.S health care costs, the application of controls towards insurer drug utilization and also the production of a less amount of new blockbuster drugs within that period (Institute for Healthcare Informatics, 2014)..

One major big data system implemented in healthcare today is Electronic Health Records (EHR). CMS.gov describes EHR as,

Over the last several years, retail pharmacies have been facing increasing amounts of competition. This is because the Internet is providing consumers with a viable alternative and the federal government has a shifting payment structure (for programs such as Medicare). The combination of these factors has forced a number of companies to adapt their business models to these new realities. As a result, some well established firms have begun offering customers a host of solutions to include: programs that are accommodating and convenient. This has led to a transformation in the business model, with a variety of companies now offering 24 hour service that is incorporated with online solutions. (Nelson, 2007, pp. 25 26)

2. Pharmacies could send a representative to work at some of the larger hospitals. This would allow someone to go in person and quickly communicate what information is needed.