Navigate Case Study Episode 2 Discussion
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School
Florida Atlantic University *
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Course
6175
Subject
Health Science
Date
Feb 20, 2024
Type
docx
Pages
2
Uploaded by JusticeJellyfish11589
Overview
Bright Road Health Care System is experiencing financial problems, for example insurers with late payments, Medicare patients with high readmission rates within 30 days (lost Medicare reimbursement), high staff turnover increasing costs, and low admissions to its obstetrics service.
The Chief Administrative Officer is very concerned as he knows this reflects on him and may affect his job. The student, a financial consultant, will work with Bright Road Health Care System staff members to review and analyze how operations in the Health Care System negatively affects its finances. Based on this information, the student will make recommendations for changes.
Learning Outcomes Addressed (Please discuss the three learning outcomes in less than 500 words. Feel free to respond to your fellow classmates.)
1)
Explain the major components of the U.S. Health care system, their components, and the relationships among these components.
The major components of the U.S. Health care system are the quad-functional: financing, insurance, delivery, and payment. Financing is a way that the healthcare system is funded
and obtain health insurance. Insurance guards the insured of health coverage against catastrophic risks and determines the type of plan the insured is eligible to receive. The health care system delivers services to the insured that is covered under their health insurance plan and receipt of insurance payments. Delivery also occurs when ownership and organizations are funded from these revenues. Payment in the healthcare system is a way funds are transferred to providers for services delivered to the insured. The quad-
functional: financing, insurance, delivery, and payment relationships are a combination of
public (government) and private sources. They are in private hands, and overlap each other, but the overlapping varies.
2)
Analyze the different ways of financing the health care system and the impact on individuals.
The health care system can be financed in many ways: government funding, taxation, out-of-pocket payments, private insurance, and donations. Government funding is government benefits like Medicare and Medicaid that finance the health care system. Taxation can be from health taxes like tobacco, alcohol, and sugar-sweetened beverages, which can help save lives, prevent disease, and advance health quality. Taxation can also be from taxes on healthcare-related services, Medicare tax, and sin tax, which is tobacco products, alcohol, and gambling. Out-of-pocket payments is for medical services that is not covered by the health insurance plan. Private insurance is plan sold by a private insurer that includes health, dental, and vision. This type of insurance does not include government benefits. The last thing that health care system is financed is through donations like charities and fundraisers. What impacts on individual is out-of-pocket payments and private insurance. Individuals are paying for health insurance thinking to help them with the medical services needed but would still have to pay out of pocket. Another thing that impacts on individual is the private insurance. Private insurance has the worse access to care, higher medical cost, lower satisfaction then those on government and public insurance programs.
3)
Use technology and information resources to research issues in health services organization.
One of the issues in the health services organization is the increasing cost of healthcare services. Healthcare services is growing faster than the cost of other goods and services in the economy. The issues for healthcare service cost to be increasing is the innovative healthcare technology. The healthcare technology is more expensive towards procedures and products. Another reason of the increasing cost of healthcare is due to the healthcare system that can lead to administrative waste in the insurance and provider payment system. The consolidation of hospitals can grant providers the opportunity to increase prices due to lack of competition. The last reason is due to healthcare prices being set in advance because of the wages increasing for health workers and delays in observable prices increase.
Reference
PETERSON FOUNDATION, P. G. (2024, January 3). Why are Americans paying more for healthcare?.
Peter G. Peterson Foundation. https://www.pgpf.org/blog/2024/01/why-
are-americans-paying-more-for-healthcare#:~:text=The%20Increasing%20Cost%20of
%20Healthcare%20Services&text=In%20addition%20to%20historically
%20high,possible%20reasons%20for%20that%20trend.
Shi, L., & Singh, D. A. (2022). Chapter 1: An Overview of U.S. Health Care Delivery. In
Delivering Health Care in America: A Systems Approach
(pp. 2–41). essay, Jones & Bartlett Learning.
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