Unit 12- Cost, Access, and Quality
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Institution
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Unit 12 – Assignments
Assignment 1
Name and describe 8 major factors contributing to the high costs of health care.
Increased demand for service
The pressure of increased population in general is exerting great pressure on healthcare services. The great number of incoming patients is forcing the government to increase its prices to remain competitive and sustain the fast-growing population. Additionally, the state’s population is aging.
Technology advancement
The high costs of technology introduced in medical field is a driver of increased cost. Technological advancement leading to improved medical equipment come at a cost. For example, various new procedures are revolutionizing care for heart disease and this is at increased cost.
Government Regulation
Increased state regulations and the introduction of new mandates are also contributing to increased health care costs. Presently, in Washington for example, four state and two federal agencies control health care insurances. There are various state statue and code regulations, and various contract compliance needs for those in medicine thus increasing costs.
Increased costs of drugs
There has been an increase in the costs of drugs as better drugged are introduced into the medical field. The data from the United States for instance has documented increase in physician costs, hospitals and the related prices.
Increased taxes
Compared to the past, various taxes have been introduced thus increasing the medical cost. Normally, such taxes are passed down to the medical treatment or costs of medicine.
The state is growing healthier and thicker
The Americans lifestyles also impact the health care industry in a big way almost sixty percent of the population is overweight and childhood obesity is rampant. Other factors that have an impact on the healthcare spending are; poor diets, high blood pressure, smoking, lack of exercise, drugs and drinking.
Medical insurances
In 2011 spending on medications, hospital visits as well as other medical care went up with an estimated percentage of 3.9 this consumed about 17.9% of the GDP. There are so many medical insurances introduced increasing the cost of medical care. This is more than three times the deficit. Much of the money is considered to be spent appropriately which is keeping people alive and healthy but of course this is a very big problem.
Fee for service.
Medical facilities and physicians are compensated for every service they offer, and this normally results to medics focusing on volumes instead of majoring on care.
Assignment 2
Explain how, under imperfect market conditions, both prices and quantity of healthcare are higher than they would be in a highly competitive market.
Under the imperfect market, healthcare utilization is controlled by the need and not the demand. The cost is increased when patients are exempted from bearing the health care cost. The medics at times induce the medical care demands so to increase their revenues. The increased consumption means an increase in number of services provided at the heath care center. In higher competitive market, costs of medical services are probable to increase making them closer to costs of service production. This is since increased costs leads to reduced demand for medical services. In an imperfect market structure, the costs of medical care will be higher than the actual economic costs of production. Medics are protected from economic effects of lower demand when prices are artificially set at higher level than competition can sustain. Health insurance also protects patients from increased costs.
Assignment 3
What are the implications of access for health and healthcare delivery?
The low socioeconomic status and minority group membership dues to increased costs of medical care implies reduced health services usage and access. Majority tend to overlook other health insurances and only concentrate on the basic thus reducing the number of patients under such cases.
Assignment 4
What are some of the implications of the definition of quality proposed by the Institute of Medicine (IOM)? In what way is the definition incomplete?
Among the implication is that quality performance occurs on a continuum, theoretically fluctuating from best to poor standards.
The aim is shifted to services offered by healthcare services compared to personal behaviors.
The Service healthcare are evaluated from personal perspectives and communities of society.
A lot of stress has been placed on desired healthcare outcomes.
When there is no scientific evidence on suitability of care, professional consensus can be employed in developing criteria from definition and measurement of the service quality.
Assignment 5
Please read the New York Times article “In Hopeful Sign, Health Spending is Flattening Out” by Anne Lowrey, April 28, 2012.
Please post your comments on the Discussion Board.
The statement by Anne Lowrey that, “Finally, and most important, health economists point to a shift toward accountable care, in which providers are paid for the quality of care, and not for the quantity” is true. But unfortunately, for some patients, this implies that often medics and hospitals are not reimbursed by CMS suppose they do not give the quality expected.
The number of people taking insurance covers when it comes to health are reducing gradually. There are many factors that attribute to such reductions for instance recessions, economy and preferences. Furthermore, the increase in the prices of healthcare related services also contribute to the same. The long term medical health cover has reduced significantly over the centuries.
Assignment 6
Please read The New York Times article “Newly Insured, Many Now Face Learning Curve” by Abby Goodnough, August 2, 2014.
Please post your comments on the Discussion Board.
This leaves a very big gap for everyone whose medical cost is increasing. The efforts given in educating the public on their promises on lowering the costs is a mess. And one cannot be sure that such promises will come to pass, with the ever-increasing medical costs in the United States and elsewhere. It is not true that we screwed up the fiancé system for three hundred million to assists eight mission, most of whom licensed for Medicaid. It would be cheaper supposing they would have been handed in insurance cards.
Assignment 7 – Terminology
Access to care
This is the get required, cost-effective and convenient, and effectual healthcare services when needed.
Administrative costs
These are the prices associated with managing the financial, insurance, delivery and payment functions. Such costs entail expenses in managing enrolment process, setting up contracts with care providers and other related costs between service acquisition to provision.
All-payer systems
This is the federal controls that allow cost-containment efforts to sweep through the whole healthcare delivery system.
Clinical Practice Guidelines (aka – Medical practice guidelines)
This describes the preferred clinical procedures for controlling clinical problems based on research evidence, where applicable, and on consensus where evidence does not exist.
Cost efficient
This is in case where the advantages received is higher than the costs associated with such service provisions. The patient gains in cost effecient conditions.
Cost Shifting
The ability for services provider to shift costs from one area to another by reducing the costs of one service and increasing another to make up for such reductions.
Critical Pathway
This is the duration that marks planned medical interventions along with anticipated result for a given diagnosis or medical situation.
Demand-side incentives
This is the mechanism for sharing costs that give increase prices on customers, and thus encouraging customers to be more costs conscious in choosing the medical care plans.
Defense medicine
This is where a medic undertakes unjustified practice to protect themselves from lawsuits.
Electronic Health Records
Entails the medical records of a patient in a softcopy that can be accessed from anywhere or over computer network.
Fraud
The unacceptable practice that tends to go against the expected standards or in conducted with an intention to harm others or access forbidden areas.
Medical Model
Prevention and character that helps in promoting health of an individual. It also entails the procedures, and the services which one subscribes to in order to boost health for instance healthcare insurance.
Overutilization
Takes place suppose the treatment costs is much more than the outcome, yet the service is given.
Payer Driven Price Competition
Occurs suppose employers buy the best value in regard to premium costs and the benefit package.
Peer Review
This refers to overall process of accessing how medical services are utilized and the quality associated with such services.
Resource based relative value scale (RBRVS)
Medics are compensated depending on units established for different services and volumes performance values was applied to contain the yearly growth rates in Medicare physician payments.
Risk Management
These are the process involved in lowering the possible hazards that are associated with given process.
Small area variations
Extensive differences in treatment patterns for similar patients.
Supply-side regulation
This is the antitrust laws put in place by the United States, which prevents business conducts that stifle competition among different providers.
Underutilization (underuse)
Occurs when the merits of an intervention are more than the risks associated, when intervention is not used.
Utilization controls
Used in doing away with some of the unnecessary or unsuitable services given to customers through the intervention of the decision arrived at by the medics in effort to make sure that only suitable or necessary services are given in a good manner.
