Impact Of Quality On Managed Care Contracting And Pricing

Consequently, it become a financial problem where physician sees no improvement in their revenue/profit, and the cost of treatments continue to rise as reimbursement challenges the physician’s charges. There is always a cost to a better health care and coverage, and vast of it comes from taxation. Hospital and physicians function on funding to keep the door open and operating, and majority of the funding are from taxation. For

The articles I chose for my annotated bibliography were about healthcare cost and quality. The theme in many of these articles was about healthcare cost and does it affect patients experience. In some settings like hospitals, the cost of quality affects patient experience. The largest component of the U.S. Gross Domestic Product goes to healthcare spending (17% in 2009), and yet the quality is unsatisfactory. It was also interesting to find out that more people die each year in the United States from medical errors than from highway accidents, breast cancer, or AIDS (National Academy of Science's Institute of Medicine, 2002).

Having access to quality healthcare is major part of one’s life however the cost of care has been on the rise over the past decades and continue to rise every day due to many situation such

Better quality health care will affect the life expectancy rate and the expenses. Patients expect doctors and hospitals to deliver the best possible care. The major issue with the quality of health care is “medical errors result from faulty systems… not individuals” (Hughes). In order to ensure patient safety and positive outcomes, hospitals have to assess for themselves the various different aspects they need to improve on. For example, hospitals could have a shortage ranging from staff, medication, or equipment. Through universal health care, “doctors… can focus on patient care”, which will aid in improving treatments for each individual (White). Along with this, there will be more government funding to improve hospitals as a means to help patients. Countries under universal health care coverage have a better quality of care, while the “United States [is ranked] last overall” (“Right to Health Care”). These benefits of medical treatments of universal health care are vital to American

One of the major problems facing our country today is the healthcare crisis. The inequality in our current healthcare system has created a huge gap in the difference between the level and the quality of healthcare that different people receive. Having an improved and reliable health care system available for everyone should be a priority that the government must make available. There are countries whose health care system meets the needs of the patients while there are countries whose health care systems need a great amount of overhaul for them to be able to attend to their patients. In this essay I will discuss the healthcare crisis and the differences in many countries

HMOs are not the only answers to cost control. Most physicians practicing in the United States consider their profession to be very much a form of art (Kleinke). The definition of art infers that within its sphere there are many variations and preferences. After all, one should not ask Picasso to carve like Michelangelo. Physicians too differ in their methods of treating patients. However when needless tests and procedures are done the treatment will cost more. This is waste. Many suggest that cutting waste will lead to a cut in quality. This is not necessarily true. Consider the following: an otherwise healthy forty-year-old male

A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare.

Substandard quality of health care is duly recognized as a major form of medical crises with potential to jeopardize the functioning and purpose of the American health care system. Whereas on the one hand medical costs of treatment are rising, on the other malpractices and non compliance on the part of medical professionals and institutions compounds the problem and seriously questions the quality of health care being provided to citizens. However, before proceeding further it is important to understand what is exactly meant by the substandard quality of care. The substandard quality of

Quality may also have many different meanings. Quality in health care economics means the superiority of something. This can also mean the best of something. Quality in health care can be determined by determining if the health care is a great fit for the person. Quality of health care can be considered as the right treatment for the right illness, and also delivering health care at the right time. Quality in health care economics means to give the best health care possible. Getzen (2007), states that medicine often involves life and death situations (p.12). In these situations, quality is crucial and quantity is irrelevant (Getzen, 2007). Quality cannot simply be added up or multiplied to arrive at a total spending limit. In medical care, getting more ounces or pounds or boxes or whatever is usually not very important, but getting higher quality is.

“Health maintenance organization (HMO) quality on several primary care indicators and more rapid quality improvement, despite its substantially lower level of expenditure” (Rosen, et al., 2011, p. 15). In the medicinal services organization, the proper goal of any human services system is to grow the cost dispersed to patients. The cost of the human services measured as far as the patient results achieved per dollar expended. It does not matter the kind of various service supplier or volume of service delivered that matters, however, the cost. More care and expensive care is not really better

In any country, external forces can influence or shape the basic character of a healthcare delivery system (Shi, 2015). These forces consist of political climate of a nation, economic development, technological processes, social and cultural values, physical environment, population characteristics such as demographic and health trends, global

Managed care was established in order to manage health care cost, utilization, and quality (Kongstvedt, 2015). In managed care, health insurance is provided through HMO, PPO, and other types of managed care. It has the potential to reduced health care spending and improved the quality of care. However, despite of its success in improving the quality of care through preventive health care services, chronic disease management program, and so forth, many physicians are reluctant to be part of the managed care environment. Some of the reasons are the impact of managed care to physician’s income and autonomy. Under managed care, insurers have decreased the fees paid to physicians. There are different ways how managed care organizations control costs. One of this is through selective contracting with health care providers and hospitals to lower costs. In selective contracting, health care providers agreed to accept lower prices in exchanged for guaranteed volume of patients under managed care plan (Culyer, 2014). This paper will discuss more issues and trends in Managed Care Organizations such as the rise of Medicaid Managed Care spending, the new Medicaid Managed care Rule, and the collaboration of Managed Care Organizations and Accountable Care Organizations to reduce health care spending and improve efficiency of care.

Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.

Access to healthcare is a factor of great importance that needs to be addressed by any healthcare system. Issues such as the

There was a need to establish bodies and systems to monitor clinical and non-clinical efficiency of the services offered in the public and private facilities. In India concerns about how to improve health care quality have been frequently raised by the general public and a wide variety of stakeholders, including government, professional associations, private providers and agencies financing health care. There also have been attempts to establish systems and process that would ensure quality of care by the health providers.