Relational Perspectives

There is a move from a noncompetitive insurance environment to a competitive one because the competition was not by hospitals to provide the best and cheapest care, but rather among the insurers to get the healthiest patients. Consumer driven plans are central to the process because they are ideal for risk selecting the young and fit who have been driven to new plans. Healthy people could watch their account balances grow which leaves the truly sick behind in traditional plans. This particular type of competition is being used to attract the healthy and in turn lead to price increases because insurers have little incentive to control the prices medical providers are charged. It is the responsibility of the patients to worry about the cost and the patient does not have the same power as the insurance competitors do. According to a key South African regulator, Alex van den Heever of the Council for Medical Schemes, “Competition based on the shifting of risk

As it is generally assumed, health care is a social component that is mandatory in any developed society. Opponents argue that patients benefit from privatisation as they will have better choices because of the competition spawned as a result. They also suggest that patients will be subject to affordable and quality services (safeguarding free services) since competition will provide different clinical groups the opportunity to solicit valuable contracts that will protect pricing and quality services (El-Gingihy,

The competitor would provide similar services that could potentially hinder PHC’s progress toward accomplishing its service and profitability goals.

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.

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

The Affordable Care Act was created to assure all Americans have access to affordable insurance, but as stated by Sir Isaac Newton for every action there’s an equal and opposite reaction. As more and more people become insured in this country, the for-profit insurance companies are reaping the benefits from the legislation of the Affordable Care Act.

Internal rivalry: Industry demand is driven by the rising costs of providing medical care. The profitability of most MCOs depends on efficient operations and the ability to negotiate favorable contracts with healthcare providers. With respect to price competition, average premium prices charged to customers have risen more than 78% since 2001 . These industry-wide increases suggest MCOs engage primarily in non-price competition. An example that supports this suggestion is the recent growth in firms’ provider networks, which can be measured by the number of doctor’s offices, hospitals, and pharmacies that accept the insurance plan in a specific geographic area

The textbook, “Redefining Health Care”, written by Michael E. Porter and Elizabeth Olmstead Teisberg introduces readers to the complex world of healthcare in the United States. Porter and Teisberg looked at major problems in the healthcare system and found that problems in healthcare were directly linked to the excessive costs of healthcare that had absolutely nothing to do with high quality care. “Redefining Health Care”, tackles the issues of how the United States can repair the healthcare system by utilizing economist strategies such as value-based competition to repair the healthcare system.

price, quality, convenience, and superior products or services); however, competition can also be based on new technology and innovation. A key role of competition in health care is the potential to provide a mechanism for reducing health care costs. Competition generally eliminates inefficiencies that would otherwise yield high production costs, which are ultimately transferred to patients via high health service and delivery costs. With so much competition going on in the healthcare field and around the healthcare organization of my choosing, reducing cost for the patients will keep my organization in the competition for more patients to come

Another group often blocked is complementary or alternative health care practitioners. These restrictions and the insurance industry unwillingness to pay for these services, gives the physicians an almost monopolist control over health care. Providers must be able to enter the market for competition to work and there must be many providers vying for the patient. To get the most out of health insurance plans Consolidation of hospitals and multispecialty group practices increases the negotiating leverage of the group but in certain areas of the US a single large medical system has become the sole provider of major health service thereby restricting competition (Shi & Singh, 2008). This consolidation while giving the hospitals and group practice leverage when negotiating prices of supplies and services tends to increase the price of health care to the patient because there is no longer any competition (Shi & Singh, 2008). For these reason “competition will remain less effective in most health care markets, because the prerequisite for fully competitive markets are not fully met” (Federal Trade, 2004, p. 20).

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.

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers (Glover & Rivers, 2009). In the health care industry, competition has an impact on many relational perspectives. There have been several studies examining the relationships between competition and quality of health care, competition and health care system costs, and competition and patient satisfaction. Some elements of competition in health care are price, quality, convenience, and superior products and

With each passing day the health care industry is experiencing an increase in participants due to its perfect competition nature. Due to this increase the industry participants, the industry has vicious competition which in effect leads to an increased in the cost of doing business. Smaller companies within the industry are hard hit by this competition due to their limited resources and therefore find it hard to remain relevant within the industry. Due to the looming threat of closure and liquidation, small companies must explore various strategies they may use to remain in operation. On the other hand large hospitals that are looking to eliminate competition and at the same time improve on their market share and in effect their revenues, merge with those that are struggling with low profitability. These mergers are beneficial to the smaller struggling companies since they provide increased savings on company overheads and availability of specialized machinery. Growth is also expected due to the increased market share as well as the good will already established by the large company. Contrary to popular opinion, mergers are not always between a large and a small company. In the healthcare industry two small companies may come together in order to pool their resources together and be in a position to compete against the large companies.

Benchmarking might help in evaluating the standards attained by the competitors, but it does not examine the circumstances or factors (such as optimization strategies used by the competitive hospitals in improving the efficiencies of patient movement) under which the competitors attained those standards. In addition, after achieving desirable outcomes or excelling beyond the competitor’s standards, many organizations develop an audacity which can impair the organization’s future growth (Nayab, 2010). Further, benchmarking can factor into financial matters by identifying the actual discrepancies between the internal and external performances. Also, it can help in facilitating the distribution of resources and justifying the budget ratios within individual units and

Alan Page Fiske catalyzed the advocacy of the relational model 's theory (RMT) in 1991. The theory states that there are four natural ways of interrelating with other people. The author established the four models in his article structures of social life. Fiske affirms that the models work together in varying combinations and control almost all transactions by human beings (Bolender, 2010, p.60). He further asserts that the models unify ideas on moral judgment, social justice, religious, political ideology, and social conflict. It also informs the reactions to misfortunes and transgression. He explains that they are the foundation of human sociality (Bolender, 2010, p.60). The four models of relations as identified by Fiske include market pricing, equality matching, authority ranking, and communal sharing. The theory suggests the four models as the first cognitive models which represent, comprehends, evaluates, and constructs social relationships (Haslam, 2004, p.3). Therefore, the models do not define the type of relationships that exists between individuals in principle; the models are not empirically independent but are a contingent matter regarding the degree of their association as they operate in a culture (Fiske and Fiske, 2007, p.284). The culture adopted by different communities varies according to the combination of the four models.