Payers’ Influence on the Health Care Industry

You need to enable JavaScript to run this app.

Print Originality ReportDownload Originality Report

SafeAssign Originality Report

CSU SafeAssign Plagiarism Check Tool•SafeAssign Originality Report Generator IV•Submitted on Wed, May 04, 2022, 3:18 PMView Originality Report - Old Design

Cornelia Smith

View Report Summary 1

Payers Influence on the Healthcare Industry

Student Name

Lecture Name

Course

Date

1

Payers Influence on the Healthcare Industry

The tremendous growth in healthcare prices is one of the most significant financial disasters plaguing both American households and businesses today.

As a result, the Medicare and Medicaid programs have risen to become the most powerful impact on the most critical aspects of health insurance coverage in the United States.

Changes in public health programs are then needed in order to accommodate the increasing healthcare costs of its citizens by implementing programs to reduce health-care expenses (Green, 2018).

The approaches include providing appropriate care to persons suffering from serious illnesses, advocating for greater drug affordability, and reducing the demand for medical care services by changing one's behavior.

The new policies and initiatives being developed by the government and private insurance providers to combat rising healthcare costs include the following:

the need for more cheap prescription medications.

It is necessary to have the proper prescription in order to cure a condition.

However, right now, only those who can afford a new pharmaceutical prescription of a drug fully recover, while those who do not have the financial means to buy the drug struggle more, resulting in many fatalities (Green, 2018).

The pharmaceuticals that are currently available have seen price increases on a regular basis, regardless of their therapeutic worth, and as a result, the market for the administration of medications is shattered.

It is clear that only a small number of people can afford to purchase medications.

In order to ensure the long-term viability of the healthcare system, the government should work to restore a balance between accessibility and incentives for medications.

Another approach is to reduce demand for medical services through behavioral modification.

The fact that the United States has the highest medical care costs in the world is due to the unpleasant and dangerous behaviors in which the people of this country engage.

The authorities should battle against the use of substances like tobacco, as it is the leading preventable cause of mortality and costs the medical system over $170 billion each year.

Alcohol consumption should also be combated, as it contributes to an estimated 27.5 billion dollars in annual healthcare expenses.

Opioid misuse must also be avoided, as the US Department of Human and Health Services reports that it costs the country 72 billion dollars per year in medical costs (Gee & Spiro, 2019).

Therefore, all of the aforementioned behaviors have a direct influence on individuals and increase health care costs for individuals of all ages.

The government of he United States should consequently focus not only providing healthcare more efficiently, but also keeping residents healthy, thereby reducing demand.

Another initiative that should be implemented in order to slow the rise in healthcare expenses is efficient and effective treatment for chronically ill patients.

Many steps, including experience and care, must be taken to ensure that Americans'

lives improve meaningfully as they save money.

Third-party payers have an effect on health coverage pricing by reestablishing fundamental care's key role.

In this situation, they select medical homes as well as other upgraded primary care systems with the express purpose of reducing the cost of healthcare (Buff & Terrell, 2014).

The demand for medical homes emphasizes both the assurance provided to the sick and the acknowledgement of their requirements (“PatientX,” n.d).

Additionally, it helps the physician to focus exclusively on the patient by delivering more effective care till the patient is fully recovered.

Additionally, third-party payers working within the Medicare system have enhanced primary care systems, their performance and results, and ultimately reduced costs for the majority of Medicare beneficiaries who face financial hardship.

In addition, the third party verifies that individuals should be considered insurance recipients in order for them to be registered in Medicaid and be eligible to receive health insurance coverage.

Improved tactics, in my opinion, might be implemented to assist in improved price control as well as fraud and waste reduction in the healthcare industry.

For example, one of them is to guarantee that the funds received by the recipients is spent correctly, with a high likelihood of improving the overall quality of life for the citizens.

This is in contrast to the improper use of the beneficiaries'

funds, which results in their lives being subjected to suffering and risk.

If the medication amount is to be offered transparently, this is necessary because, in order for a market to work properly, information must be accurate and in accordance with the price of the item being offered, and in this situation, the value of the drug being offered must be legitimate.

Before going to the pharmacy, physicians should make sure that the patient's have the correct dosage.

It is important for citizens to avoid engaging in harmful behaviors such as theft and other illegal activities.

The measures considered will have an effect on the cost of healthcare.

Households will benefit, as well as the economy will grow as a result of the absence of the load of cost-sharing obligations.

Because people will maintain their health and avoid the use of medicines, the number of deaths will be kept to a bare minimum.

Medical healthcare services provided throughout the country will also contribute to the long-term viability of the medical system, which will benefit all citizens of the United States.

References

Green, M.

(2018).

2

Understanding health insurance:

A guide to billing and reimbursement.

Cengage Learning.

3

Gee, E., & Spiro, T.

(2019).

4

Excess administrative costs burden the US health care system.

5

Center for American Progress webpage.

https://www.

americanprogress.

5

org/issues/healthcare/reports/2019/04/08/468302/excess-administrative-costs-burden-us-health-care-system.

4

Published April, 8.

medRisk Created with Sketch.

Attachment 1PayersInfluence050422.docx19%

Sources

Included sources

Highlight matchOpen matching source

• Global database (3)

  13%
  • 5

    Student paper

    Highlight match
  • 4

    Student paper

    Highlight match
  • 3

    Student paper

    Highlight match

• Institutional database (1)

  5%

  • Internet (1)

    1%

    • Top sources

      Sources

      Word Count:	Submitted on:	Submission UUID:	Attachment UUID:
      952	05/04/22	8db911b8-1cf6-4888-7c3a-ebfc49bcff36	7ec67e46-1bf6-d887-0d22-d37597c92e11

      5511535528