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Comparative Studies

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Comparative Studies
Dominique

Comparative Studies
There are many forms of health care organizations, they are grouped by their financial structures, and sources of funding. The three types that exist in the United States are for-profit, non-profit, and government funded organizations. The financial resources and how profit is appropriated are different amongst all three types of organizations.
Government Funded
The most well-known government funded health care system is the Department of Veterans Affairs. This health care system is unique in that it was created specifically to treat American veterans of the US military, whereas for-profit and non-profit organizations must treat every patient regardless of status, or ability to pay. A person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable may qualify for VA health care benefits ("Office of Public and Intergovernmental Affairs", 2014). Many diseases and permanent disabilities or service-connected disabilities, US veterans suffer from were acquired serving in wars both past and present while serving this country. It is the governments’ intention to help treat those who so bravely laid their life on the line to serve and protect this country. On that note, most military are eligible to be treated within this health care system for little to no cost, with very few not meeting eligibility requirements. There are still however financial assessments as to how much a veteran makes and thresholds that are established to determine financial contribution, if any. Upon application a veteran must provide a financial assessment which gauges the individual’s ability to contribute to his/her care. After initial financial assessments are complete, the VA will review income supplied by the IRS and Social Security to determine eligibility. Those whose income exceeds the VA threshold or refuse to provide a financial assessment will be required to contribute towards VA health care and co-pays established by the government. Those falling under the threshold receive medical care funded by the government.
The VA financial management system is comprised of the automated and manual processes; the interfaced and integrated applications; procedures, controls, data hardware, software, and support personnel dedicated to the operation; and the maintenance of the total system ("Department Of Veterans Affairs January 2013 Financial Management Systems", 2014).
For-Profit Organizations For-profit organizations such as Riverside Community Hospital differ from nonprofit organizations’ financial environment because their overall goal is the organizations ability to generate revenue. Every organization has an annual report where their annual financial statements present how well the organization manages both income and expenditures. Financial reports are annual documents compiled by the accounting department to share the financial standing and worth of a given company. Both for-profit and nonprofit organizations create these financial reports to share their financial standings ("What Are the Differences in Financial Reports for A Non-Profit Vs. A For-Profit Entity?” 2015). For-profit organizations’ main goal is to attract investors and showcase future plans regarding new technology investments and programs that will generate income and attract future clientele. In general it is said that there are only two main differences between for-profit health care organizations and nonprofit organizations, one is for-profit organizations pay taxes and they also have more access to raising capital which is used to renovate or upgrade facilities, as well as purchase new equipment and technology, again for the sole purpose of gaining revenue and attract investors. For-profit organizations
Nonprofit Organizations Nonprofit organizations such as Kaiser Permanente are quite different than for-profit organizations. Although both for-profit and nonprofit organizations claim their purpose is to serve their surrounding communities, one may be able to observe from looking at both annual financial reports that nonprofits main purpose and existence is truly to serve the community. While for-profits are concentrating on revenue generated to use on expenditures to attract investors and consumers, nonprofit annual financial reports show data of how their programs and services have benefitted their patients and the community. For-profit organizations must answer to shareholders and continually prove their viability. It is said that shareholders do not always have the same views and opinions of the community and therefore have a negative impact on what goes on within the organization. It has been observed that services and programs that have not generated income or take a loss are discontinued regardless of how beneficial it is to the community ("How Different Are For-Profit and Nonprofit Hospitals?" 2014). When discussing future financial planning, Kaiser Permanente focuses on past services and programs the organization has provided and how they can be improved and offered on a grander scale, not the bottom line as for-profit organizations do. Revenue generated annually is recycled back into the organization and utilized to benefit the patients and the community they serve.
Financial Management in Health Care Financial management is a much greater task in the health care field than any other field because there are so many platforms on which a health care organization receives payment. There are different types of insurance, government funding, and the payment being received is not necessarily the exact cost of the service being rendered. Also, when discussing reimbursement, there are many factor that tie into reimbursement, health care organizations must meet standards in order to receive reimbursement, and the better they perform, the greater the reimbursement. Diagnosis and procedure codes must be correctly entered for proper payment to be received, and medical necessity must be correctly documented. CMS monitors these standards and measurements, and makes sure that every organization receiving reimbursement is operating up to par.
Conclusion
There are many health care providers to choose from in this country, options are what makes living in this country so great. Along with the new health care reform, the government has made it possible for those who may in the past have never been able to afford to purchase medical insurance, now be treated and utilize the programs being offered to stay healthy and manage chronic conditions. The choice of where a consumer receives treatment is completely under the discretion of the consumer. For-profit, nonprofit, HMO, or PPO are some of the many choices consumers have to choose from, it is all dependent on the patients financial budget, and the model they are most comfortable with. In the opinion of a consumer, one would want to be treated where finance is secondary and quality care is the mission. Using the Internet to research and make informed decisions is key. One would expect to receive the best possible care, and it seems the best quality care would come from an organization where patients are the priority, not their financial status, or what a patient can pay. After all the whole purpose of health care is not to make a buck, but to deliver quality patient care to each and every individual that crosses the organizations threshold.

References
Department of Veterans Affairs January 2013 Financial Management Systems. (2014). Retrieved from http://www.va.gov finance/docs/va-financialpolicyvolumeichapter04.pdf
How different are for-profit and nonprofit hospitals? (2014). Retrieved from http://ctmirror.org/2014/04/25/how-different-are-for-profit-and-nonprofit-hospitals/
Office of Public and Intergovernmental Affairs. (2014). Retrieved from http://www.va.gov/opa/publications/benefits_book/benefits_chap01.asp What Are the Differences in Financial Reports for a Non-Profit Vs. a For-Profit Entity? (2015). Retrieved from http://smallbusiness.chron.com/differences-financial- reports-nonprofit-vs-forprofit-entity-23562.html

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