Controlling The Costs Of Healthcare

The Iron triangle for healthcare consists of cost, quality, and access; these three characteristics when balanced create great healthcare. Managed Care Organizations combine the three to offer consumers with care that is appropriate for their individual needs. Our book describes managed care organizations as “the cost management of healthcare services by controlling who the consumer sees and how much the service cost” (Basics of the U.S Healthcare System, Niles). Taking a look at the history prior to the Health Maintenance Organization Act of 1973 (HMO ACT of 1973) the implementation has been significant in balancing cost, and quality control. Before this Act was signed in to law by President Nixon healthcare costs were determined by fee for service. A fee for service or indemnity plan is a plan that allows the provider to determine the cost of service, this fee for service plan caused for healthcare costs to increase rapidly. An example of this would be going to the doctor with neck pain, being told to stretch then receiving a bill for 25,000 dollars. As could be understood the cost of healthcare had became a problem.

It is no secret that the cost of American healthcare is becoming increasingly more expensive. However, the issue of the rising cost of healthcare and its severity needs to be recognized as a major problem. Health prices are steadily increasing in the United States, and there is no sign of it stopping. Since 1970, spending on American health care has grown 9.8%, which is a rate that is growing faster than the economy (“New Technology”.) Furthermore, health insurance premiums are also increasing at a rate five times faster than American salaries, which makes it difficult for families to afford health care coverage (Zuckerman 28). Therefore, it has become an obligation to address why the cost of American health care is soaring and to seek out a solution to lower the cost. Many would jump to the conclusion that the United States simply charges too much for their medical services, but there are deeper influences that need to be analyzed. The causes of the rising cost of health care are people not using preventive health care, the development of modern technology, and the treatments being overprescribed. A possible solution is to have preventive health care services available in clinics of low-income areas.

One of the major functions of a nurse manager is managing a budget and allocating resources necessary to manage the unit or facility effectively. “Major steps in the budgeting process include gathering information and planning, developing unit budgets, developing cash budgets, negotiating and revising, and using feedback to control budget results and improve future plans”(Yoder-Wise, 2012, p. 244). The nurse manager must be able to accommodate variances and acclimate the budget in both the projections and up-to-date expenditures. Proficiency in managing a unit level budget is essential for both a favorable variance and optimal patient outcomes. Budgeting entails reviewing revenues and expenses, staffing costs, supplies, and capital equipment costs (Contino, 2001). This case study examines personnel, overtime (OT), supplies, travel, equipment, and staff education and the manner in which management can address these factors.

What I currently view as an Economic issue would be the rising costs of Health Care, everyone needs Healthcare, but because of how expensive it is, most of the population cannot afford it. Even if people do have Health Care, they cannot afford paying the high premiums, out of pocket and high deductibles. Health care might not seem like an important topic, but is necessary for the daily lives of people, nobody knows what will happen in the next second of their lives. Everyone needs affordable health care and I think that reducing the cost of health care and making it possible for everyone to afford it would make everyone happy.

There have been many studies performed focusing on the rising costs of health care and some of the findings state that the rising cost of healthcare premiums is a worldwide problem. However, I believe they are higher in the U.S. In 2015, U.S. health care costs were $3.2 trillion. That makes healthcare one of the largest U.S. industries, equaling 17.8 % of the Gross Domestic Product (GDP) in comparison to the late 1960s; where healthcare costs were only $27 billion, or 5% of the GDP, which averaged $9,990 per person each year. The main reason for the rising cost of healthcare is a combination of government policies and lifestyles changes. Examples included lack of coverage or costly coverage, lack of available coverage for

The high cost of healthcare continues to rise and many in the United States are optimistic for health information technology to reduce and improve our current situation. Health IT encompasses a broad array of new technologies designed to manage and share health-related information. When properly implemented, these systems can help coordinate patient care, reduce medical errors, and improve administrative efficiency. Therefore, implementing a Regional Health Information Organization (RHIO) will help the National Health Information Network (NHIN) achieve their goals in improving quality of care for the citizens of the United States. Thus, in order for the health IT to deliver on its promise, several obstacles must be overcome.

“The amount people pay for health insurance increased 30 percent from 2001 to 2005, while income for the same period of time only increased 3 percent.” (Source: Robert Wood Johnson Foundation). The rising cost of healthcare is a huge problem in America today. In this paper I will analyze the different issues and causes for the increase in cost.

“a) Contracts that explicitly detail the responsibilities of employers as purchasers with insurance, managed care, and hospitals and physician groups as suppliers, b) Information to support the management of purchasing activities, c) Quality management to drive continuous improvement in the process of healthcare purchasing and in the delivery of healthcare services, d) Incentives to encourage and reward consumers, and e) Education to assist employees become better healthcare consumers” (p. 352).

Healthcare costs in the United States have been rising for several years and show no sign of stopping. In 2008, the United States spent on 2.3 trillion on healthcare, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 19801. Although the large amount of money invested in healthcare does translate to better care for Americans, the worsening economic situation, rising costs, and federal government’s deficit have placed a great strain on the system. This includes private employer-sponsored health insurance coverage and public insurance programs such as Medicare and Medicaid. According to the Henry J. Kaiser Family Foundation, a private and non-profit healthcare analysis organization, “in 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries”1. Concerns for the enormous strain on the financial systems that fund healthcare and the desperate need to provide adequate healthcare for Americans have driven many a President since Theodore Roosevelt in 1912, to seek some type of healthcare reform and universal healthcare for all Americans. President Barack Obama succeeded where many had failed and on March 23, 2010, a national health reform law, the Patient Protection and Affordable Care Act was signed into law. On March 31, 2011, the Department of Health and Human Services (HHS) issued new rules

Health care cost has risen dramatically in the last decade. Health care plans have been forced to look at the quality of health care given by the providers so they can implement certain strategies to help reduce heath care costs. Managed Care describes a group of strategies that is looking to reducing the costs of health care for health insurance companies. (Kongstvedt 2007)

Today, health care issues within the United States are still a major concern in regards to where people of our communities do not always agree with what is being done and what is not being done. The three major issues with health care spending is how much is it going to cost and where is the money going to come from? The amount of per-patient costs have doubled more in the United States than other nations around us. The last issue is the amount of Americans that has no health care at all. This paper will discuss the healthcare expenditures that is necessary for our entire population.

Decreasing healthcare “cost” has been repeatedly debated for decades now. Despite tremendous efforts to reduce cost, the US Healthcare System is still struggling to deliver an effective and affordable level of care. Not only the cost of healthcare is higher in the U.S., there is also much waste due to unnecessary laboratory, radiology & other investigations, unwanted hospitalizations, procedures, longer hospital stay, preventable emergency room visits, and a lot of medications waste, that costs the U.S. $750 billion annually according to IOM in 2012 (Glicksman E. , 2015).

Medicaid is a vital lifeline for some 72 million Americans. Two-thirds of all Medicaid spending supports senior citizens and persons with disabilities. Cutting Medicaid would jeopardize the quality of healthcare, long-term services, and nursing home care for tens of millions of Americans. There are significant cost issues in America’s healthcare system that must be effectively addressed, but these challenges will not be remedied by benefit cuts to vulnerable

Health care spending in the United States is a key contributor to the country's economy. The health care industry provides employment as well as providing services that bring healthier lifestyles, better productivity, and a longer life. Health care also brings the development of new drugs and new medical technology that also helps keep the economy employed. However, although the health care and health care spending does tend to help the economy slightly it is beginning to hinder our economy. "In all industrialized countries, with the exception of the United States, health care affordability is ensured through universal insurance based or tax- finances systems" (Squires, 2012, p.

According to the case study, Consumer Health Care: Medtronic’s Health Insurance Options, by Herzlinger, Hurwich and Bokser, I have come to the conclusion that Medtronic was trying to offer an array of services to their employees but yet really didn’t analyze what they were providing. Currently, Medtronic offers three distinct health plans that are comparable with their employee’s as well as industry competitors. However, there were several areas that I found concerning that is in regards to cost where the company is spending more money than they need to. Within this paper, I will be addressing some factors in areas such as where money could be saved so that they may be able to use this additional money in other areas for the company.