Healthcare Payment Systems

Healthcare Payment Systems

Abstract

One of the most notable inefficient components in United States Healthcare is the healthcare payment systems which are fragmented and variable with simple tasks, such as how to pay for what service, has become much more difficult than it needs to be. This paper will addressed this problem by looking at how Healthcare payment systems can be integrated and improved to be more patient centered, reduce waste and fraud, and over all improve the quality of healthcare. I have also developed a policy proposal for a more efficient and integrated healthcare payment system where it recommends an overhaul of the current fee for service payment system to replace it gradually with a more flexible and integral system; a combination of comprehensive care and episode-of-care payment systems. In this new system a single price is charged for all healthcare service required to treat a patient with a given illness in certain conditions which are momentary episodes such as fractures or deliveries, while in other conditions that may be long term or repeated episodes such as chronic illness or heart failure. A comprehensive care system is used where a single price for healthcare is charged for all healthcare services required for a given group of people or patients over a year i.e. payments by people who suffer from diabetes. In addition this paper evaluates possible conditions in terms of macroeconomic factors which would stimulate the need for this policy reform such as rising Healthcare cost and it describes the political process to get the policy through the various measures of performance evaluations on the success of the policy if enacted.

Healthcare Payment Systems

Healthcare in the United States is cited as being one of the most expensive in the developed worlds with a high and aggressive growth rates in expenditure. In 2010, expenditures in healthcare reached about $2.6 trillion, ten times greater than what was reported...