This mass expansion of health care in America must have an effect on utilization, but this effect is not yet known and is subject to vast speculation and controversy. Many people fear that the system will become overloaded and that Americans will be forced to get on waiting lists for care or perhaps deal with providers that are chosen for them. Due to the fact that the reforms force Americans that can afford health care to buy in, however, there will likely be less people cramming emergency rooms seeking free care. Perhaps the most important change in utilization forecast is the shift from treatment of disease to preventative care. The reforms and expansion of health insurance and specials provisions relating to preventative care are designed to get Americans to think about preventing disease before it happens.
Also (except IPA members) doctors cannot participate in other plans. Provided services and drug costs are limited which can prevent physicians to make important decisions regarding patient’s care. In compare to indemnity plan HMO providers are at risk to receive lower revenue because of the capitation. Positive is low copayments and covered preventive care to patients (Raffel, Barsukiewicz, & Raffel, 2002). POS plan members choose primary doctors from the list and referrals to see specialist are required, however there is no deductible and copayments are low.
Besides state and federal regulations new companies are developed with new policies making it much harder for just anyone to open up a facility. Not only do they need to be approve but adding employees whether physicians or assistants must be an attractions to keep any other competition on the low. Due to so many restrictions helps keep the opposition on the low side. In the health care filed the bargaining power of buyers is also very narrow and restricted. The economy has no control over humanity, the reason for this will be since diseases, illness and injuries occur during any giving time.
Although managed care has been shown to reduce costs, it is probably not the answer to all of America’s health care problems. Some HMOs have made money through risk selection, accepting mostly healthier patients. Other HMOs may find it difficult to maintain quality of care once the easy savings from discounting and substitution have been taken and thus may be tempted to reduce services in precisely those areas where patients, hampered by information asymmetry, depend most on professionals for monitoring
Do not apply for a managed health care plan. Although it may be a less expensive health care plan, it is not the best type of health care. The quality of the treatment an individual with managed care may be provided is sometimes terrible and is often times unnecessary. Many times a patient with managed care will receive treatment from many different physicians. They may never see the same doctor twice.
(Department of Health (DOH), 2010). These changes are to occur in a period of financial constraint, with the aim of reducing bureaucracy and empowering front line clinicians. (DOH, 2010). The proposal to use EMTs and A&E support ignores current inefficiencies in the way patients are treated. EMTs, trained in basic and advanced life support, deal with a range of life threatening illnesses and injuries and can administer a range of drugs.
There is an increasing number of managed care organizations’ that are now emphasizing the physicians’ responsibility to oversee and control the patients access to further outside or special care needs. The reason for this is because the managed care organizations feel that hospital care and/or specialty care is too costly, and that only those who absolutely need further care should be the ones who receive it. Some feel that this method of care improves quality by necessity. They just may be right, especially when considering the skyrocketing healthcare costs along with the severe lack of healthcare coverage that is evident in the United States. The term "managed care" is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care (Wikipedia, 2008).
The impact that an EMR can have on an organizations financial goals can be it might expensive for short-term but it will pay off in the long run. EMRs will allow for medical organizations to save money in areas where more funds were originally spent like on paper for printing and ink for printers to saving that money to be used on something that is more important like new equipment. When medical organizations decide to use EMRs the organization is has to assess if the short-term finances are going to pay off in the long run. There is no need to invest into something that is only going to be beneficial for only a short period of
The Electronic Medical Record, Dollars or Sense? Anne Wolfersberger Ball State University Abstract In recent history, it has become increasingly necessary, that facilities, especially inpatient acute care hospitals, implement an electronic medical record. Clinical information technology is recognized by champions of healthcare quality as a means to save lives, improve less than optimal care, and reduce costs (J Healthcare Finance 2004). There are several advantages to adopting the EMR, from reducing preventable adverse drug events to improving drug prescribing. On the patient side it has been shown that patient compliance with medication regimens as well as follow up appointments and preventative care greatly increase with the
The quality of health care that patients receive would be greatly reduced. Nationalizing health care reduces patient and doctor flexibility leading to poorer treatment of patients. Patients are not likely to curb their doctor visits and drug costs if it is free, so total costs of health care will be several times what they are now. In order to cut costs of health insurance price and salary controls on drugs, medical equipment, and medical services will probably be put into effect. People who live in countries that have nationalized health care have to wait on very long waiting lists before they are treated sometimes.