Evaluating The Multi Faceted Issues Facing Healthcare Today

According to the Federal Bureau of Investigation (FBI) “health care fraud costs the country an estimated $80 billion dollars a year” ("Health Care Fraud," n.d., p. 1). Because health care costs continue to rise more rapidly than the rate of inflation the threat of health care fraud continues to rise. The Affordable Health Care Act has put new policies in place to identify and stop health care fraud. The FBI along with other government, insurance, and public agencies have joined together to combat fraud at every level. New rules in identifying, investigating, and prosecuting fraud before payments are made to medical providers could save billions of

A major change is occurring in the healthcare system as the United States continues to move toward enhancing patient care quality and access while also decreasing cost. This significant transformation is driven by a variety of forces, including changes in managed care, a shift from pay for service to pay for quality, and ever-evolving client characteristics. This paper aims to discuss each of these factors and the ways in which they make this major transformation a difficult one for the nation to undergo.

Throughout the years, health care leaders have tackled many challenges in the health care organization. Some of the challenges include knowing the difference between needs and wants, affordability, and sustainability, consequently these challenges can be confronted by evolving and transforming over to modern business models. For health organizations to be successful they must use planning, decision making, and training. Regardless of the changes, health care organizations must conserve excellent services. The purpose of this report is to recapitulate information shared throughout an interview between Dr. Kyle Grazier and Ronald G. Spaeth. The interview gave readers insight on Spaeth’s work, educational background, awards highlighted, and his philosophies or strategies for health care. This report will also enclose the biggest obstacles that Spaeth believes today’s health care administrator is facing in addition to the school of management theory he mostly used and why. In conclusion, I will state my opinions on Spaeth’s approaches and the lessons that individual’s can learn from the interview.

In recent year the health care industry has seen broad changes that have impacted all health care stakeholders. Often, leaders in health care believe that external factors which affect the industry, such as local and federal policies, payers, cost of doing business, technology, health of the population etc, are so powerful and so far outside of their control that whatever strategy they employ, it will not be able to counterbalance these external forces and therefore will not generate new demand and create new markets. These leaders are stuck in what Chan and Mauborgne call mental models designed to negotiate existing market spaces, which prevent them from creating new markets. They spend their time fighting to keep their patients away from

This post is a brief summation of interviews with several healthcare experts within the Willis Towers Watson Company. Their statements and ideas were beneficial, thought provoking and relevant for those in healthcare leadership. Based on our conversations we underscore here a few trends for healthcare providers whether in a single community hospital, a teaching hospital or a group of hospitals: executive compensation should be incentivized, the hiring of doctors in executive positions for providers in the nonprofit and for profit sectors is recommended and growing, the collection of vast amounts of data can be compiled to influence executive behavior and positively impact performance, and poor quality indicators directly impact the bottom line in a multitude of ways.

Healthcare costs in the United States is growing at an alarming rate. For many Americans, getting sick in America is a financial death sentence. A survey of 5,700 people released by the Federal Reserve reported that 46% of working Americans cannot pay an emergency expense costing $400 or more without borrowing money or selling their property (El Issa, 2015). It is important to recognize the different factors that contribute to the rise in healthcare costs as the healthcare industry is a vital source for job development and economic production. Although The United States of America invests billions of dollars in the healthcare system, it is still ranked as the most inefficient healthcare system among developed countries. Experts in the field broadly mention administrative costs, drug costs, and defensive medicine as the major contributors to this nationwide dilemma. To understand the growing issues facing Americans today, one must examine these three areas within the healthcare system in depth.

This is the essential concern of the human services industry as CBO estimates that PPACA incorporates diminishment in Medicare of over $700 billion amid the 2013-2022 period, principally through marginally decreasing the trajectory of using increments anticipated that former will PPACA. Singular recipients are not straightforwardly affected, the vast majority of the expense investment funds originates from diminishing future installments to healing facilities and other administration suppliers in respect to past benchmark gauges. Payroll expense base to 1.35%. Separated from these variables there are different difficulties, for example, diminishing inpatient volume, expanding expense for supplies and staff which can get greater because of insufficient subsidizing. Uninsured Americans are more averse to have general health awareness and use preventive administrations. They are more inclined to postpone looking for consideration, bringing about more restorative emergencies, which are more costly than progressing treatment for such conditions as diabetes and hypertension.

It has been said that today’s healthcare structure has become fragmented and that there is something not quite right in the planning and delivery of health services. To quote Sweeney and Griffiths (2002) “research has little direct effect on health service policy, organizational change has little effect on service provision, rational priority setting frameworks remain elusive and health economists continue to develop technical solutions that have no impact at the grassroots level.” Even at the administrative level organizations are barely capable of coping from being continuously under siege – resulting in a penchant for process rather than actual outcome indicators. This leads organization managers to present “glossy corporate images that belie problems” of the organization. Part of the problem lies in the nature of healthcare organizations being different from other sectors that have instigated cultural changes. Stakeholders in healthcare organizations “have disparate schemes of values and beliefs” while “physicians’ independent perspective often differs from organizational perspectives” (Lloyd, 2008, p.1).

The high cost of health care in the United States is one of the most important issues that the economy is facing. The United States spends the most on healthcare in the world: “Data from the OECD show that the U.S. spent 17.1% of its gross domestic product (GDP) on health care in 2013. This was almost 50% more than the next-highest spender (France, 11.6% of GDP) and almost double what was spent in the U.K. (8.8%). U.S. spending per person was equivalent to $9,086 (not adjusted for inflation).”1 All of this spending will eventually affect the growth of the economy, especially since it is only likely to keep increasing as many people still can’t afford

Johanna Bellon, MS, CFA is a PhD student working at the University of Pittsburgh Health Policy Institute with Everette James. Prior to beginning the PhD program, Johanna worked as a financial consultant in the Healthcare Industry Group at Alvarez and Marsal. She consulted on a variety of projects, involving qualitative and quantitative analysis to achieve acquisitions, restructurings, and strategic realignments within large health systems. From this work she developed an interest in how healthcare organizations innovate and effectively achieve sustainable changes within a challenging and turbulent environment. She is currently working on four research projects within the National Center on Interprofessional Practice and Education that explore

The U.S. health care system is perhaps one of the most complex and plastic industries present within the current world economy. With a projected market sector value of $3,455.1 billion by the end of 2016 the U.S. health care providers market represents a significant portion of the economy (“Research and Markets; Healthcare Providers in the United States,” 2012). For someone that finds themselves in the position of management it is certainly an orthodox presumption that they incorporate into their repertoire the tools necessary to survive in a constantly evolving workplace. The purpose of this paper is to examine several emerging influences on the U.S. healthcare system and what they mean for managers in the workplace. Specifically,

The Health care industry has many policies, rules and regulations that have to be followed in order to have a successful company in today’s world. The Health care industry has many policies that keep companies in compliance with all the rules and regulations in order to protect the consumers, patients and employees. In every hospital, doctor’s offices, therapy clinics, etc, there will always be certain protocol of running a successful and thriving business. A certain point in time where these policies were made, there was a process to developing a

The economic downturn has led healthcare organizations to think big changes. We understand that all organizations experience micro changes in their normal adjustments to operating; however, occasionally a unique climate comes together to force new ways of thinking. This new way of thinking is usually a whole novel vision and an entire new direction which “transforms” the organization. When successful, these organizations become a learning experience for other organizations that perhaps need to make similar changes. This paper discusses two

Health care is an ever-changing industry and as changes are made organizations must learn to anticipate and adapt the new changes. Although healthcare organizations cannot control external factors, they ought to analyze the trends on a constant basis. According to Ginter, Duncan, & Swayne (2013), in the healthcare sector is it challenging to identify changes that may happen and the best way to prepare for them (p. 36). Three reasons why this is vital to the success of the business is (1) to understand the competition (2) to keep up with the current laws and (3) technology changes. In a competitive market, it is critical to stay abreast with the competition to determine how they are performing, what type of services they offer along with the

Healthcare costs in the United States are soaring. To stop this cost inflation, healthcare organizations are being pushed to decrease those costs. Simultaneously, healthcare organizations are being pushed to increase quality. To motivate healthcare organizations to increase quality, the federal government has issued an enormous amount of new regulations and has decreased reimbursement when quality standards are not met. Thus, healthcare organizations must find a way to increase quality of care while decreasing costs.