Managing Healthcare Costs and Revenues Essay

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With these types of organizations they have different methods of payments and reimbursements. They have guidelines through the government that they will have to abide by. The government sponsored payers are Medicaid and Medicare. The majority of patients that are treated are on Medicare or Medicaid. With patients not insured each type of organization handles reimbursement differently. For- Profit hospitals it is bad debt, which is when charges of patient are written off. With not –for –profit organizations it is considered charity care. This type of care has to be documented and reported on tax status.
The private insurers are patients with other insurances. Under Medicare and Medicaid, services that are provided by the hospitals
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4). “A healthy revenue cycle functions through the best efforts of everyone in the organization, resulting in more revenue, which benefits all” (Kapsambelis, 2004, p. 4).
Healthcare costs are the main topic of the healthcare community and have created concerns for the nation as a whole. “Government programs have cut or severely limited increases in reimbursements for covered services. Private insurers frequently tie their reimbursement to these government programs” (Journal of Healthcare Finance, 2008, p. 63). “Changing demographics, especially the extensive demands for health care services from the baby boomers, is adding another dimension to the pressure of health care system” (Journal of Healthcare Finance, 2008, p. 63). “All health care providers are affected by the customer mix they serve. In most instances Medicaid and Medicare patients provide less revenue per procedure than patients with private insurance. However, the HCP’s often accept the Medicaid/Medicare patient because of the certainty of the reimbursement and the increased volume these patients provide. For many HCP’s the decision to accept (or continue to accept) these lower paying customers may not be “good business” from a financial perspective” (Journal of Healthcare Finance, 2008, p. 72). Since healthcare expenditures have risen rapidly, Congress passed the Tax Equity and Fiscal Responsibility Act (TEFRA) in

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