Health Care Financing And Economics

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.

I really enjoyed this article, as it went into effective financial planning. The 2 major categories of cost are total charges (the patient's bill) and the cost of providing services. These 2 costs can be defined mathematically in the following indices: average revenue per patient day and the cost per patient day.

Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow.

Essential healthcare management includes the financial growth and feasibility of the health care organization. In order for a healthcare organization to reach its full potential it needs to be fully staffed with both medical and managerial professionals, as well as having the funds to invest in the most up to date technology. According to the Kaiser Family Foundation “Baseline estimates show that over 41 million individuals were uninsured in 2013, 61% of uninsured adults said the main reason they were uninsured was because the cost was too high or because they had lost their job”. The EMTALA or Emergency Medical Treatment And Labor Act or anti-dumping law was enacted in 1986 it was designed to prevent hospitals from transferring the uninsured or Medicaid patients to public hospitals without providing a medical screening examination to ensure they were stable for transfer first. Regardless of their options to pay, they are to be seen and treated with life-saving and "stabilizing" emergency care with transfers to advanced trauma centers, if need be. Effective Human Resources coupled with a balance between cost and revenue are essential to being able to provide quality Health Care. It has been proven these elements all play positive roles in contributing to the overall efficiency of the system. An organization can enhance the quality of health care provided just by focusing on the major components.

Health care systems are made to improve and provide quality, efficient care, work in a more collective fashion to improve patient care and reduce overall healthcare cost. They must be mindful of wasteful spending and become more accountable to a diverse patient population.

“Reimbursement” in healthcare refers to the decision of the entity paying for an item or service (called the “payor”) of whether a particular item or service is covered by a particular healthcare payment program for the patient at issue and therefore eligible for payment. “Payors” refers to the entity through which an individual has healthcare coverage. The federal government is the largest single payor of healthcare services in the United States through a variety of federal healthcare programs such as the Medicare and Medicaid programs established under the Social Security Act (SSA).

The Institute of Medicine released a report in 1999 titled To Err is Human: Building a Safer Health Care System concerning the number of medical error related deaths. The report states that between 44,000 and 98,000 medical error related deaths occur each year in hospitals across the country (Kohn, L. T., Corrigan, J., & Donaldson, M. S., 2000) In response to this report, the Institute of Medicine released Crossing the Quality Chasm: Health: A New Health Care System for the 21st Century that outlines six aims for the future of the healthcare system: safe, effective, patient-centered, timely, efficient, equitable (Institute of Medicine, 2001). These aims set to establish the quality of healthcare across the country. Quality is defined by the Institute of Medicine as ““the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (2001).

Healthcare is the single largest business around the world and plays a vital role in society today. The desire to enhance quality of care in healthcare delivery has increased tremendously.

The Quality Chasm report underscores the lack of quality healthcare, cost concerns, poor use of information technology, absence of progress in restructuring the health care system, and the underutilization of resources (Stevens, et al., 2006). The quality issue that this writer has chosen to address is the poor use of information technology. According to the Quality Chasm Report, health science and technology have advanced at a very rapid pace, but due to poor use of information technology, the healthcare delivery system has not maintained delivery of high-quality healthcare services. Research results are not translated into practice, and practice lags behind knowledge (Stevens, et al.,

According to the Institute of Medicine (IOM) report, To Err Is Human, the majority of medical errors result from faulty systems and processes, not individuals (Hughes, 2008). However, due to processes that are inefficient and variable, multiple health insurance, differences in provider education and experience, and other factors that contribute to the complexity of health care the IOM has put together six aims of health care that is effective, safe, patient-centered, timely, efficient, and equitable (Hughes, 2008).

1A. Market failure is a situation in which the allocation of goods and services is not efficient. In any given market, the quantity of a product demanded by consumers does not equate to the quantity supplied by suppliers. This is a direct result of a lack of certain economically ideal factors, which prevents equilibrium.

Government financed health care typically has more control to place limitations on care offered to patients and doctors in order to keep costs down. Since payers must try to deliver the most care for the

In everyday life funding is a major criteria to maintain and improve life. Firms and institutions all need a source of constant financing. Heath financing is core in health system to be able to maintain and improve the welfare of people. Health financing is much more than simply generating funds, it concerned with the mobilization accumulation and allocation of money to cover the health needs of people. Without the necessary funds, employment of workers, buying of medicines, medical equipment to promote health and prevent diseases becomes a challenge to the health sector, hence their clients suffer the consequences.

Around the world, high-income countries struggle making a decision on whether health care is an essential coverage or an optional coverage. If one has the right to health, then should it be mandatory for all governments to provide the health care coverage one needs? This is a common question in governments around the world and most high-income countries do aim to offer universal coverage. Universal health coverage is defined as “the goal that all people obtain the good quality essential health services, including promotion, prevention treatment, rehabilitation, and palliation, that they need without enduring financial hardship” (1). However, there are several steps and obstacles a government must face before being able to achieve the ultimate goal of universal health coverage. This paper investigates the health financing mechanisms of four high-income countries (United States, Australia, United Kingdom, and Japan), which are all at different stages of this process. Although they all aim to ultimately provide reliable, affordable, and comprehensive coverage to all individuals, these countries face similar obstacles in establishing successful public health financing.

The first quality initiative that could increase patient satisfaction and potentially reduce healthcare cost is the national data warehouse. According to Brennan, Cafarella, Kocot, McKethan, Morrison, Nguyen, Shepard & Williams II (2009), “this type of quality analysis needs to be valuable to both payers and consumers. For payers, quality analysis helps them potentially understand payment mechanisms, quality providers, regional differences and medical management techniques. For consumers, there is a better understanding of practice and potentially cost differences of providers. So, the primary purpose for creating a national data warehouse will be to develop key quality measures that all parties can agree on.” The second quality initiative that could increase patient satisfaction and potentially reduce healthcare cost is creating one common contract between all health plans and providers (Brennan et al., 2009). According to Brennan et al., (2009), “to accomplish this, a national group comprised of government personnel and knowledgeable provider contractors from the health plans will set national guidelines. Regional contracting groups will be entirely made up of current health plan contractors and will do the local contracting under