Managing The Finances Of Health Care Systems

You have been asked by a health care magazine to write a series of articles focusing on health care financial concepts. The articles will be included in five consecutive issues and will be geared towards readers with little knowledge of finance. You must ensure that the articles are both informative and engaging to your audience. You must also ensure that your articles relate financial principles to the health care industry.

Despite the great accomplishments and many changes the United States health care payment system has made over the years, it is not a surprise that the system still continues to face serious challenges. Our country offers advanced technology and medicine, but it still has millions of Americans who do not have proper coverage to meet their medical needs or are uninsured and therefore cannot benefit from our advanced system. This raises a serious concern in population health, which makes us questions the country’s current system. The United States has commercial and government insurance options with different premiums and levels of coverage for its citizens. However, our complex system presents many flaws that lead Americans to live

Health care expenses are a never ending headache that create numerous liabilities. Liabilities are created when goods or services are purchased on credit and obtained through short- term and long- term loans. Health care expenses create liabilities such that payments are made late or no payments are made at all. In some cases, the cost of health care expenses are unaffordable resulting in those type of payments. To prevent large health care debt, many individuals seek health insurance. Health insurance is provided by private insurance companies or by the government. It covers health care expenses and provides the necessary health care. Although, health insurance is necessary it can also be very costly.

In a world of budget cut and layoffs, medical corporations face new and different challenges in addition to helping and healing patients. I used to work as a medical biller in a physician’s office for five years and I experienced how difficult for the health care providers to get reimbursed. The government and the insurance companies have been limiting the budget towards the health care services. This action also affects the hospitals greatly because Centers for Medicare & Medicaid Services (CMS) and some policymakers have requested the hospitals to reduce the

Over the past fifty years, the method in which healthcare services are funded has gone through significant changes. The country has seen the expansion of insurance from paying medical bills for hospital stays, to the creation of managed care, and the passing of the Affordable Care Act (ACA). While the process has not been without challenges, healthcare administrators must continue to analyze past funding systems to understand the oversights and misinterpretations to prevent complications in the future. This paper will investigate fee-for-service practices and how these practices have progressed to uncontrolled utilization.

The method in which healthcare services are funded has gone through many changes over the past fifty years. The country has seen the expansion of insurance from paying medical bills for hospital stays, to the creation of managed care, and the passing of the Affordable Care Act (ACA). In order to prevent future issues with financial options for healthcare services, healthcare administrators must analyze past funding systems to understand the oversights and misinterpretations. This paper will investigate fee-for-service practices and how this practice led uncontrolled utilization.

Revenue determination is an important tool for health care organizations because it allows for efficient management of payment systems. This paper will look at the different components that form the payment-determination bases of revenue determination. Moreover, the difference between specific and bundled service payments will be discussed. Lastly, the three ways health care providers control their revenue function will be highlighted.

In Healthcare System the role of finance is an important aspect in healthcare. In the financial role of healthcare it involves handling operations such as negotiating contracts, making cash available for expenses such as payroll and cover cost for unexpected expenses. The role of finances also makes it capable for leadership to better make plans for the future, when finances are in order organizations can better equipped to make decisions such as is the organization financial able to expand test or treatments and are they able to buy new medical equipment.

Based on the political and economic environments of states and the federal government the methods of health care reimbursement have been required to evolve. With the introduction of the Patient Protection and Affordable Care Act (PPACA) new laws have been set into place that has caused a stringent review of spending on health care. All care provided is being examined for effectiveness, quality, and the actual need of the service. Unnecessary health care functions are being screened and eliminated. The government and other insurance providers have begun to place cost containment measures in place only paying for those procedures that are deemed medically necessary for the illness that the patient is currently afflicted with. This has a direct impact on the monies that the government and insurance providers will reimburse for services. The following paper will look at the major types of reimbursement activates currently in place. The writer of this paper will also speculate on the future of health care reimbursement and how it will affect his current organization.

“Reimbursement” in healthcare refers to the decision of the entity paying for an item or service (called the “payor”) of whether a particular item or service is covered by a particular healthcare payment program for the patient at issue and therefore eligible for payment. “Payors” refers to the entity through which an individual has healthcare coverage. The federal government is the largest single payor of healthcare services in the United States through a variety of federal healthcare programs such as the Medicare and Medicaid programs established under the Social Security Act (SSA).

Even although, the cost of the health care system and the care it offers my not allow the national debt to decline to a level that will or would enhance the economy forward the cost of running a system that is backed by the government is too costly, and it will not help the deficit. , the legal responsibility of the organization is that every patron should have the same treatment for the same ailment. There are no predetermined dispositions; everyone is eligible as a government-backed facility. The funds are to assure those who have no insurance are covered. The accountable care

Without the cash flow coming in to medical facilities, the government would see this as a failure. With the cash market resting at $260 billion in the United States alone it is no wonder why this balance has to co-exist (Newswire Association, 2014). A shortage of doctors has already been anticipated by this new initiative, and means to pay cash has been a popular option among many individuals. With a fast paced society it is no wonder why citizens choose not to wait in long lines at the behest of insurance companies, or public health exchanges.

It is a patchwork of loosely connected financing mechanisms varying in terms of sponsorship and provider type. It also reflects the age, health and economic status of the specific patient groups that are being served. Considering the growing number of Americans who are uninsured for health care and the low ranking of the United States among a variety of health indicators, one may say that it is a disappointing financing system. These observations provide a basis for supporting our position for a national health care system. Where possible, comparisons will be drawn between the United States and other countries. Special focus will be paid to similarities in the public and private financing components of the system, reimbursement of various provider categories and trends that we may expect to see in the future.

Under the table payments for health care services are detrimental to a health system, affecting those with the lowest income and highest need for health care services. For this reason suggested policy options are those which increase transparency and accountability as well as focus on new funding mechanisms to ensure facilities are sufficiently staffed and equipped to deal with the demand. However, overall there is a greater need to focus on creating adequate management policies rather than creating funding mechanisms systems.

This is the first pace in financial. It is the duty of financial manager to primarily recognize the goals of the company. The subsequently responsibility is to decide on the suitable steps that have to be applied achieve the goals of the company (Baker and Baker, 2007, p. 6).