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Health Care Economics Issues Outline

1619 words - 7 pages

* Health Care Economic Issues Outline
* I. Introduction
A. More than 50 million uninsured in the United States (Young, 2012)

B. Uninsured population is considered vulnerable population

C. Uninsured use emergency department to meet their primary health care needs

D. Overcrowded emergency departments require reallocation of resources
* II. Effectiveness of the Current Procedures in Place
* A. Federal Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals
* to treat every patient irrespective of the payer source

B. Limited community resources forces uninsured population returning to emergency
department for minor ailments
...view middle of the document...

This is to help the patients you need further treatment but do not have the insurance to cover. These discounts vary from hospital to hospital (CHOMP, 2011).
IV. Effects of policy and regulatory environment on the financial decision-making process
A. EMTALA
1. Regulations designed to make sure that patients are seen regardless of their financial situation. When presenting themselves for an emergency medical screening these patients are not asked for financial information until seen by a physician and determined to be stabilized (Griffin, 2012).
2. Beneficial effects of EMTALA
a. Patients are seen in a timely manner. All patients are considered on the same level as one another with the only determining factor is their current health issue (Griffin, 2012).
3. The Negatives effects of EMTALA
b. Patient seen and discharged before financial information can be obtained. Patients are leaving without providing any information, demographics, or insurance. Therefore these visits are not being paid for (Griffin, 2012).
4. Possible Solutions
c. Obtain the necessary demographics while patient is waiting to be taken back to a room without asking for any financial information (Griffin, 2012).
d. Patients coming in for follow-up visits the follow visits do not need a medical emergency medical screen which means organizations do not violate EMTALA by asking for financial information (Griffin, 2012).
e. Patients that frequent these hospitals can be asked for demographic information just to verify. The same patients will also have financial information already input into the computer therefore information can be processed (Griffin, 2012).
f. Obtaining demographic information allows organizations to contact these patients if financial information is not obtained prior to discharge (Griffin, 2012).
Recommend Improvement Strategies

The increasing spiraling costs of healthcare have raised concerns on economists, analysts,

and policy makers about the current healthcare market place economics reconsiderations. The

government has a key role on making healthcare more equitable for all people, as well as more

efficient. Alternative reform models must be compared to the traditional competitive model that

has prevailed until now.

Governmental policies must be developed to:

* foresee effectiveness versus unnecessary utilization.

* change the current provision of healthcare as a commercial product ( production of goods and
* Change services of a for-profit process that is triggered by demand (ability to pay for it).
Economic theories

1. The traditional competitive model: healthcare providers are allowed to trade their services and products, which consumers demand for.
a. Utility: consumer satisfaction drives more utilization.

b. Indifference curves: alternative comparison between two goods/services that have the same level of utility. A rational...

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