Health Care Payment Systems

wellness C atomic number 18 stipend SystemsMiguel BoquerIntroductionHealth attention spending has been on the rise over the age and is even more so affected by the continu bothy evolving wellness wield honorarium and insurance systems. To put it into perspective, national health c ar spending has bad from 5.3 percent in 2014 to 5.8 percent in 2015 reaching an astonishing reached $3.2 meg or $9,990 per individual (Wilson, 2016). In 2016, healthc be expenditures were expected to reach $3.35 one million million million averaging $10,345 per individual (Alonso-Zaldivar, 2016). Payment and insurance systems through employers, insurance providers, and government agencies are providing for ways of verifyling factors driving healthcare costs.Payment SystemsPayment systems go through continued to evolve into many various forms over time such as fee-for-service, conduct-for-coordination, all-embracing care, pay-for-performance, bundled wages or episode-of-care, upside shared ne st egg programs (Medicare and Medicaid (CMS) or Commercial), downside shared savings programs (CMS or Commercial), partial or bountiful capitation, and global budget (McKesson, 2017). The most(prenominal) popular and original way of payment for health care services organism utilized today is the fee-for-service payment system. This system fall by the waysides for each separate service that is provided to be paid for at a set amount (Miller, 2009). From what I gathered through my question is that as the universe of discourse ages, healthcare costs rise, and technology advances, the fee-for-service isnt always the most efficient method of payment. A combination of payment systems is more pet when working with the different sources of payers such as self-payment, insurance providers, or Medicaid/Medicare. Episode-of-care and comprehensive care would be a great combination reason being that some of the aging population or those with more serious conditions dirty dog utilize episo de-of-care, whereas the comprehensive payment system will cover the population that contain conditions that require more frequent or repetitive care for chronic conditions such as diabetes. For instance, comprehensive care payment would be make to the physician practice or health system to piling with the patients who possess presumptive underlying health conditions. Then, the episode-of-care payment would be made to a hospital if a specific patient requires surgery or any other costly treatment (Miller, 2009).PayersThe Affordable Care flake (ACA) is comprised of numerous regulations that focus on the organization of healthcare like how it is delivered and so paid for. The fee-for-service system that has been the most dominant payment system is ineffectual and costly to patients and payers, which is why the regulations provided the ACA must be imposed on the flaws of the US health system. As the US economy strengthens, medical prices continue to improver rapidly, and the popula tion ages, Medicare and Medicaid are projected to grow at a fast rate than private insurance providers (Alonso-Zaldivar, 2016). In the sense of utilizing multiple payers, healthcare providers can transform the way they deliver health care to all of its patients if enabled by the changes in payment systems as long as the payers end-to-end the community are required to change their payment systems as comfortably in related ways. Additionally if the right payment is set, the health care providers will be able to deliver quality care to the patients as needed (Yong, Saunders, Olsen, 2010).HIT and Payment SystemsHealth Information Technology (HIT) is alter towards effective changes in the way payment systems are operating. HIT continues to be a vital component of directing the health care payers toward modify workflows, while amend the management of medical claims. Data can reform managed through the use of HIT innovations such as the transferring of health schooling within and in-and-out of a health plan, which is substantially important (Patrick, 2016). New, innovative healthcare technology is allowing for the combination of managed care and any additional technology that is apply in managing patient care within the patients health plan on with determining the claim payments. The large amount of data that becomes accessible as a result through that combination can be bodied with various types of data such as pharmacy or health assessment resulting in a pool of data readily available to access as needed.ConclusionThe various healthcare payment systems are being used to cover, coordinate, and manage the costs of care for patients are lavishly complex. Only through the improvements of the payment systems have payers been able to effectively control the aspects of healthcare costs. Aging population and the increasing presence of chronic illnesses are calling for improvements to the processes of payment systems such as the implementation of multiple paym ent systems. The advances of Health Information Technology will be able to allow for the smooth collaboration and integration of multiple payment systems in the efforts of improving the quality of patient care.ReferencesAlonso-Zaldivar, R. (2016). $10,345 per person U.S. health care spending reaches hot peak. Retrieved from http//www.pbs.org/newshour/rundown/new-peak-us-health-care-spending-10345-per-person/.McKesson. (2017). What Payment Models Exist. Retrieved from http//www.mckesson.com/population-health-management/resources/what-payment-models-exist/.Miller, H.D. (2009). From volume to value better ways to pay for health care. Health Affairs (Millwood) 28(5)1418-28. Retrieved from http//content.healthaffairs.org/content/28/5/1418.full.Patrick, J. (2016). Is Health Information Technology Imperative for Payers? Retrieved from http//healthpayerintelligence.com/news/is-health-information-technology-imperative-for-payers.Wilson, K. B. (2016). Health Care be 101 ACA Spurs Modest Gro wth. Retrieved from http//www.chcf.org/publications/2016/12/health-care-costs-101.Yong, P.L., Saunders, R.S., and Olsen, L.A. (2010). The Healthcare Imperative Lowering cost and Improving Outcomes Workshop Series Summary. Institute of Medicine (US) Roundtable on Evidence-Based Medicine. Washington (DC) National Academies Press (US) Payment and Payer-Based Strategies 11. Retrieved from https//www.ncbi.nlm.nih.gov/books/NBK53906/.