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Health, Medicine, Nursing
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Recent scrutiny of the current methods of healthcare pricing Essay

Essay Instructions:

In recent years, healthcare pricing has come under much scrutiny. Calls for price transparency have been made, loudly and clearly. Discounting prices to some recipients or payers occur, but how and why does this happen? Patients with insurance typically pay an insurance-negotiated discounted rate, while patients without insurance can be asked to pay the full amount that is charged by the provider or facility. Why can’t you simply look on each provider’s website to see the exact cost of your office visit, or your x-ray? With the many methods of cost-setting available to us as healthcare managers, we see how there is a high degree of variability in the amount charged per service from person to person, and state to state. In moving towards either voluntary or state-mandated transparency in healthcare pricing, we consider the following Case assignment questions.
Case Assignment
After completing the required background readings, please complete the following questions:
Describe the recent scrutiny of the methods of healthcare pricing. Is this scrutiny justified, or unjustified?
What can healthcare managers do to be best prepared for increasing future calls for transparency (either voluntary, or state-mandated)?
How have state transparency laws affected healthcare pricing in your home state, or state of current residency? Can you locate the exact costs of healthcare services you or your family may need in the near future?
How is cost-shifting implemented within the healthcare settings? Do you believe this ethical?
Assignment Expectations

Conduct additional research to gather sufficient information to support your analysis.
Provide a response of 3-5 pages, not including title page and references.
As we have multiple required items to be addressed herein, please use subheadings to show where you’re responding to each required item and to ensure that none are omitted.
Support your paper with peer-reviewed articles and reliable sources. Use at least three references, and a minimum of two of these from peer-reviewed sources. For additional information on how to recognize peer-reviewed journals, see http://www(dot)angelo(dot)edu/services/library/handouts/peerrev.php and for evaluating internet sources:
https://www(dot)library(dot)georgetown(dot)edu/tutorials/research-guides/evaluating-internet-content
You may use the following source to assist in your formatting your assignment: https://owl(dot)english(dot)purdue(dot)edu/owl/resource/560/01/. Paraphrase all source information into your own words carefully, and use in-text citations.

 

OPERATING REVENUE, REIMBURSEMENT, COST-VOLUME-PROFIT, AND BREAK-EVEN

Required Reading

Nowicki, M. (2018). Introduction to the Financial Management of Healthcare Organizations (Vol. Seventh edition). Chicago, Illinois: Health Administration Press. Part 2; pages 93-179, and pages 198-211. Retrieved from the Trident Online Library.

View: Taylor, M. (2014). Managerial Accounting: Cost – Volume – Profit and Break-Even.
Available at: https://youtu.be/zMb_IniBbDk

 

Essay Sample Content Preview:

Healthcare Pricing
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Healthcare Pricing
Recent scrutiny of the current methods of healthcare pricing
The current healthcare pricing methods are under significant scrutiny by various organizations governing the implementation of costs by the facilities. Research by Graber (2017) shows that American taxpayers, patients, and employers spend much more money on hospitals than pharmaceuticals, raising the need to evaluate the root cause and possibly develop potential solutions to address the issue. However, the hospitals and health care providers receive mere scrutiny, considering their high levels of escalating costs. They also have a highly increased number of mergers that have been driving costs higher than expected. On the other hand, they are still scrutinized to pave the way to understanding the pricing methods and their impact on patients since they are directly affected by the high pricing in health care (Graber, 2017). The primary aim of the proposed regulation on healthcare pricing transparency is to encourage consumer-friendly information.
The scrutiny has introduced federal transparency requirements and concepts for standardization, organization, and bundling as crucial aspects for introducing higher competition to enhance stabilization of the prices. The process has also sought to use disruptive changes to give consumers important information relating to pricing (Graber, 2017). Large transparency desires stricter regulations of the services being priced and pricing meeting consumers' expectations, depending on the services required at the hospital and health care provider facility. The scrutiny process also engages transformations of the country’s insurance payment system and formulation to enhance transparency to ensure consumers are price-sensitive and understand the cost for various services (Graber, 2017). At the same time, the standardization through evaluation is significant, in the focusing of suppliers to eventually compete for prices, with consumers having the opportunity to choose from a wide range of services at low prices. Thus, scrutiny is justified because it has a central aim of helping consumers understand health care pricing transparency and introducing competition in the market to pave the way for patients to choose from a wide range of services at low prices.
Preparation of managers for the increased future calls for transparency.
Healthcare managers must have the required credentials to achieve a desirable position in satisfying the calls for pricing transparency in their working environment. The openness is intended to enable patients to make viable decisions for price comparisons before their treatment procedures. Research by Keith (2019) shows that a lack of accurate, complete, and timely data on healthcare costs leads to inefficient operations in healthcare markets. Attaining considerable transparency helps lower healthcare costs and help patients choose high-quality care at relatively low prices. Thus, healthcare managers should engage in various strategies to be ready for increasing future calls for transparency. They should address patient confusion and their healthcare illiteracy by providing resources that equip them with the knowledge to...
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