The study of efficiency, effectiveness, value, and behavior in producing and using healthcare services is known as health economics or healthcare financing. In short, these systems manage payments for medical procedures and resources.
The field allows people to make healthier lifestyle choices and enhance their well-being. It also facilitates interactions between people, healthcare professionals, and clinical environments. Health economists often research how healthcare systems operate and how certain funds are allocated to develop cost-effective services.
Health insurance forms an essential element in ensuring universal accessibility of healthcare and improvement of the general health of the population. The uninsured that lack health insurance cover is, therefore, more likely to have trouble accessing healthcare, particularly when in poor health. The uninsured are likely not to receive high-cost...
Introduction Modern medical organizations are embedded in the framework of the national economy, as well. Although they operate on special terms, medical providers cannot neglect the generation of revenues and management of costs. Furthermore, this is not the case for the staff’s personal gains and shareholders’ enrichment, which may be...
The USA spends more money on healthcare than any country in the world. At the same time, there is no distinct healthcare delivery system. There are non-profit, for-profit, and government-owned healthcare facilities that satisfy the needs of those living in the US. One of the peculiarities of the system is...
Intermountain Health Care uses Clinical Quality Guidance Teams (CQGT) to improve the clinical outcomes of patients. The Guidance teams’ vital role is to identify clinical areas that need immediate improvement through analysis of patients’ data. Foremost, Intermountain records the clinical outcomes of patients which are stored in a data depository...
A risk pool can be defined as a form of managing risk where different parties come together to form a pool of protection against catastrophic risks like floods. Risk pooling is a term mainly used in insurance. It refers to the act of the parties coming together to hedge against...
Managed care, also known as managed healthcare, entails the provision of quality healthcare services to the community at a reduced cost. Managed care is a program in the Health System of the United States of America. Its main objective is to reduce unnecessary costs incurred by US citizens on healthcare....
An upward trend of the costs of health care delivery is still imminent unless a complete overhaul of the health care system is accomplished. The introduction of health insurance as a way of prepaying health care costs in the beginning of the 20th century has not yielded fruits as such...
“One needs to structure a system by which efforts must be made to deliver value to patients in terms of patient results, or outcomes per $ on health care costs, or in other words “lower costs without impairing quality.” In the present scenario, the most important drawback has been that,...
Rural hospitals can be subdivided into several categories or classifications, for instance: sole community hospitals (SCH), Medicare-dependent hospitals, and rural referral centers. In this section, it is necessary to discuss their peculiarities. At first, we need to mention that the funding provided to each of these institutions as well as...
Introduction Medicare and Medicare services, as well as managed care companies, are often used phrases in the United States’ insurance and affordable health care programs. These insurance programs are experiencing financial difficulties that must be addressed through a variety of alternate techniques. Thus, this essay will discuss both Medicare and...
Preventative healthcare interventions are an essential part of the process of health care improvement. Moreover, preventive measures lead to managing healthcare resources in an increasingly cost-effective way. Since the U.S.’s healthcare expenditures are among the highest in the world, with the quality of care leaving much to be desired, preventative...
Choosing between major medical and major non-medical health insurance relies on what an individual can afford as well as what are their needs. Major medical health insurance can protect against severe injury or illness through referrals to various inpatient and outpatient services. Besides, such plans meet the minimum essential benefit...
MCO: Managed Care Organization A managed care organization (MCO) is a popular way for US citizens to use medical services. MCO can be a health plan, health system, physician group, or hospital responsible for managing the health of various enrollees who decide to contract with them. In the case of...
Health insurance currently provides coverage for both high medical bills and preventive care. In the United States, healthcare reform mandated that all insurance cover entirely preventative treatment to promote good health. In an emergency, hospital stays, doctor visits, medicines, and other medical expenses are covered if both the employee and...
In the United States, the percentage of wasteful health care spending is often regarded as the highest one in the world. Researchers and experts have examined this issue with reference to the fact that the United States expends significant resources on health care, and much lost or wasteful spending can...
The cost of health care in the contemporary world has increased drastically. The rise in the cost of health is because of the increase in the aging population as well as the developments in new treatments (Dickman, Himmelstein & Woolhandler 2017). Poor costing systems have serious consequences, especially when dealing...
Executive Summary Spending on the health care industry represents a substantial portion of the US economy, mainly because of drug pricing issues. Numerous factors explain the presence of this adverse phenomenon and its effects. Thus, the problem is that high prices result in the fact that medical services become less...
Currently, the healthcare system primarily uses two reimbursement methods: fee-for-service and pay-for-performance. The two are not mutually exclusive, and each affects the revenue cycle in a distinct manner. Moreover, recent developments, such as the expansion of Medicare and the introduction of various new systems and requirements for hospitals, have further...
Introduction Budgeting can be defined as the allocation of resources to different sectors in an organization to improve productivity. Since the health industry is a broad scope comprising private and public sectors, the government is involved in the allocation and formulating of the budgetary protocols to be followed. The government...
Unequal income distribution is a key driver of the United States of America’s high health care costs. Excessive income spending on investment in the healthcare sector plays a crucial role in the overall performance of the economy. The U.S has an unsustainable healthcare cost and growth patterns that are not...
Introduction Although the intention of the government is to create a strong healthcare system, some mistakes, shortages, and problems might provoke new organizational, financial, or emotional challenges. In 2010, President Obama signed the Affordable Care Act (ACA) to provide more people with health insurance, expand the existing Medicaid program, and...
Introduction Social determinants of health allow healthcare providers see whether the patient has adequate access to healthcare, possesses enough financial resources to afford health care, and can independently maintain health (Healthy People, 2017). The strategy used for asking questions about social determinants was personal interactions in an informal atmosphere between...
Organizational Overview, Service Charter, Objectives, and Mission Organizational Overview M&Y Care, LLC is a home health care agency, specializing in Medicaid community-based services and Medicare certified home health care. Founded in 1999, M&Y Care, with its corporate headquarters in West Bloomfield, Michigan for the past 16 years, now has (6)...
Abstract The future of healthcare in America looks bleak—but it does not have to be. Envoy Paul Ryan (R–WI) has proposed “A Roadmap for America’s Future”—the only complete plan in America that deals with the threatening pecuniary and economic crisis, driven by ever-increasing government spending on health care. Ryan’s Roadmap...
Introduction It is not a secret that healthcare remains an essential element of people’s lives. Nowadays, it is difficult to imagine a person who has never applied to medical institutions either for medical help or for immunization to prevent diseases. Therefore, access to healthcare is a crucial factor that defines...
Introduction Financial planning is a necessary tool for managing health organization’s activities. But this process is individual for each particular medical institution. It is compiled on the basis of the priorities of the action, the model of the provision of services, and the approaches of management teams regarding the development...
Effectiveness, efficacy, and sustainability are critical issues in the delivery of medical services in every country. Unfortunately, different variations in the quality of healthcare outcomes continue to be recorded in the United States. A detailed analysis of such gaps can make it possible for stakeholders and policymakers to implement superior...
A Person Is the Best Judge of His or Her Own Welfare The economic behaviors of individuals are driven by self-interest, and it means that consumers’ freedom of choice induces greater satisfaction. However, the assumption is not always applicable to the modern healthcare market because access to healthcare goods is...
The USA insurance system has a unique history and structure. The rapid growth of the economy and accumulation of capital created all the necessary conditions for the insurance institution development. The insurance system, which directly depends on both the economy and welfare of citizens, is an indicator of the overall...
One of the most crucial indicators of any country’s state of the art is its healthcare policy and related legislation regulating the mentioned sphere. Citizens’ health might be a vital aspect of national harmony within a state. Hence, when people need treatment, they should be provided with high-quality medical services,...
Introduction For more than seven decades, the U.S. health care system was dominated by market relations that determined the basic principles of the entire system. Namely, those were unregulated state voluntary medical insurance for the majority of the population, unregulated prices for medical services, and patient freedom of choice of...
Introduction There are two principal approaches to healthcare: public, where the state funds the care providers, and private, where patients pay for treatment. However, there is another distinction that many people frequently ignore in the United States. Private healthcare organizations can be either for-profit or nonprofit, with the differentiation implied...
In the context of healthcare, value-based purchasing (VBP) is defined as the strategy of linking the payments for received services to the improved performance of healthcare providers. This type of payment ensures that providers hold themselves accountable for both the quality and the cost of services they offer. Therefore, inappropriate...
Introduction Human beings continue to grapple with numerous health challenges that make it impossible for them to lead high-quality lives. Some of these conditions include tuberculosis, cancer, HIV/AIDS, and malaria. When the government provides timely and sustainable health services, it can be possible for more people to achieve their potential...
Universal insurance solving “market failure” in health insurance The question of universal insurance is rather controversial, and it is associated with a lot of the economic issues such as the questions of equity and efficiency which can be discussed with references to the market failure (Sloan and Hsieh). Mandating universal...
Health-care cost management has become important because an increase in inflation has pushed the price of health care even higher. A lot of people were optimistic that the different programs and policies implemented by employers, insurers, and the government during the 1990s to manage the rising costs would help to...
Introduction The process of planning a budget for a healthcare establishment involves considering many factors that influence the operations. In the case of this clinic, the purchase of an MRI machine, and the acquisition of billing software will impact the distribution of finances. Additionally, various environmental forces, including significant changes...
Introduction Insurance is a promise of indemnity for specific future losses in exchange for periodic payments (premiums). There are several covers that insurance companies offer to their clients. Among them is long-term care insurance which is provided at the expense of the cost of long-term care beyond predestined time. Young...
Dear Sir, As I am aware of the GenFac Insurance Corp. need for innovative training and development, I decided to address your need and offer my services in conducting training workshops to develop the skills of new sales associates for individual health insurance at GenFac. In this respect, I would...
Write the formula for price elasticity of demand and describe what it means The formula that should be used whenever calculating the price elasticity of demand is presented below. According to this formula, Q0 is the demanded quantity (initial) at the time when the price is P0 (or unchanged). The...
The Hillingdon Hospital in North West London had a problem of having frail patients with different medical conditions. An old model with two consultant ward rounds per week was being used. A junior medical team member or a consultant on a need basis would see patients at different times apart...
American Health System The American health system has undergone a major evolution since the inception of the nation. America’s health system has been under much scrutiny over a long time, more so because it is fragmented and, to some extent, inefficient. Indeed, the U.S. spends more than any other developed...
The Patient Protection and Affordable Care Act is a bill passed into law by the U.S. president Barrack Obama in the year 2010 (Goodson, 2010). This act is normally referred to as Obamacare. The act collectively with the Health Care and Education Reconciliation Act symbolizes the most important government development...
Introduction Medical knowledge is useful for guiding the trajectory of business development, depending on the trends in the healthcare industry. One viable option is to pursue the opening of a specialized pharmacological venture. It is considered realistic in this case due to previous experience in pharmacodynamics and clinical trials. Even...
Abstract In the United States, the economy and health care are two critical issues. The two issues cannot be separated because they are mutually dependent. The increased spending on health care is the driving force to the local economy. The development of several towns and ICT infrastructures in the US...
What does “universal health care” mean? Which countries in the film have universal health care? Universal health care also referred to as united health care, is an essential healthcare service system that incorporates all legal residents of a society or a country, usually provided by the government. The government settles all...
Concept of Insurance in the US health care Health insurance refers to an arrangement involving payment of medical expenses for patients (41). Under this concept, the entities involved in catering for the expenditure are private insurance companies, social welfare organizations and social insurance schemes (Niles, 38). Thus, some insurance programs...
Abstract Many governments have implemented unique healthcare delivery systems to meet their citizens’ medical needs. A single-party payer model has continued to deliver positive outcomes in different countries across the world, including Taiwan. The hybrid system associated with the United States has failed to meet the medical demands of many...
Implementing Health Care Reform — An Interview with HHS Secretary Kathleen Sebelius Politician interview overview Sebelius is the current Secretary of the Department of Health and Human Services has taken over when Congress was debating the sweeping healthcare reform bill that was put forward by the Obama administration. The Following...
Introduction A healthcare system constitutes the model through which a country or region mobilizes, accumulates, and allocates resources to cater for the health needs of the population(1). Regarding the role that the health care financing system plays, the literature indicates that if it is dysfunctional, there is a likelihood that...
Introduction The cost of health care has grown tremendously over the past few decades, necessitating the need for the implementation of efficient strategies to cut down healthcare spending. Various scholars have come up with proposals on the best ways to deal with the ballooning cost of healthcare without compromising its...
Introduction Health care is a very important consideration for every government across the world. Generally, health care is quite broad and involves numerous stakeholders, including doctors, nurses, dieticians, and therapists among others. This paper looks at the role of insurance in managed care in the United Arab Emirates (UAE) and...
Today, the United States is one of the industrialized countries that spend a lot of money on healthcare. However, it has not been in a position to extend healthcare services to all its citizens. It has been observed that a lot of money is spent on health services per capita...
Medicare Payment Mechanism Today hospitals and physicians are reimbursed by a range of different public and private services. The payments they provide can be both direct and indirect. Today the government tries to control healthcare costs by reducing reimbursement and establishing managed care programs for Medicare and Medicaid (Banach and...
Unlike other developed nations such as Germany, the United States does not have a universal healthcare system. Most of the implemented policies have not been able to improve the effectiveness of the country’s health sector. Consequently, the common consensus in the nation is that the healthcare system should be fixed...
To organize powerful strategic management within a health care organization, its leaders need to realize the extrinsic environment surrounding their hospital. They need to comprehend and promptly react to the crucial changes happening in this environment. Companies that are unable to prepare for alterations, disregard the external factors, or confront...
Managed care is one of the tendencies that exist in the current U.S. healthcare market. Its original goal was to introduce a sufficient managerial mechanism to enhance the quality of the provided services while relying on the methods of cost-effectiveness (Collins, Piper, & Owens, 2013). The primary goal of the...
Introduction and Background Even though the United States spends more on healthcare than any other developed nation, the quality and accessibility of health care remain low. The United States government initiated healthcare reform to address some of the most glaring issues, such as a large number of uninsured. While laws...
Abstract Health care insurance coverage is an essential element of health care that is used to enhance access to health care in the society. The coverage not only removes the disparities in health care access, but also reduces the cost of health care for different groups of people in a...
Distribution of National Health Spending by the Type of Financing Source Bodenheimer (2005) noted that 45 % of healthcare spending comes from the government, 36 % from employment, 15 % out of the pocket and 4 % from other sources. 33 % was spent on hospitals, 23 % on Physicians...
The provision of healthcare is a real concern for many countries. The traditional approaches to health care financing no longer make sense because of the increased cost of offering medical services, against a backdrop of difficult economic times (Perkins, 2006). Austerity measures proposed by governments do not exempt health care....
Abstract This paper focuses on the UAE’s health sector, which is undergoing immense changes that are fuelled by the demand for effective, quality, accessible, and financially sustainable health care. In line with many Arab nations, the government has financed the UAE’s healthcare for a long time. However, as this paper...