ESSAY: Healthcare Payment

Write a 750-1,000 word synopsis describing the different types ofpayment that are taken for health care.
1.Describe how the charging and pricing processes of health carefacilities are different from those of other industries.
2.Describe how private and government insurers and payers impactactual reimbursement.
3.Justify which form of payment has themost merit. Explain why.

Prepare this assignment according to the guidelines found in the APAStyle Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior tobeginning the assignment to become familiar with the expectations forsuccessful completion.

ANSWER

Healthcare Payment

            Healthcare payment system and health care prices are opaque, and physicians/clinicians and patients are equally not privy to them. Considering the unprecedented rates with which Americans are enrolling in highly deductible healthcare plans, the health care affordability has drawn significant attention, in recent years (Tompkins et al., 2006). The obscure nature of the healthcare payment system is evidenced by the healthcare delivery costs covered in layers of complex accounting terms and jargon. There are various terms such as “price,” “cost,” “charge,” and “reimbursement” whose interpretation primarily depends on the specific perspective under consideration. At the same time, the health care costs, charges, prices, and reimbursements are different from those of other industries and given health insurance available in the healthcare industry, these payment processes require more clarification and transparency (Hall & Schneider, 2012). In this paper, the focus will be on how different the healthcare pricing and charging processes are from other industries’, determine how government and private payers and insures influence actual reimbursement and, lastly, a justification of the most merited model of payment in healthcare.

How different Healthcare pricing and charging Processes are from other Industries’

            The pricing and charging processes in healthcare are different from those of other industries considering these industries, other than healthcare, have automated their processes. Essentially, all the payment process in healthcare are not automated, and is attributed to the complex nature of healthcare technology, which has not facilitated these process, and are also not as advanced as the technological milestones made in other industries. According to Hall & Schneider (2012), healthcare demands the kind of technology that is applicable in a patient by patient basis.

Secondly, healthcare pricing and charging processes are different because of the localized nature of healthcare. In this case, it implies that healthcare services should be offered locally, thus affecting the prices structure. Tompkins et al. (2006) observe that healthcare charges or prices are influenced since different healthcare institutions compete with the local communities pitting the unemployed against the skilled individuals for higher health care costs and more quality care. At the same time, it is challenging to deny patients healthcare…

How Government and Private Insurers and Payers influence Actual Reimbursement             Reimbursement in healthcare refers to the payment that a hospital, diagnostic facility, doctor or any other healthcare provider receive for providing the necessary medical care (Tompkins et al., 2006). Often, a government payer or h