Cost of Health Care

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Apr 3, 2024

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The Cost of Health Care Midley Joseph Capella University NHS4000: Developing a Health Care Perspective Professor Susan Patterson March 6, 2024

2 Cost of Health Care Over the past decades, healthcare costs have risen at an alarming rate. Rising costs are one of the most pressing issues with regard to healthcare provision because the financial affordability of healthcare is one of the leading barriers to healthcare seeking (Fazal et al., 2022). The substantial expense associated with healthcare services presents a notable obstacle for both patients and the healthcare system. Undoubtedly, the continuously rising expenses in healthcare are of utmost importance to me as a healthcare professional. As a healthcare provider, I have firsthand experience witnessing how unaffordable healthcare costs affect both patients and the healthcare system. The significant barriers individuals encounter in accessing necessary medical treatments are primarily due to the high expenses associated with healthcare. As a result, instances of treatment postponement or complete avoidance are frequent, thereby exacerbating health problems and potentially leading to increased costs in the long run. It is important to note that the high costs of healthcare are not a burden to the patients only; rather, it is a challenge that impacts all the stakeholders, including healthcare providers. The ever-increasing healthcare costs should, therefore, be addressed to ease the burden on all stakeholders within the healthcare system. Search Criteria, Article Selection, and Assessing Credibility and Relevance of Information Sources In my research, I searched through trusted databases like PubMed, MEDLINE, and Google Scholar, using key terms like "healthcare financing," "out-of-pocket expenses," and "health economics." I made use of keywords such as to ensure that only the articles that were related to the overall topic were returned from my searches. In addition, I limited my search

3 results to present articles published within the last five years to meet the requirements of currency and relevance of this literature. I made sure the articles I chose were reliable by ensuring that they came from peer-reviewed journals and that the information they provided was still pertinent to the discussion on healthcare expenses in today's healthcare environment. Annotated Bibliography Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care. Annals of Internal Medicine, 172(2), S7. https://doi.org/10.7326/m19-2415 In this article, which notably is part of the American College of Physicians policy framework, Crowley et al. (2020) discuss how supportive policies can address the issue of rising healthcare expenditures. As per my research, the rising costs of healthcare have not resulted in improved healthcare outcomes in equal measure, which, therefore, means that increasing expenses of healthcare services do not necessarily lead to better results. In light of this, it argues that there is a gap in addressing the rising costs of healthcare that can be closed through policy intervention. The policies should ensure that healthcare becomes affordable while ensuring that the patient's outcomes are enhanced. As per the article, the policy landscape offers a great potential solution to the rising costs of healthcare. More precisely, policy interventions should target cost concerns using approaches such as VBP and the Single-Payer Model. As an advocate for lowered costs of healthcare services, it is important to understand the role of policy-making in addressing the pressing problem of healthcare costs, which means that this article is highly helpful.

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4 Han, A., Lee, K.-H., & Park, J. (2022). The impact of price transparency and competition on hospital costs: a research on all-payer claims databases. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08711-x This particle article analyses the impact of price transparency policies, specifically the implementation of all-payer claims databases (APCDs), and market competition on hospital costs in the United States. The authors used regression analysis to examine the relationship between relevant variables. As per my findings of this article, hospitals in states with APCDs tended to have higher average operating expenses compared to those without APCDs, which, therefore, implies that price transparency initiatives are more likely to be adopted by states with higher healthcare expenditures. Moreover, the study results indicate a link between reduced market competition and increased operational costs, backing up the principles of conventional competition theory. However, the research found no considerable link between the combined impacts of APCDs and competition on operational expenses. Thus, the study concludes that to genuinely manage hospital expenditures effectively, states need to go beyond simply promoting the price transparency or fostering market competition. Han and colleagues offer valuable perspectives on the efficacy of price transparency endeavors, ultimately making the piece a particularly informative reference when investigating the issue of escalating healthcare expenditures and how best to tackle them. Leao, D. L. L., Cremers, H.-P., van Veghel, D., Pavlova, M., & Groot, W. (2023). The Impact of Value-Based Payment Models for Networks of Care and Transmural Care: A Systematic Literature Review. Applied Health Economics and Health Policy , 21 (3). https://doi.org/10.1007/s40258-023-00790-z

5 In this article, Leao et al. (2023) conduct a literature review to assess the impact of value- based payment (VBP) on various healthcare-related factors, including the costs of the services. According to the paper, VBP is an effective means for shifting from a quantity-focused service delivery model under fee-for-service, which prioritizes quantity over quality. As per my findings of this article, most studies that were reviewed supported the idea that VBP is an effective initiative to improve both clinical and cost outcomes. On the whole, this article is a comprehensive assessment of the VBP models, presenting the model's potential in controlling the worrying continuous rise of healthcare costs. The article, therefore, is a highly relevant source of information in relation to the topic of the rising costs of healthcare as it directly addresses the impact of VBP models and how the models can be used as one of the interventions for dealing with the problem. Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the U.S. Health Care System. Journal of the American Medical Association , 322 (15). https://doi.org/10.1001/jama.2019.13978 As per the article, healthcare costs in the U.S. are about 18% of the GDP. That said, various studies have argued that about 30% of the total costs of healthcare can be considered waste. In light of that, Shrank et al. (2019) estimate the magnitude of waste in the U.S. healthcare system and identify potential areas for cost savings. Through conducting what can be termed as a thorough investigation, the authors found out that the claim by many of the articles that there is a significant waste in healthcare is true. For instance, in the study, they found that there are persistent inefficiencies in a number of services, such as the provision of unnecessary services. They suggest that about 25% of all healthcare spending in the U.S. is wasted. Discovering that a significant portion of healthcare investment is wasted calls for the need to impose the right measures to avoid avoidable costs.

6 Summary of Learning Exploring the research articles I have presented in the annotated bibliography has helped me accumulate more knowledge regarding the issue of the rising costs of healthcare. I was able to delve more into the complexities that surround the issue of the high costs of healthcare and understood why the problem calls for a collaborative approach by all stakeholders. In addition, addressing the problem, as studies have shown, requires a combination of strategies because, although some interventions like value-based payment models and price transparency initiatives have shown potential, their impact remains inconclusive, suggesting the need for a multifaceted approach.

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7 References Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care. Annals of Internal Medicine , 172 (2), S7. https://doi.org/10.7326/m19-2415 Fazal, F., Saleem, T., Ur Rehman, M. E., Haider, T., Khalid, A. R., Tanveer, U., Mustafa, H., Tanveer, J., & Noor, A. (2022). The rising cost of healthcare and its contribution to the worsening disease burden in developing countries. Annals of Medicine and Surgery , 82 , 104683. https://doi.org/10.1016/j.amsu.2022.104683 Han, A., Lee, K.-H., & Park, J. (2022). The impact of price transparency and competition on hospital costs: a research on all-payer claims databases. BMC Health Services Research , 22 (1). https://doi.org/10.1186/s12913-022-08711-x Leao, D. L. L., Cremers, H.-P., van Veghel, D., Pavlova, M., & Groot, W. (2023). The Impact of Value-Based Payment Models for Networks of Care and Transmural Care: A Systematic Literature Review. Applied Health Economics and Health Policy , 21 (3). https://doi.org/10.1007/s40258-023-00790-z Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US Health Care System. Journal of the American Medical Association , 322 (15). https://doi.org/10.1001/jama.2019.13978

Cost of Health Care

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