Unit 5 Individual Project the US Health Care Economy
Patient’s decision
The patients are customers consuming various healthcare services offered by providers and their decisions can be influenced by such providers. The decision made by the patent can influence by the health care facilities and even the physicians. In case of health care facilities, the patient’s decision will be determined by the services quality of services to be offered and whether they will satisfy their health needs. The consumer engagement level with the physicians and the information they provide to them will contribute towards the decision made and especially if they are happy if such information provides the desired care (Abraham et. al 2011). This boils down to the various personal and structural characteristics which influence how patients will select the health care centers and physicians. The significant attributes can be associated with how the care is structured including the distance between the health facility and the home of the patient. This also includes the length of hours that physicians are available in their offices and whether the patient may be attended to by other providers within a certain group practice. The significant personal attributes of the provider relates to ability of physicians to keep the patients engaged and their professional qualifications. The provider’s demographic factors like gender and race also influence the decision of the patient especially if both the provider and patient have similar attributes (Abraham et. al 2011). The decisions involve the health facilities to visit, physician’s choice and whether to come back for these services.
The setting of the orthopedic center involves a value-based payment whose aim is to provide enough resources for provision of efficient and high quality care. The aim is to remove any issues especially in terms of finances such as penalties that may hinder the improvement of efficiency and quality services. To ensure the growth of patient engagement with physicians, the center encourages consultation services in offices where the various tests and treatments are provided at the personal level. In addition, the center encourages the patients to attend the facility where complete care can be provided. Health care centers or hospitals are able to offer a very inclusive medical care where a doctor will be in charge of an individual’s care. The center offers various services including consultation and outpatient treatment for those patients with various health issues including body system’s disorders, injuries corrections and even inpatient treatment services for critical conditions. The re-imbursement method used is Protective Payment System where the patient’s Medicare payment is based on amount that is fixed and pre-determined. The method ensures quick efficient response given since it ensures since different types of the systems are used depending on the services needed by the patient.
Impact of patients and doctors decisions on insurance plans
The patients and physicians decisions have impact on the health insurance plans in terms of the type and quantity of medical consumption that patients and physicians expect. This is because such factors affect the type of covers that patients or even the physicians chose. Normally , the patients makes their recommendation to these patients and the importance of having the insurance cover for specific medical needs which they may address in coming days (Santilli & Vogenberg, F2015). It is important to note that the choice of health insurance depends on the particular anticipated utilization while on the other hand the choice of the health insurance plan determines the utilization. Such kind of interdependence indicates that providers of health insurance including the government have to consider these issues. They have to keenly monitor the change in trends in terms of expected health needs of various patients and hence come up with insurance plans that align to the demand resulting from the ever changing patient needs. The cost sharing aspect also influences the health insurance plan especially when insurance policies are being formulated. The expected medical needs like outpatient medical services determine the extent to which cost sharing is to be done. In case the anticipated needs of the patient are many, their net price will be more in comparison to those who anticipates few needs (Santilli & Vogenberg, F2015).
The health insurers have to understand the changes and dynamisms of demands of a customer so as to develop insurances plans that will allow attractive cost sharing so that customers will not feel disadvantaged. If they do not respond to such aspects in the market and remodel their plans, there is the risk of customers shifting to competitors. Other loses include may include loss of efficiency, risk-sharing and others that may arise if the health insurance providers adjust their plans in an effort to enhance the various insurers. These losses indicate the effects the needs and demands of customers on the formulation of insurance plans in a market where there are many options. While trying to accommodate the physicians and patients and their preferences, the providers have to ensure that their plans are re-insured against any prospective risk that may occur any time (Santilli & Vogenberg, F2015).
Impact of government regulations on healthcare economy
The regulations adopted by the federal and state governments have various effects on the relationship between the patient and physician and the health care economy. These regulations interfere with the how the physician and patients relate in an effort to improve the health of the patient and the working conditions for the physicians. The regulations are likely to hinder the special positions that a physician is accorded in the society, which is a very important principle in the health sector. The regulations affect how a physician relates with the patient and hence the regulations introduced may hinder service delivery. The regulations comes in terms of licensing and enforcement programs for the physicians and especially when dealing with the patients with an aim of protecting the interests of the patient. The government regulation on patient relates to expenditure on health care products and services (Larrat, Marcoux & Vogenberg, 2012).
The various regulations have to an increased growth of health economy that is more advanced technology and even collection of personal data. This has led to a situation where health care providers including physicians are more interested in such aspects at the expense of the patients’ treatment and life-saving efforts. Such advancements are majorly costly and even complicated and for the health care providers to have an edge in addressing the needs of customers they have to invest heavily. Otherwise they risk being overlooked by patients who deems the advancement in technology as a means of improved health services. Hence, in responding to customers’ needs they have to consider the changes in technology (Larrat, Marcoux & Vogenberg, 2012). The health care economy has seen the emergence of organizations with that are devoted to complying with regulations while neglecting care provision. The orthopedic center has to rise above such standards in order to have effective response.
References
Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012). Impact of Federal and State Legal Trends On Health Care Services. Pharmacy and Therapeutics, 37(4), 218.
Abraham, J., Sick, B., Anderson, J., Berg, A., Dehmer, C., & Tufano, A. (2011). Selecting a provider: what factors influence patients' decision making?. Journal of Healthcare Management, 56(2), 99-116.
Santilli, J., & Vogenberg, F. R. (2015). Key strategic trends that impact healthcare decision-making and stakeholder roles in the new marketplace. American health & drug benefits, 8(1), 15.
