The Healthcare Market
HSA 510: Health Economics
Dr. David B. Tataw, PhD, FACHE
There are many factors that have influenced the changes of health care economics. Money and technology has definitely been the reason for the change of health care economics over the years. Money is want makes the economy evolve. There will be advancement in technology and there needs to be people are managing these to keep up with the changes. The U.S. has definitely progressed as far as influencing factors to change in new advancement of technology and medical care. Having a good financial manager in your organization will prepare for these upcoming advancements and changes. Money drives these advancements in providing successful health care industries. Most of the funding that comes to make these changes comes from insurance companies but it also affects patients. Patients have to pay for insurance and the money adds up. It can be very expensive to pay for health insurance as well as medical bills and prescription medication. Today in society we provide services in health care for money. Money creates revenue for the organization can pay for supplies, workers, and other things to keep the organization running. Before money was involved physicians would trade in their skills and work for supplies to help you live. The current health care delivery structure in my state of Ohio The Affordable Care Act (ACA) went into full effect, ushering in health insurance reforms and new health coverage options that are impacting Americans across the country. Ohio is experiencing changes to its health care delivery system as the state expands Medicaid, targets the uninsured with a federal health insurance marketplace, streamlines health and human services programs, and implements new health care delivery payment systems (PR Newswire US, 2013). In collaboration with CMS, Ohio extended coordinated care to its dual eligible population through an Integrated Care Delivery System (ICDS). The Integrated Care Delivery System (ICDS) is a system of managed care plans selected to coordinate the physical, behavioral, and long-term care services for individuals over the age of 18 who are eligible for both Medicaid and Medicare. This includes people with disabilities, older adults and individuals who receive behavioral health services. Ohio’s ICDS is called “MyCare Ohio.”
The MyCare Ohio approach is centered on the individual to effectively coordinate their care based on their specific needs. This care team includes: the individual, the individual’s family/caregiver, the MyCare Ohio plan care manager, the waiver service coordinator (if appropriate), the primary care provider, specialists, and other providers as applicable. Ohio selected five managed care plans, through a competitive process, to comprehensively manage the full spectrum of Medicaid and Medicare benefits.
The benefit package includes all benefits available through the traditional Medicare and Medicaid programs, including long-term care services and supports and behavioral health services. In addition, MyCare Ohio managed care plans may elect to include additional services in their benefit packages. The main competitive forces in the your healthcare delivery system in Ohio There are over 60 active health plans across the state of Ohio, many with very small market share. These plans currently pursue a wide range of payment innovation, creating mixed incentives for providers. Patients often face a disjointed provider system with inadequate coordination and accountability. Similarly, Ohio health and human services policy, spending and administration have historically been split across multiple state and local government jurisdictions, impeding innovation and lacking accountability. Health care spending is growing at an unsustainable rate. When Governor Kasich took office in 2011, Medicaid spending was growing four times faster than the...
Please join StudyMode to read the full document