...Financing and Structuring Health Care Alicia Rodgers HSA 500 – Health Services Organization Instructor – James P. Driscoll Jr. July 24, 2011 Abstract There are many explanations on how health insurance is financed and structured. In this paper, different types of insured plans are reviewed and broken down to fully understand the design and goal of each policy. Overall, this research is very significant and consistent on the procedures of how these policies were developed. These health insurance plans have their advantages and disadvantages but they all aim as a beneficiary for the purchaser. According to Merriam-Webster, health insurance is defined as a form of policy that provides compensation for medical expenses and loss through illness. Health insurance can be obtained individually from a provider or through an employer or organization. When purchasing health insurance, the policy holder must pay a premium, which is the amount one pays to health plan to keep coverage. Identify and describe the three main types of health insurances in the U.S. There are three main types of health insurances in the United States. They include: Indemnities, Managed Care, and Health Savings Accounts (HAS). Indemnity plans are a fee-for-service plan. It is a flexible insurance that allows the policy holder to choose what physicians, facilities, and services they want. For this plan, the policy holder will pay an annual deductible and the insurance will pay the rest of the bill....
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...Running head: An Overview of the Canadian Health Care System with a Comparison to the United States Heath Care System Canadian And American Health Care Parween Nooruddin Stratford University Abstract The reason for this exploration paper is to look at healthcare systems in two very progressed industrialized nations: The United States of America and Canada. The principal piece of the exploration paper will concentrate on the portrayal of healthcare system in the aforementioned nations while the second part will dissect, assess and measure up the two systems in regards to value and proficiency. Canadian And American Health Care In this research paper I will be comparing Canadian and American HealthCare systems. In this paper I will provide a description of health care system for each country. I will also analyze, evaluate and compare the two systems regarding equity and efficiency. We begin by giving a general portrayal and examination of the structure of Healthcare systems in Canada and the United States. CANADA’S HEALTH CARE – OVERVIEW Canada's health care system is a group of socialized health insurance plans that provides coverage to all Canadian citizens. It is openly subsidized and controlled on a common or regional premise, inside rules set by the national government. Under the health care system , singular natives are given preventive care and medical treatment from essential consideration doctors and in addition access to clinics, dental surgery and extra...
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...Singapore government helps its citizens to pay for their healthcare needs. The primary policy that will be discussed will be the Ministry of Health’s 3M framework and a policy analysis will be conducted based on it. A brief introduction of the development of this policy will be provided followed by an evaluation of the policy and recommendations on how to improve the policy. The report will be concluded with a discussion on the impacts that the policy brings about. 1.2 Background Public health care is an emotive issue that remains a major concern of the public in our country. With the rising costs of financing public healthcare systems and the pressing aging problem issue, how our government finances our public health care systems becomes a major issue and debate within our public sector. Hence, I have decided to study on the Singapore’s Ministry of Health and how it plans to help Singaporeans to finance for their health care in a framework known as the “3M Framework”. This was also specially mentioned in the Budget 2008 announced recently and I will also discuss about changes to this framework in the report. 1.3 Objectives This project aims to study the effectiveness of the 3M framework as a financial means to help Singaporeans finance for their healthcare. 1.4 Scope This project will cover a brief history of the Ministry of Health and the 3M framework as well as the framework’s role in Singapore’s public healthcare policy. 1.5 Methodology The basis of the report...
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...worksheet and will describe the financial structure of each financial environment. This paper will also address the policies that make this financial environment unique and identify which financial management practices are prevalent in the financial environment. This paper will also explain why effective financial management is more difficult in health care than in other industries. Entities FP, NFP, and government facilities exist throughout the country. This paper identifies the first entity FP healthcare organization JFK Medical Center. The second entity is Naples Community Hospital (NCH), a NFP healthcare organization, and the third entity is the Veterans Administration, a government funded facility. JFK Medical Center is a 460-bed acute care medical/ surgical hospital specializing in cardiovascular care, oncology services, neuroscience, bariatric, and orthopedics. It is located at the heart of West Palm Beach, Florida (“Jfk Medical Center”, n.d.). The NCH Healthcare system, a NFP organization, has multiple facilities consisting of two hospitals, dozens of medical facilities throughout Collier County and...
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...Meeting the Challenges of Stakeholder Engagement and Communication: Lessons From Teacher Incentive Fund Grantees The Harvesting Project Julia E. Koppich J. Koppich & Associates Meeting the Challenges of Stakeholder Engagement and Communication: Lessons From Teacher Incentive Fund Grantees As of August 2010, a total of 33 states, school districts, charter school coalitions, and other education organizations¹ had received Teacher Incentive Funds (TIF) to redesign compensation programs for teachers and principals. The U.S. Department of Education named a new cohort of TIF grantees on September 23, 2010. TIF grantees have faced a number of challenges as they have worked to design and implement new educator pay programs. Among the most demanding challenges has been developing a targeted set of metrics around available and manageable data. Grantees use these metrics to measure teacher or principal effectiveness and assign pay. Recently, grantees have made it a priority to sustain operation programs once their federal funding expires. TIF grantees have also found, often belatedly and unexpectedly, that effective stakeholder engagement and communication are challenging and essential to the success of their pay programs. Stakeholder engagement helps to create buy-in and initial acceptance of the TIF plan. It allows different voices and perspectives to be heard and recognized as new approaches to compensation develop. Communication provides the synergy to broaden buy-in and...
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...Healthcare Spending HCS/440 Healthcare Spending United States healthcare spending exceeds healthcare spending in any other country in the world. These increasingly high figures of healthcare spending cost are influenced by several different reasons. An aging population, illegal immigration, and technology advancements are some of the few influences on rising healthcare costs in America. It is imperative that health care costs are managed and soon because the government is finding it quite difficult to sustain everyone’s needs. In addition, healthcare reforms must be made to lessen healthcare costs before the quality of healthcare reduce in a drastic way. Healthcare spending has been on a continuous incline in America throughout the years. According to Center for Medicaid and Medicare Services, in the year of 2008 health care cost rose to $2.3 trillion in the United States; this was 4.4% higher than 2007 costs. Healthcare costs are averaging a little over %16 of the entire Gross Domestic Product (GDP). In 2008 Medicare spending increased 8.6% and Medicaid spending increased 4.7% in the same year. In addition, hospital stays physician rates, clinical visits, and prescription medications increased as well. 31% of a $1.6 trillion healthcare cost has been designated strictly for hospital stay care. Clinical and physician services are accountable for about 22% however, proposals from physicians account for a much vaster percentage of health care costs. Prescription medications...
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...expand capabilities of treatments. One major subject of debate has been on the ability of nations and communities to pay for health care with their available resources. One debate has been researched that Americans are paying more for healthcare services than any other nations. It is said that there is a struggle providing health care services and other programs while maintaining economic stability. This could possibly promote frustration for healthcare providers and payers in situations like these. In the efforts to research these concerns of health care policies, it was found that there are significant economic challenges that have direct implications for health care financing and delivery. Concerns about quality could frustrate important changes in health care delivery and financing. Policymakers, payers, managers, and others must confront current and potential quality-of-care problems with the same vigor and sophistication that they are directing to issues of cost. At its best, health care in the United States is superb. Even Americans with insurance, including Medicare and Medicaid, may not always have access to adequate care. At the same time, some Americans may be subjected to inappropriate or unnecessary procedures. American healthcare, with all of its pros and cons, is very expensive. Researchers continue to make efforts to limit the growth of health care spending. It is essential to limit growth with hopes to meet other socially important needs. To be most effective...
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...Canadian Healthy Policy vs. United States Health Policy AHS 330 Health Care Systems: 7Q April 2, 2014 Healthcare in the United States is extremely different from the rest of the world. Over the years government and political analysts have compared and contrasted the health care systems of the United States to that of Canada’s. Despite being located on the same continent both countries have different ways of delivering health care to its citizens. Canada has a single-payer system that is publicly funded, while the United States has a multi-payer system that relies heavily on privately owned healthcare. This could be due to the differences in how many patients are cared for compared to those in America or it could be just a matter of who developed the better healthcare. However, due to the close proximity of the countries it is possible that the United States can adopt the Canadian healthcare system. According to Health Canada, Canada's publicly funded health care system is best described as an interlocking set of ten provincial and three territorial health insurance plans. Known to Canadians as "Medicare", the system provides access to universal, coverage for hospital and physician services. With this being said it is safe to assume that health care services are provided on the basis of need, rather than the ability to pay. “The Canadian Health Act contains a single national plan that is composed of thirteen provincial and territorial health insurance plans that all share...
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...regarding health care as a universal right The U.S healthcare reimbursement system is very complex. It involves private and public payers and changes in the reimbursement approach of one payer have implications for the other. One feature lacking in both type of payers is reimbursement linked to quality. Payment is based on delivery of services: “Right or Wrong”. The current system does not promote quality care and most services for preventive care are not reimbursed. Those components don’t contribute to the overall effectiveness of the system. Given a clean slate, would you keep the current system, keep components of the current system or change it altogether? One thing we should keep in mind is, although not effective, the current system works! Billions of service transactions occur each year and providers receive payments that sustain them financially even though some physicians believe reimbursements are not sufficient to support their increasingly complex practices. The problem is that: * The current system leaves approximately 45 million American uninsured and a considerable number underinsured. * Health care expenditures are rising at a rate that makes most payers tense. * Because there are many payers and each has specific rates and administrative rules that are continuously changing; the current reimbursement system is burdensome. Those growing signs prove that the inadequacies in our healthcare financing system may break the entire edifice. The best...
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...of Health Economics Many years ago healthcare and its delivery system were limited in care for patients or treatment options for physicians. The procedure of care includes diagnosis, treatment, prevention, rehabilitation, and palliative care (Buchbinder, 2012). However, over the years there is much to be learned from the discipline of health economics which vary from studies, practices, and demand by discipline of health promotion. Unfortunately, health promotion has not always gotten the attention by health economists because contributing factors lack demand, scare resources, and unclear utility analysis of health care (Teiltelbaum & Wilensky, 2013). As with any given system, values contribute to decision making route in which delivers thoughtful insight into how health operates from a planned and funded context to address an extensive scope of matters in a clear systematic manner. Benefits of Health Care Financing and Delivery There are many profits to understanding health policy or governmental involvement in health care financing and delivery. Financial or economic assessment consists of a set of methods designed at inspecting other ways of action that aids in making choices in terms of their costs and benefits (Getzen, 2013). In theory, these practices are useful to promote health in personal development, promote, and maximize concepts in public policy. Some of these practices can enhance policy surrounding healthcare by identifying barriers associated with...
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...SINGAPORE’S INNOVATIVE HEALTH FINANCING SYSTEM Introduction Health care costs are escalating rapidly in many countries. This reflects several factors, such as aging populations, changing disease patterns, high-cost technology and prescription drugs. But, it is also a consequence of health financing systems. Traditional indemnity insurance, which guarantees third-party payment for service provided, contributes to these cost pressures since patients and physicians are shielded from the real cost of those payments. In an effort to contain costs, governments, employers and insurers have modified payment schemes and coverage. This increasingly leads to rationing, restricted consumer choice and, in some cases, denial of care. Singapore’s ‘3M’ health financing system combines universal medical savings accounts (MSAs) with unique supplementary programs to protect the poor and address potential market failures in health financing. The results have been impressive, with excellent health outcomes, low costs and full consumer choice of providers and quality of care. This note describes Singapore’s experience and its possible application to other countries. Background Despite Singapore’s small size, with only 3.22 million residents in a land area of 660 square kilometers, the country has been a stellar economic performer, rising from impoverishment only 40 years ago. Its per capita GDP increased from US$427 in 1960 to US$24,740 in 2000, one of the highest in the world...
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...declaration” (Difference Between Accounting and Finance). Accounting and finance both need each other. A company needs both. To determine financial viability within a heath care organization, they need a functioning finance and accounting departments. In a health care organization, there needs to be a high functioning finance department. There needs to be an innovative way to run a health care facility. “The current economic situation, together with the uncertainty of healthcare reform, has fueled the demand for efficient and effective facilities” (Elting, D. 2009). Financial departments have to run an efficient department to assure that they are not faced with high debts that could cause a healthcare to shut down. With all of the changes occurring in healthcare there needs to be a financial team that can try and run a healthcare system in the most efficient way. They need to be able to decrease unnecessary costs and still be able to provide high quality patient care. This is the way that healthcare is turning, trying to cut unnecessary costs. There are teams formed within the hospital to assure that there is not overspending occurring in the health care system. Luckily, competition for health care...
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...the world's second-largest country by land and the largest country by population. Knowing this, healthcare must be one of the most important issues in China. As China becomes more populated, there is becoming a greater need for health care professionals, quality health care facilities, technological improvements, and most importantly a proper amount of funding to support a successful health care system. However, recently, China has been struggling in regards to health care. There has been a widening gap in health status between urban and rural residents, correlated with increasing gaps in income and health care utilization. There have also been drastic changes in health care financing, including a dramatic reduction of insurance cover for the rural population. In 1949, the Chinese government took complete control of the healthcare system. Under the Chinese government, the country’s officials, rather than local governments largely determined access to health care. Referring to an article, “Equity in Health and Health Care: The Chinese Experience”, written in the Social Science and Medicine Journal, Yuanli Liu, William Hsiao, and Karen Eggleston exaggerate that the rural areas were in the biggest need for a healthcare reform during the late 1940s era. The authors explain (1999) “The Rural Cooperative Medical System (RCMS) was established as a three-tier system for rural healthcare access. The RCMS functioned on a pre-payment plan that consisted of individual income contribution...
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...Health Care Law and Regulations University of Phoenix Louise Underhahl HCS 545 Health Care Law and Ethics 2012 Health Care Law and Regulations One of the areas that are currently affecting the Health Care industry is Regulatory agencies. There is much dissatisfaction over the current state of healthcare in the U.S. Within all of our organizations, regulatory agency surveys are conducted to better the organizations as well as its employees. The purpose of the regulatory surveys is to focus on the areas that need improvement as well as promoting better health care access to the people in the community. Regulatory agencies serve as authority as well as enforcement to regulate laws from the government. Some examples of regulatory agencies are Food and Drug Administration (FDA), Agency for Healthcare Research and Quality (AHRQ), and Occupational Safety Health Administration (OSHA). There are many examples of laws and regulations that are currently being faced in health care. Analysis of health care laws and regulations help one understand their influences on the provider. There are many ways that laws and regulations affect our lives and community. The FDA is responsible for the oversight of drugs, medical devices, vaccines, blood products and biologics, establishing rules for testing, clinical trials and approval of new products. The AHRQ is a federal agency under Health & Human Services working to improve the quality, effectiveness and safety of health care...
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...aspect and technology has also changed healthcare. More money is being spent on technology which allows better treatment for patients. Advanced technology has led to better health care quality and the reduction of medical errors. There are social dynamics that also helped shape healthcare. The changes in demographic across the country play a major role in the type of health care that is needed and available for a specific group of people depending on where they stay and their income. Some of the major fluctuating and daunting challenges in health care management are operating cost, government mandate and regulation, and the new system put in place to comply with the ICD-10 diagnosis code system. All of these things play a major role in health care and the changes that are happening everyday. The amount of people who are uninsured in the United States is substantial. Most people who do not have insurance are low income working families. In most instances, the adults are the ones who are not insured but the children are. The reason for the rise of uninsured Americans is the high price of health insurance and the loss of jobs due to recession. “Growth in Uninsured” (2005) states that at a November 4 policy briefing examining the latest health coverage trends and the implications for the nation’s healthcare safety net, the Kaiser Commission on Medicaid and the Uninsured profiled the growing uninsured population and portrayed the healthcare safety net as increasing straining...
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