Patients Fare No Worse: Article Analysis

Healthcare is in a constant state of change with movements that impact rates, access and quality of care. Hospitals have become more competitive due to the rising cost of care delivery and the reduction in reimbursement from payers. This causes difficulty in delivering quality care to all patients, which is being measured by mandated patient perception surveys, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS scores are part of value

The report provides a good data compilation, but provides little insight into the meaning of the data. Although the report provides little analysis, tax-exempt hospitals have provided significant amounts of financial assistance and other community benefits. [What remains to be seen, however, is whether insurance expansions under the ACA thereby decreasing pool of uninsured patients will cause these numbers to decrease in the future. Tax-exempt hospitals could further struggle to justify tax-exempt status.]

According to the American Hospital Association the cost of equipment, services, and information services has risen drastically. A huge problem for hospitals now is that there has been an enormous increase in patients who have Medicare or Medicaid. The Hospital Association states that “60% of all admissions. Neither program fully reimburses the cost of hospital care.” Not only is the hospital not getting paid the full amount through the health insurance, but they have also seen a jump in people who do not have insurance and cannot pay for their hospital expenses this averages out to about six percent of hospital expenses. Hospitals must assume these costs as a part of their charity pay. These costs are then calculated and increase the costs of health care for people who pay for it, in order to cover these costs.

“The U.S. spends nearly twice as much money per capita on health care as other developed nations, yet the metrics show that Americans end up with worse care and poorer health.” (Hill) The rising cost of healthcare has pushed some non-profits to become for-profit organizations.

For- profit health care and organizations have a misconception that this automatically means higher costs and a lower level of quality. There are several studies that directly contradict this assumption. In a study that was conducted by Blue Cross, the findings showed that there was not an increase in costs and that there was not a negative effect on the availability of health care.

Back in twentieth century, a tiny fragment of mere 5% population was comprised of people aged 65 and above. A little spike in this segment was observed during the period of 1950s-1960s; however, that spike was not significant and restricted to 8% of entire population (Chart 1.1). Many factors were responsible for the small proportion of senior population, the most prominent one though, low life expectancy, high fertility/birth rates and limitation of health services.

Growth and development is an essential part of the life cycle, which leads to the occurrence of different phases like childhood, teenage and late adulthood. Aging is the period which is characterized by the onset of personal, cognitive and social changes. They feel hard to adjust the changes. Like rest of the world, the US also falls in the list of countries which have the highest population of elderly people. According to the Population Reference Bureau report, Americans ages 65 and older has projected to increase more than double from 46 million today to over 98 million by 2060, and the 65-and-older age group’s share of the total population will rise to nearly 24 percent from 15 percent (Mark Mather). The

This unfortunately, reduces the quality of care a patient might receive in the different settings. Whatever the case might be, I do not think there should be a difference in quality of care the patient receives, but do understand that due to lower funds and resources, there has and will probably always be a difference. However, I do not agree that there should be a difference in quality of care when it comes down to hospital acquired conditions (HACs), low incident reports, good service etc. This type of quality should be the same regardless whether a consumer receives medical attention from a for-profit or not-for-profit

MD Anderson had operating profits of $531 million in FY 2010. This represented a profit margin of 26% on revenues of $2.05 billion. Stamford hospital is midsized nonprofit hospital located in Stamford, CT. It has revenues of nearly half a billion dollars. In fact, its revenues exceeded all money paid to the city of Stamford in taxes and fees. The hospital is a bigger business than its host city. Although the true cost of healthcare is difficult to calculate, many other hospitals throughout the United States are generating record profits and revenues. These profits and revenues are under heavy criticism because non-profit hospitals often outperform their for-profit counterparts. Many believe that unfair medical billing practices and skyrocketing prices contribute to these record profits at the expense of economically strapped patients. Non-profit entities enjoy tax-free status on the profits they generate. These profits are used by hospitals to expand their practices and buy out competitor hospitals, laboratories and other medically related cash generating businesses. Anti-trust laws must be enforced effectively to prevent these non-profit hospital systems from becoming monopolies within a geographic area and preventing healthy competition.

The majority of hospitals in the US are private nonprofit hospitals. Community hospitals make up the majority of private nonprofit facilities. These hospitals have an average of 190 inpatient beds. The nonprofit hospitals are exempt from federal, state and local taxes. Nonprofit hospital are owned and operated by hospital districts or nongovernment organization and benefit the community that they serve. They provide public good and do not distribute profits to individuals or stockholders.

In 2004, thirteen class action lawsuits had been filed in eight different states against not-for-profit hospital systems. In general, the reason for these lawsuits consisted of breach of contract, EMTALA violations, fraud, unjust enrichment, and civil conspiracy. In exchange for tax exemption status, the not-for-profit hospital systems were to provide affordable medical care to their patients. However, the plaintiffs, patients, were charged excessive amounts

Not-profit driven hospitals spare more than $24 billion a year in government, state and neighborhood expenses. There are general rules that direct that these hospitals must give an advantage to the group, however there is no base necessity. Singular hospitals set their own arrangements. A patient that fits the bill for philanthropy care at one hospital may have their charges considered terrible obligation at another clinic.

Quality of care has always been a concern in the U.S. health care system. Although great strides have been made to improve the quality of care delivered, many critics still believe that the United States has a long way to go before truly delivering uniform quality care.

Only one major difference is evident (Egger et al. 2008). Foundation trusts only hire professional services of their doctors who are responsible for payment of these services, contrary to the USA where the services of professional services of doctors are not salaried by the institution/hospital, but are independently paid by third party payers or the government (Greener, 2009). The main concern for foundation trusts is if they will suffer from the same amount of pressure that the nonprofit tax exempt hospitals in the USA suffered in the 1980s (Bhattacharya et al. 2010). A concern is whether foundation trusts will be pressed to diverge away from the inpatient services that are hospital-based to adapt to cheap cost systems in which quality health care shall be rendered (Walshe, Smith, 2011). Will the shortages in revenue from the services of inpatients push the foundation trusts to find new ways of getting revenue? Will there be a need for expansion in fundraising and development ventures in organizations that are not attached to the hospital? In the USA, the current pressure to diversify forced hospitals to find and manage new corporate structures (Greener, 2009). As a consequence of the pressure, a lot of tax-exempt nonprofit hospitals chose to move from individualized nonprofit, tax-exempt ventures to a more complex model

“According to the projections, the population age 65 and older is expected to more than double between 2012 and 2060, from 43.1 million to 92.0 million. The older population would represent just over one in five U.S. residents by the end of the period, up from one in seven today. The increase in the number of the “oldest old” would be even more dramatic — those 85 and older are projected to more than triple from 5.9 million to 18.2 million, reaching 4.3 percent of the total population” (US Census, 2012).