WK3 discussion

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Walden University *

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Apr 3, 2024

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WK3 Main Post Three Healthcare Concerns in the US Today & Economic Issues Three critical healthcare financing concerns in the United States today are Rising Healthcare Costs : For decades, healthcare expenses have steadily increased in the US. This is a complicated problem fueled by things like the high price of drugs, administrative costs, and medical technology. For instance, the cost of prescription prescriptions has soared recently, especially specialty drugs. The price of medical treatments has dramatically increased, from simple check-ups to surgery. For example, the average annual premium for employer-sponsored family health coverage rose to $21,342 in 2020, with employees shouldering an increasing portion of these costs through higher deductibles and copayments (KFF, 2020). When the cost of healthcare services and goods increases faster than the rate of inflation or wage growth, it becomes increasingly unsustainable for individuals and adds pressure on public and private healthcare financing systems. This problem is strongly tied to the fundamental economic idea of "price." Next, Healthcare Disparities and Access: In the United States, access to healthcare is still a major issue. Despite being one of the richest countries in the world, a sizable section of the populace still lacks access to health insurance. This lack of accessibility is frequently associated with factors like income, work, and location. For instance, a lack of healthcare infrastructure in rural locations may make it difficult for locals to get care. Limited supply (healthcare facilities and facilities) and high demand (people needing healthcare services) can lead to higher expenses and less access, especially for vulnerable populations. The issue of healthcare access is

strongly related to the economic idea of "supply vs. demand." These disparities contribute to inequalities in health outcomes and exacerbate existing social and economic inequalities. For instance, individuals from racial and ethnic minority groups are more likely to be uninsured or underinsured, leading to delayed or forgone medical care and poorer health outcomes (CDC, 2020). Lastly, Affordability of Health Insurance and Medical Care: Rising healthcare costs directly relates to the economic concept of price. As costs increase, individuals and government programs like Medicare and Medicaid must allocate more resources to healthcare spending. This can lead to higher insurance premiums, out-of-pocket expenses, and increased government expenditures. This spending will likely rise quickly due to the aging population and rising healthcare costs. The success of these initiatives is crucial to the federal government's long-term financial stability. The economic concept of "budget constraint" is applicable in this case. This limits the resources for other essential government functions like education, infrastructure, and defense. A survey found that 25% of adults reported skipping necessary medical care in 2019 due to cost concerns (Commonwealth Fund, 2020). Economics of Proposed Healthcare Solution The lack of personalized care coordination for members with complex needs directly intersects with the healthcare financing concerns mentioned earlier. Without personalized care coordination for individuals with complex needs, healthcare costs can escalate due to inefficiencies in care delivery. Patients with complex medical conditions often require multiple specialists, frequent hospitalizations, and extensive medication regimens. Without proper coordination among these various aspects of care, there is a higher risk of redundant tests,

avoidable hospital readmissions, and inappropriate treatments, all of which contribute to increased healthcare spending (Elliott et al., 2020). Members with complex needs, particularly those from disadvantaged or underserved communities, may face additional barriers to accessing coordinated care services. These disparities can stem from various factors, including socioeconomic status, geographic location, language barriers, and lack of health literacy. With adequate care coordination, individuals with complex needs may be able to navigate the healthcare system, leading to delays in receiving necessary treatments and exacerbating health disparities (Nouri et al., 2020). Lastly, the lack of personalized care coordination can result in fragmented and costly healthcare experiences. Without a comprehensive approach to managing their care, patients may incur unnecessary expenses related to emergency department visits, hospitalizations, and prescription medications. Additionally, the absence of care coordination may lead to gaps in care and preventable complications, further increasing healthcare costs in the long run. By providing personalized care coordination services that focus on preventive care, care management, and patient education, healthcare organizations can help reduce the financial burden on patients and improve the affordability of healthcare for individuals with complex needs (Schiff et al., 2019). In summary, escalating healthcare expenses, disparities in healthcare access, and affordability concerns stand as significant healthcare financing challenges in the United States. These issues intertwine with fundamental economic principles, including price regulation, supply-demand dynamics, and resource distribution, illustrating the intricate relationship between healthcare policy, economics, and public health. Addressing the absence of

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personalized care coordination for individuals with complex medical needs offers a potential solution to mitigate these pressing financial concerns. Enhanced care coordination not only improves the quality of healthcare but also diminishes unnecessary service utilization, thus reducing overall healthcare expenditure. Moreover, it fosters better accessibility to care and affordability for all patients, underscoring its potential in addressing critical healthcare financing issues. References Centers for Disease Control and Prevention (CDC). (2020). Health disparities and inequalities report. Retrieved from https://www.cdc.gov/mmwr/volumes/69/su/pdfs/su6901-H.pdf Commonwealth Fund. (2020). Americans' experiences with ACA marketplace and Medicaid coverage: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February–March 2020. https://www.commonwealthfund.org/series/affordable-care-act- tracking-surveys Elliott, R. A., Barber, N., & Clifford, S. (2020). Care Bundles to Reduce Prescribing of Problematic Polypharmacy: An Economic Evaluation. International Journal of Environmental Research and Public Health, 17(7), 2296. Kaiser Family Foundation (KFF). (2020). 2020 Employer Health Benefits Survey. https://www.kff.org/report-section/ehbs-2020-summary-of-findings/ Top of Form

Nouri, S., Khoong, E. C., Lyles, C. R., & Karliner, L. (2020). Addressing Equity in Telemedicine for Chronic Disease Management During the Covid-19 Pandemic. The New England Journal of Medicine, 383(12), 1185-1187. OpenAI. (2024). ChatGPT (May 24 version) [Large language model]. https://chat.openai.com/chat Schiff, G. D., Galanter, W. L., Duhig, J., Koronkowski, M. J., Lodolce, A. E., Pontikes, P., ... & Lambert, B. L. (2019). Principles of conservative prescribing. Archives of Internal Medicine, 169(19), 1892-1895.

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