Another way managed care organizations control costs is by eliminating expensive doctors from their provider list. Expensive doctors are usually noticed because he/she order many more x-rays, CAT scans and laboratory procedures than normal. By using a computer managed care organization can tell how many of these costly procedures each doctor has ordered and how many patients he/she has treated. Doing away with providers who over-use these facilities saves money two ways, getting them off the list first and by making the remaining providers more aware of the problem. Some managed care organizations operate their own clinics, with staff doctors paid salary instead of fee-for-service.
Citizens that pay taxes right now are supporting the people that receive Medicare and Medicaid. Accepting the cost of the reform bill is better than allowing millions of Americans to continue to go without health insurance coverage. “With the cost and employment trends working against us, we need to recognize the failure of healthcare in America for the crisis that it is” (Witherbee). If there is a reasonable alternative for the United States to get out of health care debt, it would have happen years before the bill passed in
Trinity Community Hospital should seek ACOS accreditation. However, hospitals seem to survive better than independent practices. The costs of many oral oncology drugs have become an issue since the patient still have large out-of-pocket expenses to cover. Many of the oncology patients are covered by Medicare but the 2003 Medicare Legislation did little to help patients pay for oncology medications (Georgetown University, 2014). The expansion of 340B discounts, where oncology drug makers provided outpatient drugs at deep discounts to facilities that met their criteria, also faced lots of criticism since the facilities where to pass on the discounts to the patients but did not (Wang, Tao & Hamilton, n.d.).
For so many years they have paid doctors and hospitals a fee for every test, procedure or other service they perform. It rewards the quality of care, but not better care. I believe the doctors and hospitals should be paid for the quality and outcome of patients’ care. The new approach to paying for health care promotes improves patient care and slows the rise in health care costs. The Alternative Quality Contract (AQC), doctors and hospitals are paid for the quality, not just the quantity of the care they provide to the members.
The current alternative to the fee-for-services is the capitation arrangement. The physicians believe that the pay-for-performance is controlling how that he or she conducts the practice, but it will eliminate many expensive and unnecessary procedures (Shi & Singh, 2012).The pay-for-performance in the United States healthcare industry comes after the capitation and managed care and if managed correctly will become an asset and if not it will become a major blunder. The goal of pay-for-performance is to change patient behavior and doctors and hospitals with a rewards systems or punishment. A pay-for-performance bonus for doctors can be an increase for the general fee-for-service hospitals can receive an extra in the form of the diagnosis group-based payment (Shi & Singh,
Lastly, the amount of personal bankruptcies will be reduced. Many Americans file for bankruptcy because of their medical bills, if the rates go down and more people can afford coverage then it would make sense that the amount of bankruptcies would also go down. Even though the pros all help and seem great the cons to this policy also holds valid points. First, “18 million of the uninsured will be forced to go under Medicaid, while the rest will have to accept another government program. Even so, millions will remain uninsured,” (Pros and cons of Obama care June 29, 2012).
To eliminate such process, the new bill will, offer new, low cost coverage through a national “high risk” frees, to protect people with preexisting condition until a new exchange is created. The pro of the new health care bill is that it will not add a dime to the current deficit and it is paid for, upfront. This reform will create independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. Not only that, but it will order immediate medical malpractice reform projects that will help doctors to put their patient first instead on defensive medicine practice. However, it will require large employers to cover their employees and individuals who can afford it to buy insurance so that everyone will the share the responsibility of the
Say for instance that the US and the UK were on the same production function, but the U.S. economy were on the flat of the curve with little marginal gain in health at its current level of healthcare spending, then U.S. health outcomes might deteriorate relatively little when expenditures are cut back to the U.K. levels. This would result in substantial cost-saving and an increase in average productivity. But if the U.S. healthcare system lies on
So the government should set aside some finances for the implementation of this bill wisely and carefully by making sure that it does not drive up the taxes as the prices of goods are already high as it is. For the insurance agencies, they should include an all out and fair insurance cover which will not prejudice against the low income earners. As suggested by Blendon, R.J and Benson JM (April 2010). In their article, "Public opinion at the time of the vote on health care reform". His advice to the government and the Medicare experts are simple, they suggested that the government should look into the bill again and revise it allowing for purchases of drugs from Canada and ensuring a limitation of the malpractices and for the government to reduce the qualifying age for Medicare.
Introduction The U.S. health care system is the subject of a debate that is different for different observers. There are those who argue that America has the “best health care system compared to other countries in the world”, based on the grounds of the availability of the freely accessible modest medical technology and medical facilities (Barton, 2007). On the hand many critic argues that the medical healthcare in the United States is fragmented and inefficient, noting that many America spends more than any other citizens in the world yet the rate of the un-insured citizens still remain so high, and uneven healthcare distribution to the underserved and marginalized communities/groups (Dolan, 2011). The thesis of this paper is “to analyze