HSA 546 Week 1 Discussion: Group Medical Practices in the US

Week 1 Discussion – Group Medical Practices in the U.S

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Week 1 Discussion – Group Medical Practices in the U.S

Q. According to the textbook, a comparison of several countries with different levels of income shows that quality of healthcare and life expectancy among these nations are similar. However, the cost of care in the U.S. is the highest among the nations in the comparison. Analyze the main specific factors that affect the cost of healthcare services in the U.S. and recommend one (1) way that physician practices can help reduce the overall cost of healthcare services in the U.S. Provide a rationale for your response.

Answer:

The cost of care in the U.S. is the highest as compared to other nations. The main specific factors that affect the cost of healthcare services in the U.S. include:

Greater demand for healthcare services: Greater demand for healthcare services due to increased number of chronic disease, increasing numbers of elderly and an increasing population is one factor that affects the cost of healthcare services (Taube, 2016).

New healthcare technology: Healthcare technology is another factor that affects the cost of healthcare services. Use of new healthcare technology provides quality of healthcare, but they come with significant cost. Due to increasing demands for access to new healthcare technology in U.S, the cost of care in the U.S. is the highest (Wolper, 2013).

Pricing: Price variation due to unwieldy and unregulated prices for drugs and hospital services is another factor that affects the cost of healthcare services. In U.S, the cost of prescription drugs and hospital services is more as compared to other nations, which increases the healthcare cost (Wolper, 2013).

Administrative Obligations: Administrative costs, including the management of patient records and billing increases the healthcare cost. The mandatory implementation of Health Insurance Portability and Accountability Act (HIPAA), Electronic Health Records and some technology as required by federal government increases the healthcare cost of U.S. to a large extent (Wolper, 2013).

Medical malpractice: Malpractice insurance premiums, fraudulent billing, and jury awards in medical lawsuits are also some of the factors that affect the cost of healthcare services (Taube, 2016). One major cause in increasing cost of healthcare is due to increase in the practice of defensive medicine- doctors prescribe unnecessary tests or treatment in order to avoid the fear of facing a lawsuit or litigation in future.

Avoiding over treatment or avoiding practice of defensive medicine is one way that physician practices can help reduce the overall cost of healthcare services in the U.S. Many physicians prescribe expensive and unnecessary drugs, tests, treatments, and procedures, often unnecessarily or inappropriately, and at times indiscriminately. These over treatment or unnecessary practices increases the overall cost of healthcare services. So by avoiding those unnecessary practices, the cost of healthcare services could be reduced to a great extent.

Q. Assess the key different types of physician practices and evaluate three (3) administrative challenges that practice administrators face in providing quality services to the communities they serve. Support your analysis with specific examples.

Answer:

The administrative challenges that practice administrators face in providing quality services include:

Shortage of Healthcare Professionals: The healthcare industry increases day by day due to increased number of patients and chronic diseases (Wolper, 2013). Due to shortage of healthcare professionals, administrators face with the task of figuring out how to recruit and hire qualified employees to treat patients effectively and efficiently.

Growing Need to Specialize: With the rapid growth of special facilities in U.S., the physician-run outpatient surgery centers and diagnostic centers (Freel, 2012). The patients are shifted towards specialty facilities as they provide the opportunity for higher quality care. The rapid growth of specialty facilities is a challenge for administrators. For providing quality services, the administrators must be prepared to set their hospitals apart through a specialized care strategy.

Managing Medicare and Medicaid: Management of Medicare/Medicaid Payments is one challenge that is faced by administrators (Wolper, 2013). Due to increased numbers of unemployed people and senior citizens, the number of uninsured and underinsured Americans continues to grow. Providing healthcare services to these Medicare and Medicaid patients while maintaining fiscal responsibility is a challenge for administrators.

References:

Freel, M. (2012). Challenges hospital administrators must overcome to succeed in today’s rapidly changing industry. Becker’s Hospital Review, Retrieved from: https://www.beckershospitalreview.com/hospital-management-administration/5-challenges-hospital-administrators-must-overcome-to-succeed-in-todays-rapidly-changing-industry.html

Taube, S., (2016), What is Driving Rising U.S. Healthcare Costs? United States Common Sense, Retrieved from: http://uscommonsense.org/research/whats-driving-rising-u-s-healthcare-costs/

Wolper, L. F. (2013). Physician practice management (2nd ed.). Burlington, MA: Jones & Bartlett Learning.