Preview

Financial Environment In Health Care

Better Essays
Open Document
Open Document
905 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Financial Environment In Health Care
Financial Environments
Megan Kilkenny
HCS/577
January 20, 2014
Crystal Chilman

Financial Environments Introduction

With recent big changes in healthcare legislation, health care organizations are moving towards a system that changes reimbursement procedures. Health care organizations will be reimbursed by the government based on the quality of care provided by that organization. The Affordable Care Act (ACA) requires certain steps to make Medicare more resourceful by decreasing the amount of overpaid funds to insurance companies, adjusting reimbursement rates to levels that are more suitable, and altering payment scales and systems to support the delivery of efficient, premium health care ("Centers For Medicare & Medicaid
…show more content…
These are investor owned organizations that must pay taxes and do not receive the same benefits that not-for-profit organizations receive. For-profit healthcare organizations are owned by investors. In terms, this means they have shareholders who benefit directly from any profits that are generated from this organization. Unlike, not-for-profit organizations, these for-profit organizations do not usually have the mission of taking on charity work or …show more content…
Three examples of not-for-profit healthcare organizations include The Hospital of the University of Pennsylvania (HUP), Memorial Sloan-Kettering Cancer Center, and The Cleveland Clinic. Gapenski (2008) explains that not-for-profit organizations must be structured and managed so that they operate exclusively to the interest of the public. Non-profit organizations were formed with the purpose of servicing the needs of the less fortunate. This later led to non-for-profit hospitals being free from paying taxes because of the fact that they were providing certain social services. Due to the fact that individuals can not benefit from the profits of not-for-profit organizations, dividends from these organizations cannot be paid (Gapenski, 2008). Not-for-profit organizations are also controlled by a board of trustees, which often times makes it hard to make certain changes or decisions without everyone in

You May Also Find These Documents Helpful

  • Good Essays

    Patton Fuller Community Hospital is a for profit organization. The organization is committed to providing quality and service to their patients. Its organization is owned by a group of active physicians that can provide care approximately to 600 patients in a full service environment. As Finkler and Ward mention every health care organization should show signs of profit in order to purchase the newest technologies and be able to be compete (Finkler & Ward, 2006).…

    • 780 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Given the lower reimbursements provided by medicare/Medicaid combined with the growing number of uninsured, and the longer A/R process in medical practices it is a daunting process for a medical provider to reach this level of patient revenue from services.…

    • 391 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    Medicare, enacted in 1965, based reimbursement for physician services on the actual charge on the current bill, the customary charge over the past year, or the local medical profession’s “prevailing” charge over the past year, whichever was lowest (2). This system was chaotic and confusing. In response, the Omnibus Budget Reconciliation Act of 1989 switched Medicare to the Resource Based Relative Value System (RBRVS). This used Hsaio et al’s estimates of physician time and effort to assign Relative Value Units (RVUs) to physician services (3).…

    • 2223 Words
    • 9 Pages
    Powerful Essays
  • Good Essays

    Not-for profit entities are facing similarities with governmental entities and for-profit entities because of the current changes considered to provide insurance to the uninsured. The Affordable Care Act will help individuals with receiving care however, the changes with reduce the net income based on the funding for Medicaid and Medicare (Scalesse, 2013).…

    • 444 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    March Of Dimmes

    • 2179 Words
    • 9 Pages

    Not-for-profit organization’s primary goal “is not to increase shareholder value; rather it is to provide some socially desirable need on an ongoing basis. It generally lacks the financial flexibility of a commercial enterprise because it depends on resource providers that are not engaging in an exchange transaction. The resources provided are directed towards providing goods or services to a client other than the actual resource provider. Thus the not-for-profit must demonstrate its stewardship of donated resources —money donated…

    • 2179 Words
    • 9 Pages
    Powerful Essays
  • Powerful Essays

    Medicare is not in a good position right now: rising costs are predicted to bankrupt the present system. The steady rise in costs due to technology and an aging population necessitate changes to Medicare. There are proposed alternatives to reduce costs of Medicare over the long run. The current health care system has to be more flexible, participant-controlled, and outcomes-oriented.…

    • 2917 Words
    • 12 Pages
    Powerful Essays
  • Good Essays

    Reimbursement methods in health care refer to the capability of an individual to acquire compensation for out-of-pocket medical expenses paid by them from their insurance companies. In addition, reimbursement involves more than just what an individual gets paid since it is a long and frequently convoluted process (Quinn, 2015). The Value-based care (VBC) reimbursement models that replace the traditional fee-for-service (FFS) model, greatly affect the healthcare industry by increasing the costs and most importantly, the insured individuals put stress on their providers to supply quality care with greater efficiency (Quinn, 2015). The different reimbursement methods also help health care providers settle upfront productivity loss and investment costs. The different reimbursement reform acts increase the market competition.…

    • 815 Words
    • 4 Pages
    Good Essays
  • Best Essays

    According to Merriam-Webster.com, Not-for-Profit, also known as nonprofit is defined as, “not existing or done for the purpose of making a profit.” Whereas For-Profit is the opposite and is defined as “existing or done for the purpose of making a profit.” I am an ethnographic researcher for a popular organizational behavior research journal. In this article, we will be looking at 2 popular and major organizations, where one is Not-for-Profit and the other is For-Profit and identifying a key problem related to business ethics.…

    • 2902 Words
    • 12 Pages
    Best Essays
  • Good Essays

    Health Care Reform

    • 444 Words
    • 2 Pages

    2. With the increase in revenue due to the use of services, getting paid for Medicaid and Medicare services would mean formulation of new payment standards to include the measures of quality care.…

    • 444 Words
    • 2 Pages
    Good Essays
  • Good Essays

    The current structure of Medicare is unnecessarily complex. While most employers offer employees a comprehensive coverage that includes hospital care, physician services, and prescription drugs, Medicare offers fragmented coverage with separate parts for each of the services. Low income, beneficiaries, unable to afford the high out of pockets expenses and ineligible for supplemental insurance such as Medicaid, are left without proper medical coverage. The growth in total program spending continues to increase, as the baby boom generation retires, putting increased pressure on Medicare finances and the federal budget. Medicare reform is required in order to effectively deliver medical care. Generally, all Part A beneficiaries also purchase Part B (Neuman 23). Thus, combining Part A and Part B decreases the structural complexity of Medicare and also introduces same deductibles for hospitals and physician services. In addition, establishing a Medicare out of pocket maximum reduces the risk of having to pay catastrophic amounts for large Medicare bills, reducing the need for Medigap and other supplemental services (Neuman 24). Finally, allowing the government to negotiate with drug companies would decrease the high costs of drugs for beneficiaries as well as for the government. These reforms would strengthen Medicare so that it can provide medical coverage to its intended…

    • 635 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Health Care Reform Paper

    • 1937 Words
    • 8 Pages

    The American healthcare system of today faces many issues and problems. The growing population of elderly and high rate of unemployment has left many Americans without any type of healthcare at all. To reform healthcare that has to first the infrastructure established that is sustainable for doctors, suitable for members, and costly enough to be sponsored. Hospitals are bulking up into huge systems, merging with one another and building extensive new doctor work forces. They are exploring insurance-like setups, including direct approaches to employers that cut out the health-plan middleman. WSJ 's Anna Mathews joins the News Hub to discuss the changing face of health care in the U.S. as a result of pressure to cut costs. AP Photo. On the other side, insurers are buying health-care providers, or seeking to work with them on new cooperative deals and payment models that share the risks of health coverage. And employers are starting to take a far more active role in their workers ' care. (Wilde-Matthews, 2011) This new and innovative plan does seem to be valid and more cost-efficient. The main issue with current health care plan and especially government mandated health care plan are the doctor’s reimbursement rates for procedures. Doctors argue that current reimbursement rates are too low, causes them to lose money, and force sub-par healthcare to members. Many argue…

    • 1937 Words
    • 8 Pages
    Powerful Essays
  • Good Essays

    It proposed to resolve many issues being faced by the healthcare delivery and the way the complex payment methodology is involved. The ACA target various aspects of the health reforms addressing the healthcare delivery, its organization and the reimbursement methodologies. It provides multi-variable approach to build various new models to identify more efficient and productive system. The reimbursement system is linked to the patient’s outcome, the healthcare delivery and more importantly developing nation-wide resources for providing quality healthcare. Similarly, Medicare under ACA has substituted its predominantly fee-for-service structure to value based model of care providing an enticement to reduce the overall cost and expenditure for its beneficiaries.…

    • 1747 Words
    • 7 Pages
    Good Essays
  • Good Essays

    References: Bryant, D. (2012, April 22). Healthcare reimbursement will change dramatically in the future. Retrieved January 19, 2014, from http://www.kevinmd.com/blog…

    • 881 Words
    • 4 Pages
    Good Essays
  • Better Essays

    For-profits differ from nonprofit organizations in that all of their labor is done by employees, while nonprofits mainly use volunteers. As well, nonprofits are often the recipients of donations and grants, while for-profits are paid in dividends.…

    • 1168 Words
    • 5 Pages
    Better Essays
  • Powerful Essays

    A key difference between a for-profit organization and a not-for-profit is that for commercial organizations, the company delivers a product or service in exchange for cash. At which point the company’s obligations usually end and the company is free to spend the proceeds for its business purposes. In a not-for-profit, the organization’s obligations do not end at point of donation. In fact, charities can be viewed as a trustee of donors’ money, where they have a duty to ensure that the donations have the maximum impact on the charity’s beneficiaries. Since a charity’s obligation does not end at the point of sale, charities have a duty to donors to ensure…

    • 2911 Words
    • 10 Pages
    Powerful Essays