Government/Payers: There is a medium level threat from the government and payer forces. Payers, including managed care organizations and insurances, conduct a cost/benefit analysis of every new product and services that is introduced and performed. The ACA mandate has forced the population healthcare pay model that is to be used for Medicare and Medicaid reimbursement, but the insurance industry has also adopted the underlying idea of managed-care. As a result of the mandate we should also expect to see a decrease in self-pay patients, as a huge proportion of the self-pay patients that were uninsured become insured. Based on the future trends of healthcare delivery reimbursement there will be a need to decrease costs while simultaneously increasing
Health care costs are a longstanding concern to policymakers. For years, health care spending has been rising faster than the rate of economic growth, raising the question of what factors are responsible for rising health care costs. This paper explores published articles that report results from research conducted on technological innovations in health care and its relation to rising health care costs. The cost increases have a significant effect on households, businesses, and government programs. Health care experts indicates the development and diffusion of medical technology as primary factors in explaining the persistent
Throughout the history of the United States, the economics of the health care system has experienced many changes. There are many factors to consider that has been the drive behind many of the changes within the health care system. Medical and surgical technologies are some factors that relate to the changes in health care. Besides these factors, allocating sources to fund health care services has always been the most critical factor. One might consider the economic term supply and demand when looking at the history of health care economics and the primary funding source. Health care funding
Payment for services will determine the advancement of technology. Research for cures, disease prevention, and new medications are examples that humans value. The involvement of the CMS affects many health care organizations. Even with the new health care reform, costs continue to rise and there remains a lack of access to many.
There are many factors that have influenced the changes of health care economics. Money and technology has definitely been the reason for the change of health care economics over the years. Money is want makes the economy evolve. There will be advancement in technology and there needs to be people are managing these to keep up with the changes. The U.S. has definitely progressed as far as influencing factors to change in new advancement of technology and medical care. Having a good financial manager in your organization will prepare for these upcoming advancements and changes. Money drives these advancements in
In the past several years, there have been several changes in economic policy at federal and state levels. The two economic policies that present to be the most precedent for healthcare leaders with concern to facility reimbursement are the Affordable Care Act (ACA) and the switch from volume to value reimbursement. First, there is the ACA policy, which have affected healthcare facilities and their reimbursement methods. In fact, ever since this policy was implemented, provider reimbursement has started to decrease in terms of fee-for-service payments (The Common-Wealth Fund, 2015). In other words, the intention of this policy was to provide budget relief to the government payers as well as giving providers an incentive to provider patients with great quality of care.
Overall, economic factors will always be unpredictable. Within the healthcare arena, today’s political aspects have directly impacted current and future economic variables. Obamacare places restrictions on insurance spikes without approved justification. The regulatory measures will keep citizens with medical coverage for longer timeframes. Affordability will be the
There are so many different health care providers and types of health care services that we as consumers can receive. All those different services or facilities are going to have competitive prices for our medical care. I think a patient as a consumers are going to benefit from this. Not only do medical facilities have competitive prices but also insurance
Healthcare in America is a very complex system. It is very different from what it used to be. It is moving from what was considered an indemnity type of care plan into a more managed care plan. There are a lot of factors that has influenced the fast growing system. Factors that are considered a contributing to this is the growth in the US population, people are living longer than before. An increase in technology, easier access to information. There is an alarming growth rate in the allied healthcare professionals. The cost and dependence on drugs and the pharmaceutical cost has increased. The rising cost of individual and family healthcare insurance. Because of the rising cost of malpractice insurance, case settlement and jury awards.
Throughout the past few years the healthcare industry has taken some precautions due to the recent bill passed that affect it, that being the healthcare reform or the Affordable Care Act (Kavilanz, 2010). In the past years healthcare has not been a concern of the average American, but this is changing rapidly. Though in 2014 healthcare was not among the top three concerns it did fall at number four (Cook, 2015). While at number four on the list last year it’s surely to increase in concern as the healthcare act becomes in full swing in 2015 (Cook, 2015). As Lindsay cook points out in her U.S News article on health care 2015 will be the year doctors see a pay cut and Americans without insurance see a penalty (Cook, 2015). Just like the rule of supply and demand, when the money supply of hardworking Americans decrease, the demand or concern in this case will increase.
Per your conversation with Barb, we have added information on some national trends in healthcare along with the economic/employment statistics previously provided. The entire list is below.
The next factor to consider is competitive position and healthcare firms can substantially ensure higher quality of care when pricing there products and services at an increased level. Aside from pricing, cost is another major aspect since it can drastically affect a company’s competitive position. A hard investment would involve a MRI device that insurance companies or healthcare organizations could reimburse the office at a higher rate for providing the patients of improved cost-efficient results. As a result, such benefits accrue primarily from savings in drug expenditures, improved utilization of radiology tests, better capture of charges, and decreased billing errors, (Wang et al., 2003). Physician providers are always in competition with the latest and greatest technology, EMR system, and most effective medication for patients.
Medicaid is one of the factors that can cause the cost curve to shift. The government funded insurance has a profound impact on the cost curve as it increases the cost of health care to recoup funds to cover the cost of care for Medicaid recipients. Health information technology is a subsequent factor that influences the cost curve. In the age of technology, health care organizations must have updated equipment to aid them in providing faster top notch care. In both of these instances, there needs to be a way to fund Medicaid and technology consequently; these costs are passed on to the consumer causing the cost curve to shift increasing the cost of medical services.
There are many different forms of competition among health care organizations. Some of them are the prices of services, different co-pays someone will have to pay out of pocket, lower premiums, they have to be competitive in the quality of the service in which they perform daily. The health care competition is being advertised every day. The competitive nature of business cause them to reach out to the community. The health care industry has to fight for the approval of the community, the government, the insurance companies, the pharmaceutical companies and of course the stake holders as well as future investors.
Competition drives innovation and ultimately leads to the delivery of better healthcare. Competition has played a vital role in shaping the delivery of healthcare in the United States. Competition results in lower prices and broader access to health care and health insurance. Competition among and between hospitals and physicians intensified with the development of managed care organizations. In addition to putting pressure on costs, managed care plans have pressured providers to use shorter hospital stays and to offer alternative outpatient treatments (Botti, 2007). This led to lower costs and an increase in choice without sacrificing quality. Lower costs and improved efficiency has made health insurance more affordable and available. Another benefit of competition in health care is the innovation in healthcare technology (i.e. endoscopic surgery, anesthetic agents available in ambulatory surgery centers).