Innovation In Healthcare Case Study

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

Anderson, Amy. “The Impact of the Affordable Care Act on the Health Care Workforce.” The Heritage Foundation. N.p., n.d. Web. 14 July 2015. This paper is a through report on the impact of the ACA on the workers in healthcare, particularly on the ratio of worker to patients. It shows that the act will increase the physician shortage, particularly in already underserved areas and specialties. It will also greatly increase the stress on workers, due to the increase demand from each physician or nurse and the increased amount of regulatory paperwork required. Many healthcare providers are merging into larger business to cut costs; others are running cash-only or annual-fee models. The act attempts to transition to paying physicians for performance

The aim of the ACA is to provide affordable health care to all Americans, but it still leaves some issues unaddressed that will impact the access to health care. Covino (n.d.), “Though the intentions of the legislation are good, the Affordable Care Act does little to improve the actual health care delivery system” (para.1, page 2). According to the American Medical Association, we are facing an increasing Physician shortage. As of 2010 we faced a shortfall of 13,700 physicians, the estimate is that number will increase to 62,900 by 2015, 91,500 by 2020, and 130,600 by 2025 (Krupa, n.d.), with primary care taking the largest impact. Health Care coverage will be of no benefit if there are no doctors to treat the patients. An example of this occurred in 2002 when Thailand’s’ “30 Bhat Scheme” added (CNN n.d.) “14 million people to the country’s health care system, resulting in long waits and subpar service” (Your health is covered, but who is going to treat you?) Several factors contribute to the physician shortage. Many physicians are reaching the age of retirement, the Association of American Medical Colleges estimates nearly 15 million physicians will be eligible for Medicare in the coming years (CNN n.d.). The increasing cost of malpractice insurance also deters many from pursuing a career in medicine, and is forcing some doctors to retire. Also contributing to the physician shortage is a lack of spots in residency programs. “In 2011, more than 7,000 were left

It is essential for an administrator to understand how private and government payers impact actual reimbursement. Government payers have a standardized benefit structure. The one benefit is that registration staff have an easier time calculating payment due (copayments) for service and can set up payment arrangements. Since the most significant proportion of funds coming into a healthcare organization is usually payments from third-party payers, therefore, it is critical to know how each reimbursement affect the others that come in. Healthcare organization may have hundreds of different payer’s relationships in the form of different contracts that have their own rates of payment that are usually different from other payers for an identical

It is commonly believed that the method of physician remunerations affects their professional behavior. As a result, payment systems are therefore manipulated in attempts to achieve policy objectives with the primary aim to improve quality of care, contain cost and maintain recruitment of human resources in underserved areas. (2,1)

Changes to the health care system throughout the United States will greatly influence health care utilization. Trends in health care utilization can be used to project future health care needs, predict expenditures, or for training personnel in new medical procedures and policies (Berstein, Hing, Moss, Allen, Siller & Tiggle, 2003). For example, the increase in ambulatory surgery was changed by improvements in anesthesia and improved techniques in Cardiopulmonary Resuscitation (Berstein, Hing, Moss, Allen, Siller & Tiggle, 2003). Advanced medical procedures that used to require a few weeks of bed rest now only need a few days in the hospital. Shorter hospital stay makes the patient happier and it

The Affordable Care Act includes changes to Medicare, Medicaid, private insurance, and creates many conflicts and benefits around how it will affect health care in the future. Clearly, all items within the medical reform are connected, so that a positive impact in one area may inversely affect another. The primary change is the extension of health care coverage to the uninsured, but it comes with a cost. Costs include penalties, taxes, reduced medical access, and lower reimbursement rates for physicians and hospitals. The Affordable Care Act is conceived with a good purpose; as a result, everyone will now have access to affordable health care, although, “affordable” is not yet well defined. Health care providers will be able to continue their vocation of providing good care for our society, but in some cases, changes to insurance may still have a poor outcome.

Due to the rapid rise of health care, our country has great concern. Our annual growth

One class of American citizens view on the Patient Protection and Affordable Care Act is doctors, and it is very negative. Third-party payment plans already hinder the independence and integrity of the medical field. This act now will reinforce the worst of these features. Physicians will fall prey to more government regulation and oversight, and will now be increasingly dependent on a not to reliable government reimbursement for their services. A doctors job will only be become more difficult.

The Obamacare/ACA, might have helped numerous of individuals in acquiring health care, but the health professionals are facing a shortage of reimbursement difference for their services. As a result, Hospitals and healthcare providers were force to layoff personal and come up with innovative solutions. This point is proven by the renowned author, Amy Anderson by stating as follows: “The American health care framework has had shortages of personnel for quite some time and would not be prepared to give the adequate service to this amount of patients in need of medical attention. Training new professional health services personnel could take years. There is a shortage of graduates from medical and nursing schools. Doctors, nurses and health professional are sharing responsibilities prospective patients will face a longer wait time”. (Anderson, 2014)

In 1983, the Medicare prospective payment program was implemented which allowed hospitals to be reimbursed a set payment based on the patient’s diagnosis, or Diagnosis Related Groups (DRG), regardless of what treatment was provided or how long the patient was hospitalized (Jacob & Cherry, 2007). To keep the costs below the diagnosis related payment, hospitals had to manage efficiently the treatment provided to a client and reduce the client’s length of stay (Jacob & Cherry, 2007). Case management, or internal case management “within the walls” of the health care facilities was created to streamline costs while maintaining quality care (Jacob & Cherry, 2007).

HMOs multiplied rapidly with the new federal giveaways. Managed care, now including PPOs, mushroomed. Employers initially perceived managed care plans as cheaper than traditional fee-for-service insurance. Gradually, they stopped offering a choice of health plans, making individual policies more expensive. HMOs' penetration of the industry had been subsidized into existence. Government had instituted managed care. Today, while overall quality of patient care remains the best in the world, doctors practice medicine in an increasingly intricate web of rationing and regulations: Physicians are stripped of professional autonomy. As patients wander the maze of managed bureaucracy, costs rise and quality deteriorates. Every American dependent on a third party for health coverage is a potential victim of managed care. And state sponsored management of medicine

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.

Technology has been advancing every day, which has tremendous effects on the lifestyle of people. People are dependent on technology, and as a lifestyle of people change, a demand of advance technology grows. Technological advancement has both positive and negative effects, for instance, benefits of technological advancement are time saving, increases the production, simplifies the communication, improved the health care and education and others. On the other hand, technology has decreased the human interaction, people are lazy and dependent due to technology, which has decreased the innovation and increases the health risks such as weight gain and obesity-related health issues. This paper will describe regarding the historical perspectives of U.S health care delivery system. The paper will contrast and describe the two technological advances and their impact on a health care delivery system. In addition, a paper will explain regarding the author and public opinion on technological advances.

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