The Importance Of Direct Cost In Healthcare

The articles I chose for my annotated bibliography were about healthcare cost and quality. The theme in many of these articles was about healthcare cost and does it affect patients experience. In some settings like hospitals, the cost of quality affects patient experience. The largest component of the U.S. Gross Domestic Product goes to healthcare spending (17% in 2009), and yet the quality is unsatisfactory. It was also interesting to find out that more people die each year in the United States from medical errors than from highway accidents, breast cancer, or AIDS (National Academy of Science's Institute of Medicine, 2002).

Cost containment is a way for the U.S health care delivery system to solve inflation in cost which will save money for the hospitals involved. According to “Health Care Cost Containment: A Contradiction in Terms?” cost inflation has many contributors including the increased cost in hospitalization, advancing medical technology, prescription drugs, professional degrees, legal settlements, and other related services (McConnell CR, 2002, p.70-71). All of these contributors are coming from different aspects of the health care delivery system but they all end up with the same results. Cost containment effort ideas can solve all of those problems as long as they are properly implemented and people really believe in helping to keep costs at a

With the Centers for Medicare and Medicaid (CMS) providing coverage for over 100 million citizens in the United States and being the largest care delivery system, it is hard to ignore their presence in the ever changing health care delivery system. Some say, that where Medicare goes, private payers will follow. Today, hospitals, health systems and other providers have been highly influenced by Medicare. Medicare, Medicaid, the Children 's Health Insurance Program, and the Health Insurance Marketplace are leading the way in the movement to provide coverage under this system. As the Affordable Care Act is ironed out, there are still billions of dollars being spent within the Medicare/Medicaid programs. In an effort to try and combat some of the overwhelming costs of these programs, the Accountable Care Organization (ACO) Model has slowly begun to integrate itself into the Medicare/Medicaid system. This has brought about some interesting changes with reimbursement, cost containment, and quality of care. Each making slow shifts towards change and developing new systems of providing quality health care.

Everyone wants to have access to health care and in order to access it they need insurance, but unfortunately not everyone can afford health insurance. The United States spends more money on health care than any other country, but raise the cost of health insurance to the citizens. Health care should be affordable if the government is willing to spend as much money as they are on it. Health insurance should be able to affordable to all classes lower, middle, and higher. The citizens of the United States has the right to know why their insurances cost are going up and if they are going to get more bang for their buck. The reason why

Cost sharing can be defined as shares of costs that are covered by insurance companies that the patient has to pay out of their own pocket. These can include deductibles, copayments, and coinsurance (Cost Sharing, n.d.). Within the past ten years, health insurance cost sharing has increased due to the changes in health care which has led to the need for increased deductibles, copayments, and insurance prices in general. The actuarial value is the expected percentage of health care costs that will be enough to cover the average population. The actuarial number for an employer-based plan is 83%, and 59% for an individual plan (Gable et al., 2016). According to the Kaiser Family Foundation (2016), employees are covered by their employer’s

President Donald Trump announced last week that his administration will no longer make cost-sharing reduction payments, which have helped nearly 6 million low- and moderate-income Americans afford the health care services and medicines they need. The Affordable Health Care Act requires health insurers to reduce consumer cost-sharing requirements, such as deductibles and co-payments for enrollees who earn between 100 percent and 250 percent of the federal poverty level. The administration's decision to end the cost-sharing reduction payments not only disrupts the health insurance market, but contradicts many of the health reform priorities expressed this year by both the president and members of Congress.

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.

Aleshia, your statement “direct costs are costs that can be easily associated with the production of a particular good or service”. The main cost component for outpatient diabetics’ care in both public and private has been medication costs. This is compatible also with what happened to the cost component of diabetics care in 2000 in Iran. It is estimated that direct medical costs of diabetes are 2–3 times higher than nondiabetic people (Davari, Boroumand, Amini, & Aslani, 2016). These additional costs are mainly attributed to the fact that diabetics are at high risk for blindness (retinopathy), kidney failures (nephropathy), neuropathy, foot ulcer and amputations, and disorder in sexual function(Davari, Boroumand, Amini, & Aslani, 2016). Cost

In the past, health care costs has been between 1% and 2.25%, greater than the potential gross domestic product (GDP) (Congressional budget office, 2013).

The opening statement of the presentation accurately summarizes the United States’ healthcare system as it relates to everything that Dr. Roper said in his speaking. I found it shocking that America spends more money on healthcare than any other country in the world, yet everyone does not have proper health insurance, meaning they are underinsured or simply uninsured. Most of the problem, in my opinion, lies in the cost driven system for healthcare in this country. As a matter of fact everything about this country is money driven; everything is about how it will affect the economy. From the hospital companies down to the patients who receive services, the major concerns are rooted in cost. When doctors are paid based on how many patients they serve and not how well they serve the patient's, everything is more about numbers where it should be about the welfare of the patients. The system is rigged to being more about quantity than

The cost of medical treatment has increased dramatically, placing more focus on the significance of the doctor’s actions about what treatment suits the patient the best. Hall and Schneider ( 2008) found that the medical field is highly impacted by money. It is impacted by money creating a place where uninsured patients pay one third to one half more than patients who are insured. They still express that having access to health care is important by stating that, “ Still, professional ethics should encourage physicians to five patients in economic trouble at least the benefit of the lowest rate they accept from an established payer” (p.1257) Having access to basic health allows patients to be wise about their options in medicine. Hall and Schneider explain “Since the early 1990s, hospital list prices have risen almost 3 times more than their cost, and their markups over cost have more than doubled from 74% to 164%” (p.1259). The increases in prices may stop a patient from receiving a treatment for an illness. For the patients who ultimately do have to get the treatment it is extremely important to get a treatment that has the

Additional costs of being in the hospital, post-operative care, follow up visit, such as, child minding.

It is very important that we utilize cost control methods in the health care field. The reason being is that about 10% of the population, usually with chronic to severe problems, use approximately 70% of the total spending (Shi, & Singh, 2008). If we didn’t monitor the costs and spending we wouldn’t be using the money efficiently. To avoid potential problems we frequently use six different cost control methods to monitor what medical services are necessary, the most cost efficient way for these services to be provided, and keep an up to date chart of the patient’s condition to offer only treatment deemed necessary.

The adoption of the five strategies associated with costing will allow hospitals the ability to recognize and anticipate new changes, and allow providers the ability to adapt to healthcare reform through direct communication and action with their managers and accounting. This will enable hospitals the ability to competitively and fiscally combat the challenges arising in the healthcare marketplace. Furthermore, with many of the legislated reforms being implemented within three years, providers should actively reassess their costing programs now in an attempt to adapt to the impending change.

There are several factors that contribute to the expensive healthcare costs in America, including – but not limited to – acts of defensive medicine, cost shifting, and lack of consumer awareness. As a healthcare professional, the threat of a malpractice suit is a looming fear. As these suits can be expensive, many providers will run unnecessary tests – whose costs can run high – to ensure that their inclination of a diagnosis is not incorrect. Unnecessary tests can also be run as patients are often removed from the price tag of their healthcare costs. As many with insurance are only familiar with their deductible or co-pay, patients may ask for additional tests to be run without being aware of the costs of insurance; increasing the costs for