Finance
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Finance
Financial management has been one of the most important issues in the healthcare spending and growth. According to O’Cathain et al. (2019), the main factors that influence healthcare spending growth include health insurance coverage, market power, technology, patient characteristics, health care services, and the price of products. Due to increased healthcare spending factors such as the affordable care act, funding sources, economic factors, reimbursement methods, business influences, and cost containment have affected overall health care funding in the United States. The purpose of this paper is to discuss financial factors that influence health care today and their impact on the quality of service.
Financial Factors that Influence Health Care Today
Healthcare in the United States is still not affordable and accessible to all citizens. This is despite the advancements in technology. Very few people can afford access to good healthcare. The services are highly expensive and majority of the population lack any meaningful insurance covers (O’Cathain et al., 2019). The demand for health care services keeps on increasing with the increasing number of the aged population . Making Decisions concerning finance and the quality of health services has been a problem, primarily due to socioeconomic factors and medical innovations. As a result, it has become evident that discussing the allocation of public resources and utilization of government funds has been a big problem despite the increased nature of healthcare financial issues (O’Cathain et al., 2019).
Funding Sources
The ability of the government to fund healthcare institutions have been one of the biggest problems. Healthcare services are funded by public and private programs such as Medicaid and Medicare (O’Cathain et al., 2019). These financial programs are highly impactful especially to the older population and the disadvantaged groups. Apart from government-funded programs, self-paying and insurance covers provided by organizations play an essential part in promoting health care. A person’s economic status influences the type of health services provided in the institutions (O’Cathain et al., 2019). For instance, high-income earners access and receive better and urgent services compared to low-income earners. Providing health care insurance to everyone would be essential to ensure that everyone access health care services.
Reimbursement Methods
The reimbursement of healthcare includes the government of private organizations to pay for health care serves for their employees. According to Wong et al. (2020), medicare holders can access health care services easily compared to non-members. Furthermore, Medicare members are provided with a code known as the common procedural terminology used for negotiating reimbursement rates. Healthcare reimbursement is well explained by the United States Center of Medicare and Medicaid Services. Employers determine how much money to contribute towards the cover as well as healthcare cost compensation (Wong et al., 2020). Medicaid and Medicare represent 25% of the overall healthcare payments, significantly influencing medical treatment payment levels.
Economic Factors
Economic factors are the primary determinant of a patient’s treatment. People from higher socioeconomic status access health care services quickly and faster than people from low- social-economic status (Scott, Liu, and Yong, 2018). Low-income earners are at a greater risk of losing their lives and greater risk of health conditions and delayed medical attention. The economic stays of people in the united states play an essential role in receiving health care services. According to Scott, Liu, and Yong (2018), health disparities in the United States based on race and economic status have been a major issue for years. However, the affordable care act was developed to reduce health disparity and promote equal health opportunities to all citizens.
Business Influences
Health care institutions operate like other business organizations, where the institutions cater for people with insurance, and finances leaving people with no funding means (Scott, Liu, and Yong, 2018). Since the health care organizations are businesses and are expected to make more money to remain in operation, the ACA emphasizes business organizations provide health insurance to employees, especially if the company has more than fifty workers (Alcalá et al., 2017).
Cost Containment and the Role of Nurse
Cost containment is a method used by insurance companies to reduce the rates of payments in hospitals. The cost-containment method aims at the provision of quality care without necessarily using more resources. The approach was developed to help save a massive amount of money for hospitals. An example is the use of Medicare to contain costs through monitoring spending (Stefko et al., 2017). Nurses are trained and provided with a better opportunity to provide the best healthcare services to their patients. Through the affordable care act, nurses ensure that health care services are affordable to all patients. Furthermore, nurses collaborate with social workers to attend to patients that cannot make it to hospitals due to severe health conditions. Nurses act as advocates for patients who cannot afford treatments and medications.
Funding Affordable Care Act (ACA)
The ACA is an approach used by the government for funding health care through cutting government spending and increasing taxes; The approach mainly focuses on the less privileged and people who cannot afford health care services (Alcalá et al., 2017). Apart from improving funding in the health care system, the programs also work at fighting for the rights of people when it comes to accessibility of health care services by making sure organizations provide health insurance for their employees. The ACA, also known as the Obamacare act aims at providing affordable health care to all Americans (Alcalá et al., 2017). The Act mainly focuses on low-income earners, the disabled, or people who cannot access decent insurance health cover due to health conditions and poverty. There is a close relationship between socioeconomic status and health care outcomes because access to health care services depends on individual affordability. According to Alcalá et al. (2017), health care should not be treated as a privilege but rather a right because health care is a human right according to the affordable care act.
My ideal vision for the American health care system is the provision of equal healthcare services to all Americans despite their social status, ethnicity, or race. Furthermore, the government should be able to provide insurance covers to all citizens without any demands such as source of income, or employment. The affordable care act should provide free services to women and children, especially when it comes to maternity services and children’s medical care.
References
Alcalá, H. E., Chen, J., Langellier, B. A., Roby, D. H., & Ortega, A. N. (2017). Impact of the Affordable Care Act on health care access and utilization among Latinos. The Journal of the American Board of Family Medicine, 30(1), 52-62.
O’Cathain, A., Croot, L., Duncan, E., Rousseau, N., Sworn, K., Turner, K. M., … & Hoddinott, P. (2019). Guidance on how to develop complex interventions to improve health and healthcare. BMJ open, 9(8), e029954.
Scott, A., Liu, M., & Yong, J. (2018). Financial incentives to encourage value-based health care. Medical Care Research and Review, 75(1), 3-32 .
Stefko, R., Jencova, S., Litavcová, E., & Vasanicova, P. (2017). Management and funding of the healthcare system. Polish Journal of Management Studies, 16.
Wong, A., Goh, S. N., Sowa, P. M., & Bauer, J. D. (2020). A narrative review of healthcare financing and reimbursement of nutritional support for patients in Singapore. Health Policy, 124(10), 1146-1154.
