Healthcare is one of the most regulated industries in the United States. Regulation also adds cost. “Health care facilities, providers, insurance companies, drug companies and device manufactures expand huge amounts of resources”. In this paper, I will provide a summary of chapter one, describing a variety of indicators/drivers that are responsible for our healthcare cost and include approaches and innovations used to control healthcare and provider cost. Payment System: Medicare and Medicaid
Healthcare professionals and facilities are paid for each service they provide, the more services provided the more fees will be paid. According to the author of our book, a fee for service is a method of reimbursement based on payment for services rendered, with a specific correlated to each specific service (Zelman, McCue & Glick, 2009). An insurance company, the patient, or a government program such as Medicare or Medicaid may make a payment.
The majority of 47 million people on Medicare were on the fee for service Medicare program with 24% enrolled in a Medicare Advantage Program plan (Manchikanti, Caraway, Parr, Fellows, & Hirsch, 2011). Individual not eligible for Medicare will qualify for Medicaid based upon a modified adjusted gross income. Aging population
The increased need for long term care for elderly has led to increased health care cost (Zelman, McCue & Glick, 2009). The average life expectancy of Americans has risen only slightly over the past few decades from 71.1 to 75.2 for men and from 78.2 to 80.4 for women from 1983 to 2005 (Zelman, McCue & Glick, 2009). Aging population impacts system wide health care spending and federal spending. By driving up per capital health spending for all age groups, such as increases in the unit costs of health care naturally will amplify somewhat the modest impact that aging by itself will have on health spending through the demand side (BPC, 2012). Chronic Diseases
Individuals with chronic diseases overcome a...
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