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Module7Assignment.docx

HCA 6013 Dynamics of Healthcare Markets

Module Seven

Study Questions

Healthcare Supply: The Profit Motive in Healthcare

1) Identify the two assumptions of firms in competitive market theory that the authors argue are violated and describe how they may be violated in healthcare.

2) Summarize the characteristics of for-profit and not-for-profit healthcare entities.

3) What are some of the current impacts of private equity on healthcare? How do their strategies differ from traditional for-profit healthcare entities? Use the supplemental articles in the module and/or the Commonwealth Fund’s The Dose podcast also available here: https://www.commonwealthfund.org/publications/podcast/2025/may/how-private-equity-deals-are-reshaping-your-health-care

4) Briefly describe the differing results of research presented in the chapter in (quality, trustworthiness, prices and efficiency) between for-profit and nonprofit health entities.

5) Using the Sage Price Transparency Data Dashboard and the “hospital” tab, Investigate and Report the requested data from 2 non-profit hospitals and 2 for profit hospitals in your city, state or region. You may need to expand your typical area to find 2 for-profit hospitals. Below the table, write a paragraph briefly interpreting the data. An example was provided during the lecture. https://dashboard.sagetransparency.org/

Sage Transparency Dashboard Data Comparison	NP1	NP2	FP1	FP2
Name
City/County, State
Hospital operating margin
Payer Mix % Medicaid
Payer Mix % Charity Care
SCHIP & Low Income Gov. Program
Totaled Qualifying NFP Care: Charitable and Medicaid

6) Describe the process for the development of new drugs/pharmaceuticals.

7) Senate Bill (S. 229) DTC Act of 2025 https://www.congress.gov/bill/119th-congress/senate-bill/229 was introduced at the beginning of 2025. Read the description on this webpage. Using the arguments in the chapter on what is positive and/or negative about DTC, present an argument for or against the DTC Act of 2025. Using economic theory, predict what the demand and price response of DTC drugs might be if it is enacted.

8) One of our obstacles to addressing the commercialization of healthcare is not knowing enough about it. What study should be or has been completed with US midlevel healthcare administrators as the population studied?

Module6Assignment.docx

HCA 6013 Dynamics of Healthcare Markets

Module Six

Competition in the Supply of Healthcare

1) What factors might influence a physician’s ordering of services for patients?

2) What type of physician reimbursement mechanisms can be utilized to reduce services?

3) Describe the diagnosis-related groups (DRG) reimbursement system and how it is designed to function in hospital reimbursement? What factors limit its effectiveness?

4) Complete the table with supply side strategies detailing how they are designed to function and what the known limits/outcomes are of each model.

Cost Containment Strategies	Definition and Mechanism/ what is it designed to do?	Known Limits/failures (quality, effectiveness, etc)
VBP
Practice Guidelines
Managed Care
ACOs
Utilization Management
PCMHs
Selective Contracting

5) Identify 2 ACO’s in your state/region, describe who operates them (e.g., hospital system?) and their membership size/scope. Use CMS’ ACO site to find ACOs if you do not know.

6) How can market power affect the US Healthcare System, using chapter, lecture and/or powerpoint points to explain your answer? What are some possible policy responses?

7) What is cost shifting and how could we better address it?

Module7Assignment.docx

HCA 6013 Dynamics of Healthcare Markets

Module Seven

Study Questions

Healthcare Supply: The Profit Motive in Healthcare

1) Identify the two assumptions of firms in competitive market theory that the authors argue are violated and describe how they may be violated in healthcare.

2) Summarize the characteristics of for-profit and not-for-profit healthcare entities.

3) What are some of the current impacts of private equity on healthcare? How do their strategies differ from traditional for-profit healthcare entities? Use the supplemental articles in the module and/or the Commonwealth Fund’s The Dose podcast also available here: https://www.commonwealthfund.org/publications/podcast/2025/may/how-private-equity-deals-are-reshaping-your-health-care

4) Briefly describe the differing results of research presented in the chapter in (quality, trustworthiness, prices and efficiency) between for-profit and nonprofit health entities.

5) Using the Sage Price Transparency Data Dashboard and the “hospital” tab, Investigate and Report the requested data from 2 non-profit hospitals and 2 for profit hospitals in your city, state or region. You may need to expand your typical area to find 2 for-profit hospitals. Below the table, write a paragraph briefly interpreting the data. An example was provided during the lecture. https://dashboard.sagetransparency.org/

Sage Transparency Dashboard Data Comparison	NP1	NP2	FP1	FP2
Name
City/County, State
Hospital operating margin
Payer Mix % Medicaid
Payer Mix % Charity Care
SCHIP & Low Income Gov. Program
Totaled Qualifying NFP Care: Charitable and Medicaid

6) Describe the process for the development of new drugs/pharmaceuticals.

7) Senate Bill (S. 229) DTC Act of 2025 https://www.congress.gov/bill/119th-congress/senate-bill/229 was introduced at the beginning of 2025. Read the description on this webpage. Using the arguments in the chapter on what is positive and/or negative about DTC, present an argument for or against the DTC Act of 2025. Using economic theory, predict what the demand and price response of DTC drugs might be if it is enacted.

8) One of our obstacles to addressing the commercialization of healthcare is not knowing enough about it. What study should be or has been completed with US midlevel healthcare administrators as the population studied?

Module6Assignment.docx

HCA 6013 Dynamics of Healthcare Markets

Module Six

Competition in the Supply of Healthcare

1) What factors might influence a physician’s ordering of services for patients?

2) What type of physician reimbursement mechanisms can be utilized to reduce services?

3) Describe the diagnosis-related groups (DRG) reimbursement system and how it is designed to function in hospital reimbursement? What factors limit its effectiveness?

4) Complete the table with supply side strategies detailing how they are designed to function and what the known limits/outcomes are of each model.

Cost Containment Strategies	Definition and Mechanism/ what is it designed to do?	Known Limits/failures (quality, effectiveness, etc)
VBP
Practice Guidelines
Managed Care
ACOs
Utilization Management
PCMHs
Selective Contracting

5) Identify 2 ACO’s in your state/region, describe who operates them (e.g., hospital system?) and their membership size/scope. Use CMS’ ACO site to find ACOs if you do not know.

6) How can market power affect the US Healthcare System, using chapter, lecture and/or powerpoint points to explain your answer? What are some possible policy responses?

7) What is cost shifting and how could we better address it?

Module7Assignment.docx

HCA 6013 Dynamics of Healthcare Markets

Module Seven

Study Questions

Healthcare Supply: The Profit Motive in Healthcare

1) Identify the two assumptions of firms in competitive market theory that the authors argue are violated and describe how they may be violated in healthcare.

2) Summarize the characteristics of for-profit and not-for-profit healthcare entities.

3) What are some of the current impacts of private equity on healthcare? How do their strategies differ from traditional for-profit healthcare entities? Use the supplemental articles in the module and/or the Commonwealth Fund’s The Dose podcast also available here: https://www.commonwealthfund.org/publications/podcast/2025/may/how-private-equity-deals-are-reshaping-your-health-care

4) Briefly describe the differing results of research presented in the chapter in (quality, trustworthiness, prices and efficiency) between for-profit and nonprofit health entities.

5) Using the Sage Price Transparency Data Dashboard and the “hospital” tab, Investigate and Report the requested data from 2 non-profit hospitals and 2 for profit hospitals in your city, state or region. You may need to expand your typical area to find 2 for-profit hospitals. Below the table, write a paragraph briefly interpreting the data. An example was provided during the lecture. https://dashboard.sagetransparency.org/

Sage Transparency Dashboard Data Comparison	NP1	NP2	FP1	FP2
Name
City/County, State
Hospital operating margin
Payer Mix % Medicaid
Payer Mix % Charity Care
SCHIP & Low Income Gov. Program
Totaled Qualifying NFP Care: Charitable and Medicaid

6) Describe the process for the development of new drugs/pharmaceuticals.

7) Senate Bill (S. 229) DTC Act of 2025 https://www.congress.gov/bill/119th-congress/senate-bill/229 was introduced at the beginning of 2025. Read the description on this webpage. Using the arguments in the chapter on what is positive and/or negative about DTC, present an argument for or against the DTC Act of 2025. Using economic theory, predict what the demand and price response of DTC drugs might be if it is enacted.

8) One of our obstacles to addressing the commercialization of healthcare is not knowing enough about it. What study should be or has been completed with US midlevel healthcare administrators as the population studied?