Contact Us
Sign In / Sign Up for FREE
Go to advanced search...

Healthcare Utilization and Finance - Essay Example

Comments (0) Cite this document
Topic: Healthcare Utilization and Finance Student: Course: Date: Professor: Mrs. Zwick’s costs coverage Medicare Part A This part covers inpatient care but does not cover custodial care. According to Mrs. Zwick’s case, part A will take care of the bills pertaining to the initial three days of the five days that she was hospitalized for stroke treatment…
Download full paperFile format: .doc, available for editing
GRAB THE BEST PAPER95.8% of users find it useful
Healthcare Utilization and Finance
Read TextPreview

Extract of sample "Healthcare Utilization and Finance"

Download file to see previous pages Medicare Part B Essentially, this part covers healthcare services that are not provided for in part A of the Medicare. In Mrs. Zwick’s case, the cost of the different diagnostic tests that she underwent during her hospital stay and time of rehabilitation would be paid for in this part. Medicare Part D This last option of insurance cover deals with payment of the cost of drugs that are prescribed during a hospital stay. The antibiotics that were prescribed during the initial hospital stay will be catered for here. Moreover, the medication that prescribed upon her discharge will be also paid and by extension the walker that she required to walk around. Medicare policies and Reimbursement of Additional Care The policy by Medicare not to pay additional costs emanating from hospital acquired infections means that these cases have to be HAC (hospital-acquired complications) in terms of high cost. This in turn means that a patient with such a problem would have to be assigned to payment of higher premiums to cover the whole cost. It is however predicated upon the premise that the complication was due to secondary diagnosis and could have been prevented through utilization of evidence based guidelines. These additional policies of Medicare on hospital acquired infections means that the hospital will not get reimbursement for them (McNair, Luft, & Bindman, 2009). For instance, the antibiotics that were prescribed to her and these drugs were for urinary tract infection (UTI). With UTI being one of the complications that are not catered for by Medicare, then Mrs. Zwick and her daughter would have to pay from their pockets. Ethical Implications for Incurring Costs Related To Her Hospital-Acquired Condition The ethical implication for costs that emanate from hospital acquired infections to the concerned patients is that they have to pay for the additional cost. This is regardless of whether the infection was due to negligence on the part of the hospital or the infection just arose spontaneously. In order for clients to be shielded from this, they are forced to pay more so that in the advent that the complications that occur due to a person being hospitalized may be reimbursed by Medicare. Such a proactive move is quite unfair to the payer and the extra charge is quite punitive bearing in mind that these infections are completely out of a payer’s control when they happen. Another ethical implication is that it has to be proved beyond doubt that the hospital acquired infections were not due to negligence on the part of a hospital. This may arduous and quite challenging and it takes time (Zhan, Friedman, Mosso & Pronovost, 2006). Scenario 2 Consolidated Omnibus Budget Reconciliation Act (COBRA) Since COBRA insurance was designed to cover for people who have lost their job due to legitimate reasons, the cover is usually paid by the former employer but it is not subsidized. It follows then that the payments for health coverage premiums are remitted by the former employer in full and an additional administrative cost of two percent. However, coverage is considered under group coverage which therefore means that the cost of the premiums is still low although they are slightly higher than when the employee was working. Many of the individuals that invoke the COBRA coverage usually have a big time difference between their last day at work and ...Download file to see next pagesRead More
Cite this document
  • APA
  • MLA
(“Healthcare Utilization and Finance Essay Example | Topics and Well Written Essays - 1000 words”, n.d.)
Healthcare Utilization and Finance Essay Example | Topics and Well Written Essays - 1000 words. Retrieved from
(Healthcare Utilization and Finance Essay Example | Topics and Well Written Essays - 1000 Words)
Healthcare Utilization and Finance Essay Example | Topics and Well Written Essays - 1000 Words.
“Healthcare Utilization and Finance Essay Example | Topics and Well Written Essays - 1000 Words”, n.d.
  • Cited: 0 times
Comments (0)
Click to create a comment or rate a document

CHECK THESE SAMPLES OF Healthcare Utilization and Finance

Financial Management in Health Care

...these organizations aims at utilizing the available financial resources to achieve maximum returns on investments. The funding for the organizations comes from owners’ equity among other financing options. The entities operate with financial resources that should be refunded to the financiers. The fund could be borrowed from finance institutions and payments should be done from the ensuing profits (Finkler & Ward, 2006). Profitable operation of these institutions remains essential in ensuring completion of the repayments. Other healthcare entities, like the non-profits organizations, never have to repay the operating capital. These organizations operate to offer services...
4 Pages(1000 words)Essay

Healthcare Utilization and Finance

...? Healthcare Utilization and Finance Urinary Tract Infection Urinary Tract Infection (UTI) refers to a condition that affects the urinary tract, which is caused by bacteria (West, 2006). The main parts of the urinary tract affected are kidney and bladder. The infection causes a lot of pain during urination. It may also affect the whole process of urination whereby the infected person experiences frequent urination (Bernard, Hunter & Moore, 2012). This paper discusses some of the Medicare available for Mrs. Zwick, who is suffering from UTI, together with some other issues associated with Medicare insurance. Medicare Part A (Hospital insurance) This refers to hospital insurance plan, which...
7 Pages(1750 words)Research Paper

Healthcare Finance and Accounting

...the company’s ability to repay current liabilities using only current assets (Garrison and Noreen, 2003). Working capital is calculated subtracting current liabilities from current assets. In order for a company to have solvency it must have a positive working capital. A positive working capital is obtained when current assets are higher than current liabilities. References (2012). Limitations of Financial Statement Analysis. Retrieved September 17, 2012, from Healthcare Finance: An Introduction to Accounting and Financial Management. Retrieved September 17, 2012, from...
3 Pages(750 words)Essay

Utilization Management

...Utilization Management Identify at least three strengths of concurrent utilization review. Briefly discuss and justify your selection. Utilization theory is the concept through which businesses make use of system and workflow modeling to increase the flow of operations and therefore efficiency for the business processes. In the utilization review however specifically for the medical care industry, the tool can enable the concerned parties and the stakeholders to change the method of operation of the medical entity to reflect standardization and professional autonomy. "The Process of concurrent utilization review (UR) is a utilization...
4 Pages(1000 words)Essay

Healthcare finance

...Healthcare finance Elements of Profit Analysis that Change when a Provider Moves from a Fee For Service to a Discounted Fee For Service Environment Fee for service method differs from discounted fee for service method, in terms of profit analysis because of the involved discount in the discounted fee for service method. The discount identifies change in marginal cost equation, contribution, profit-volume ratio, and breakeven point. Contribution defines positive difference between sales and variable cost and effects of discount on sales implies effects on contribution. Consequently, contribution reduces as a provider moves from a fee for service environment to a discounted fee for service environment....
1 Pages(250 words)Assignment

Healthcare Finance

...Healthcare Finance Healthcare Finance If I were the CEO of Bayside Memorial Hospital, I would advocate for a top-down approach to budgeting as opposed to a bottom up approach because of its many advantages. Among the reasons that make top-down approach the most ideal is the fact that it allows the upper-level executives to come up with budgeting information without relying on the lower-level managers. This in turn allows the lower-level managers to focus on their departmental roles without necessarily having to look for budgeting information. This is unlike the bottom up approach where the upper-level executives wait for the various departments to come up with their budgets and then compile them into one budget. This saves time... Finance...
1 Pages(250 words)Assignment

Health Care Utilization

...Health care utilization Healthcare is very important and as such numerous stakeholders must be involved in ensuring that everyone accesses affordable healthcare and has sufficient health insurance coverage. Recent reforms in healthcare have targeted issues such as rising number of deaths due to chronic diseases, for instance, Type Two Diabetes and lifestyle diseases that can be attributed to sedentary lifestyles. The aim of the reforms is to sensitize people on the need to eat right diets and exercise regularly (Gulliford & Morgan, 2013). Of course, effective healthcare is a collective responsibility of everyone; this therefore means that many people are...
4 Pages(1000 words)Assignment

Healthcare finance

...Healthcare Finance Healthcare Finance The article addresses health care finance revenue and costing in healthorganizations, which is an important sector in the health care industry. The revenues generated keep the medical industry running. These costing mechanisms affect the efficiency of health services offered, while the amount of revenues generated will affect the quality of medical services rendered. First and foremost there is need to understand the billing of health care services. An accurate cost of events, practices and procedures along the delivery of services is essential in order to generate commendable profits. Once this is understood, the...
1 Pages(250 words)Essay

Healthcare Finance

...Healthcare Finance Southwest physicians, a medical group practice, are just being formed. It will need $3,000,000 of total assets to generate $ 5,000,000 in revenues. Furthermore, the group expects to have a profit margin of 5 percent. The group Is considering two financing alternatives. First, it can use all-equity financing by requiring each physicians to contribute his or her pro rata share. Alternatively, the practice can finance up to 50% of its assets with a bank loan. Assume that the debt alternate has no impact on the expected profit margin. What is the expected return on equity (ROE) if the group finances with 50 percent debt? Net profit $ 5,000,000 x 0.05 = $250000 Consequently ROE = $250000/$3000000 = 8.3... % What is the...
2 Pages(500 words)Speech or Presentation

Chinas Security and Healthcare Systems

..., it is important to consider the various stakeholders in the system and their duties. The Ministry of finance is responsible for supporting government health budget (Hougaard et al., 2011). The Ministry of Health and SFDA is involved in RCMS, public hospital reforms, drug procurement and utilization, quality supervision of drugs and food, and public health service (Hougaard et al., 2011). The Ministry of Civil Affairs works for poverty alleviation and providing medical aid for the poor. The distribution of drug and medical devices is controlled by the Ministry of Commerce. The Ministry of Human Resource and Social Security administers UEMI, URMI, reimbursement and payment system (Hougaard et al., 2011)....
10 Pages(2500 words)Term Paper
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.

Let us find you another Essay on topic Healthcare Utilization and Finance for FREE!

Contact Us