HSM544 Discussions Week 1-7

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HSM544 Discussions Week 1-7
With each year that passes there are new issues within the health industry, as one is solved…

 

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HSM544 Discussions Week 1-7

HSM544 Discussions Week 1-7

All Posts 393 Pages 

Week 1 All Students Posts – 49 Pages 

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Three Major Tasks of Economics – 24 Pages 

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Identify the three major tasks of economics and discuss why they are important. What are their roles in organization management?

With each year that passes there are new issues within the health industry, as one is solved another one surfaces, we are always going to have issues with the health care industry. One of the issues we’ve been facing recently is the quality of healthcare as it appears that the focus has shifted to making money rather than providing quality care. Because of the focused placed on fee-for service, where providers are paid for their services provided, providers focus on providing quantity of care with the interest in generating profits and neglecting the quality of care provided. This resulted in the over use of resources and providers billing for unnecessary procedures and services. Programs such as the Center for Medicare and Medicaid Services have since created value-based programs that are directed at changing this concepts by connecting the providers payments to the quality of service they provide, thus reducing unnecessary charges and cost…

Factors Influencing Healthcare Demand – 25 Pages 

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Identify and discuss the factors that influence the demand, in turn healthcare economics. What factor do you believe has the greatest impact on healthcare economics and why?

Availability is a factor that influences health care services. Your access to transportation may limit the availability you have to some better health care services or treatments at locations not close to your home. Availability of more skilled nurses or doctors may be limited if you live in a rural geographical location or one with challenging economic conditions. Likewise, specialized equipment may be in short supply, too, reducing immediate availability. If you have a unique health condition, the availability of a professional who can meet your health care need may not even reside in the same country, further influencing whether you can meet a health care need.

Cost – Personal financial situations are a factor that influences health care services, even if you have some form of insurance. Some medical doctor’s offices and hospitals may refuse to treat you for certain conditions without adequate…

Week 2 All Students Posts – 57 Pages 

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Financing Healthcare – 31 Pages 

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Discuss the role of all parties (patient, providers, and payers) to contain costs. Analyze the impact of cost-containment efforts on the rising cost of healthcare.

Hospital cost-reduction efforts are usually tactical, not strategic: Goals are modest, fixes are one-offs and the causes behind inefficiency are not targeted. Such an approach is equivalent to treating symptoms rather than curing the disease. Hospitals’ service mission makes addressing clinical utilization (the right people doing the right things in the right way) especially challenging. Managers are reluctant to make decisions that could jeopardize jobs or alienate physicians, and the clinical staff understandably resists anything they believe could compromise quality of care or patient experience.

As a result, cost-reduction initiatives create churn and a demoralized workforce, with few lasting benefits. Budgets may be reduced, but work processes remain the same. Eventually, either costs creep back up or employees are asked to work harder — or both…

HSM544 Discussions Week 1-7

Production Function Analysis – 26 Pages 

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I think the aging population is a huge production economic factor that will break the bank for our nation. Imagine that know we have 50 million on Medicare and by 2045 this number will be 90 millions. How on earth are we going to pay for their healthcare costs? Medicare is already financially unstable and in a few years it will go under.

Medicare is in over its head and if it remains along that path it will go under. The federal government needs to figure out what to do contain cost and keep the program afloat, if not it could be detrimental. Private facilities may not want to provide services for Medicare members for fear of not getting paid. As the population ages the number of Medicare members increases as well as the cost, this is why it is important to promote preventative care so that the population would be healthier and would not be reliant on medical care. Though Medicare have good intention, it is quickly becoming problematic and  in jeopardy of increased debt if there isn’t a reform soon.

Week 3 All Students Posts – 61 Pages 

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Managed Care Concept – 31 Pages 

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The shift from volume-based to value-based health care is inevitable. Although that trend is happening slowly in some communities, payers are increasingly basing reimbursements on the quality of care provided, not just the number and type of procedures. But because most providers’ business models still depend on fee-for-service revenues, reducing volume (and increasing value) cuts into short-term profits.

Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.

By contracting with various types of MCOs to deliver Medicaid program health care services to their beneficiaries, states can reduce Medicaid program costs and better manage utilization of health services. Improvement in health plan performance, health care quality, and outcomes are key objectives of Medicaid managed care.

Some states are implementing a range of initiatives to coordinate and integrate care beyond traditional managed care. These initiatives are focused on improving care for populations with chronic and complex conditions, aligning payment incentives with performance goals, and building in accountability for high quality care…

Redistribution and Social Insurance – 30 Pages 

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Redistribution from an economic stand point means the theory, policy, or practice of lessening or reducing inequalities in income through such measures as progressive income taxation and antipoverty programs.  Where as Social Insurance is protection of the individual against economic hazards (such as unemployment, old age, or disability) in which the government participates or enforces the participation of employers and affected individuals.

Health insurance, like any kind of insurance, can be framed after the fact as redistribution. You pay health insurance premiums, you stay healthy, and therefore you “lose” your money goes to pay for other people’s losses. The framing of the health care individual mandate as a transfer from the healthy to the sick is the exact same as the framing of tax funded social insurance programs as a transfer from the rich to the poor. At the time you enter the system, you probably don’t know which category you will fall into. You might have some knowledge of the probabilities, but you could turn out to be very wrong: there are plenty of people who are healthy in their twenties but get very sick later. In either case, the framing as redistribution and the focus on winners and losers is a way of making something that all people value protection from risk, backed by the federal government’s balance sheet seem like a from of zero-sum redistribution brokered by that evil, meddling federal government.

For reducing inequalities in income through such measures as progressive income taxation and antipoverty programs. Whereas Social Insurance is protection of the individual against economic hazards (such as unemployment, old age, or disability) in which the government participates or enforces the participation of employers and affected individuals…

HSM544 Discussions Week 1-7

Week 4 All Students Posts – 55 Pages 

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The Role of Nonprofits in Healthcare – 28 Pages 

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As a general rule, for-profit corporations pay taxes: federal and state income taxes on income; state and local sales taxes on purchased goods and, in some states, services; and local real estate and personal property taxes on land, buildings, and major equipment. Not-for-profit corporations pay no taxes; they are therefore tax-exempt.

Governments grant tax-exempt status because it relieves them of the burden of providing the services itself. For example, tax-exempt hospitals must provide healthcare services to state residents who cannot afford healthcare services (charity care). In the absence of this arrangement, the government presumably would provide these healthcare services itself. Another reason for granting tax-exempt status is the benefit provided to the well being of the community by organizations providing uncompensated health-promotion programs to the community.

At the most basic level, healthcare organizations of all sizes and types are either nonprofit (NP) or for profit (FP). Similarities between both types of organizations include but are not limited to:

Both have universal goals to provide the highest quality healthcare services needed by patients served.

Both have universal goals to balance costs, quality, and access among all stakeholder groups (e.g., patients, providers, administrators, third-party payers, etc.).

Both MUST make a profit to stay in business and continue providing healthcare services to patients who need them.

Both have to comply with legal policies and regulations at local, county, state, and federal levels.

Both experience similar challenges such as healthcare professional shortages/turnover/burnout, high rates of malpractice lawsuits/litigation, highly complex reimbursement for services and products provided.

Differences between NPs and FPs included but are not limited to:

NPs do not pay income taxes, whereas FPs do pay income taxes (mostly at corporate rates). In return for the benefit of NPs not paying income taxes, legally these organizations are required to treat a reasonable volume of patients for free (i.e., without the ability to pay for services through insurance or personal funds). Conversely, FPs are not legally required to treat patients without an ability to pay for services received.

NPs must put profits into an “excess account” earmarked for a capital improvement projects such as a new piece of technology or structure remodel/addition, etc. FPs pay taxes on profits and distribute the remaining amount to owners/shareholders.

NPs are eligible to apply for and receive numerous federal grants to supplement income and pay for services that may lose money (aka lost leader programs) whereas FPs are typically not eligible to receive grant monies.

NPs typically have a much larger source of gifts and donations by patrons through foundations than FPs.

NPs typically have a much larger volunteer staff than FPs.

Public Health Insurance – 27 Pages 

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This article makes a great point in that adding public insurance as an option in the complex American health care system has been treated as a consolation prize for those who really favor single-payer health care, but the lighter approach might pack much more punch than you might think. What’s more, the best way to see that is by looking at the Indian labor market and the Mexican grocery market.

Here’s how a public option could play out in American health care.

The government would begin to compete with private insurers by giving people the opportunity to buy health care coverage through an existing program like Medicaid or through an entirely new plan. Some people will buy the publicly run insurance, but many others will stick with the private insurance to which they have grown accustomed.

Based on the article titled Why Public Health Insurance Could Help, Even if You Don’t Want It, Jayachandran illustrates how the federal government of Mexico provided essential foods such as beans and rice to the poor.  India provided its poorer citizens with welfare for work.  In both instances, these governments took responsibility because they were able.  I believe the same is true for health insurance, specifically public health insurance in the United States…

HSM544 Discussions Week 1-7

Week 5 All Students Posts – 57 Pages 

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Human Capital and Policy – 29 Pages 

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We believe that primary care is the foundation of a robust health care system. It will take all providers working to the fullest extent of their educational preparation to ensure an effective health care system that meets the triple aim of improving the patient experience and the health of populations, and reducing the cost of care.

However, costly and unnecessary barriers to NP practice continue to exist, impeding both NPs and physicians from working to their fullest capacity. The unnecessary requirements in numerous states for physicians to sign orders for physical therapy or other referrals, supervise NPs, or sign off on numerous other documents are costly, waste precious physician time, and are not feasible in the real health care world.

Access to primary health care services in a timely manner is a significant factor for optimal public health outcomes. However, there is currently a notable shortage of primary health care workers, which may compromise the quality of patient care. It has been established that practices with more than 2,000 patients per practitioner working full-time are not able to provide the level of care and access to their patients as required. At this ratio, each primary care physician is estimated to spend more than 17 hours each day in the provision of acute, chronic, and preventative health care. This is clearly not feasible and does not include other responsibilities and paperwork associated with the position.

Attracting a greater number of medical students into the provision of primary health care, rather than specialization, would help increase the number of primary care practitioners. There are several ways of doing this, including:…

Impact of Health Policy – 28 Pages

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What is the impact of health policy on resourcing (i.e., funding, technology, capital assets, and other key, nonhuman means of healthcare delivery)?  How do we increase awareness about health policies among the targeted population?

Healthcare Reform Act—officially called the Patient Protection and Affordable Care Act (PPACA)—institutes sweeping changes across all healthcare stakeholders, including payers, providers, and plan members. In fact, the amount of change required by the PPACA is so extensive, distilling all the changes down and accounting for their impact is a serious challenge for the industry as a whole. However, if we focus on the apparent macro changes that affect payers—an increase in competition for the group market, an increase in overall access, and new regulations on expense caps for medical costs—a rational set of assumptions becomes apparent for predicting the direct impact on stakeholders. The implementation of these changes will cause payers to:…

Week 6 All Students Posts – 60 Pages 

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Healthcare Coverage – 32 Pages 

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What means exist for U.S citizens to obtain healthcare coverage? Should coverage be voluntary or mandatory?

The Affordable Care Act provided Americans with better health security by putting in place comprehensive health insurance reforms that: expanded coverage, holds insurance companies accountable, lower health care costs, guarantee more choice, and enhance the quality of care for all Americans (Medicaid).

Prior to the passage of the Affordable Care Act, the individual insurance market was a notoriously difficult place for consumers without employer-based health benefits to purchase insurance. It also was challenging for insurers to sell insurance without incurring large losses. As a result, insurers went to great lengths to exclude people with even mild health problems. In 2010, the Commonwealth Fund Biennial Health Insurance Survey found that more than one-third of people who tried to purchase health insurance in the individual market in the previous three years—an estimated 9 million people—had been turned down, charged a higher price, or had a condition excluded from their health plan….

HSM544 Discussions Week 1-7

Political Issues to National Health – 28 Pages 

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What are the most important political issues that challenge the creation of a national system of healthcare? What should we do differently to control healthcare costs? Are we doing enough or should we look at other countries that have been able to control and manage their healthcare expenditures?

Worldwide there is a growing awareness of the need to adapt health care systems to meet the challenges of the twenty-first century.  The reasons for this need are many but include shifting trends in demographics and illness, epidemiological knowledge of the social determinants of health, the radical possibilities of new technologies, and rapidly increasing health care costs as well as relatively long-standing concerns about the need to respect and support the autonomy of patients…

HSM544 Discussions Week 1-7

Week 7 All Students Posts – 54 Pages 

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National Systems of Healthcare – 28 Pages 

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Investing in services that provide support in these areas can make our population healthier as a whole and reduce health care costs.  Describe a developed nations system of healthcare. Your description should provide (only) one positive and one negative quality about that system. Connect both of these qualities to either cost, quality, or access.

The United States has a mix of clashing ideas  private insurance through employment; single-payer Medicare mainly for those 65 and older; state-managed Medicaid for many low-income people; private insurance through exchanges set up by the Affordable Care Act; as well as about 28 million people without any insurance at all. Hospitals are private, except for those run by the Veterans Health Administration…

National Healthcare in the United States – 26 Pages 

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Provide an example of a national-level policy directed at health. Explain the policy.

Health care spending in the U.S. far exceeds that of other high-income countries; though spending growth has slowed in the U.S. and in most other countries in recent years. Even though the U.S. is the only country without a publicly financed universal health system, it still spends more public dollars on health care than all but two of the other countries. Americans have relatively few hospital admissions and physician visits, but are greater users of expensive technologies like magnetic resonance imaging (MRI) machines. Available cross-national pricing data suggest that prices for health care are notably higher in the U.S., potentially explaining a large part of the higher health spending. In contrast, the U.S. devotes a…

HSM544 Discussions Week 1-7