The Single Payer Reimbursement System - 1608 Words

What is a Single Payer Reimbursement System? Single payer reimbursement is a health care financing system that â€Å"includes both the collection of money for health care and reimbursement of providers for health care costs.† In such a system, the government or a quasi public agency is the entity that bears full responsibility of collecting funds and reimbursing appropriate parties, but the provision of care remains in private hands. Through taxpayer funds, the government collects money from individuals and businesses, and then reimburses providers who delivered health care services to those individuals enrolled in the public health insurance program. (http://www.pnhp.org/facts/what-is-single-payer). Current Healthcare Financing System in the United States The United States currently employs a multipayer system. The payers in this system include the government and private insurance companies., thus the collection of money for health care is a joint responsibility of both parties. Private insurance companies collect premiums and other payments from enrolled individuals and businesses. The government collects taxes from individuals and businesses. Regarding reimbursement, the private insurance industry reimburses providers for health care services delivered to privately insured individuals, while the government reimburses providers for health care services delivered to publicly insured individuals (e.g. people enrolled in Medicare, Medicaid, S-CHIP, or the VA). A Comparison ofShow MoreRelatedHigh Technology Solutions For Preventable Problems1619 Words   |  7 Pagesto preventable problems the characteristics of the medical care culture that encourage the latter approach, describe how the ‘bottom line’ focus has changed the nature of the US health care system and lastly, state my views on the influences that the U.S. insurance industry has on the single payer system concept. High-technology solutions to preventable problems Medicine in the 21st Century has continued to push the boundaries of science to unthinkable limits, oftenRead MoreThe Issue Of Healthcare Reform1570 Words   |  7 Pagescontinues to be a topic of discussion among politicians, medical professionals, and many Americans who are struggling to pay for care in a system where costs are skyrocketing out of control. Consequently these costs are forcing many Americans to file bankruptcy due to the massive amount of medical debt that they owe, slowing our economy and reducing reimbursements for medical facilities (Khazan) The debate on how to fix health care continues, even after the Affordable Care Act was passed in 2010 Read MoreModule 2 : Professional Development1728 Words   |  7 Pagesthan prevention, the impact of financial solvency on the health care system and resistance to a single payer system in the United States Keywords: high technology health care, financial solvency, single payer health care system Module 2: Professional Development The purpose of this paper is to address the three questions posed in the second professional development module. Characteristics of High-technology Driven Health Care Systems Throughout the United States a rapidly increasing burden of chronicRead More Canada Healthcare System vs. The United States Healthcare Systems1499 Words   |  6 PagesIt is an interesting debt as to which provides a superior healthcare system. In order to better understand the strengths and weakness of the two systems, this paper will review four important structural and functional elements of each system. 1. Who receives healthcare coverage? 2. How is healthcare delivered? 3. How is healthcare paid for? 4. How is the payment system organized? An analysis of the US and Canada’s systems reveals advantages and drawbacks within each structure. While it is apparentRead MorePolicy Issues in Telehealth Essay1146 Words   |  5 Pagesthat prevent the expansion of telehealth, including reimbursement issues raised by Medicare and private payers, state licensure, and liability and privacy concerns. Reimbursement Issues Reimbursement policies prevent the total integration of telemedicine into health care practice (Prinz, 2008). Today, there is no overall telemedicine reimbursement policy in the federal health care system (HRSA, 2011 OAT, 2003). As a result, reimbursement for telecare has been limited and somewhat haphazardRead MoreSb8-101387 Words   |  6 Pagesassignment is, State Senate Bill 810 authored by Senator Mark Leno; a Democrat from the city of San Francisco and presented in March 2011 as The California Universal Health Care Act. This landmark legislation establishes a modern universal health care system to cover every California resident with comprehensive benefits for life, building upon the well-tested principles of our popular Medicare program that American seniors have relied on for decades. SB 810 provides universal care without increasing overallRead More Value of Health Care Essay1100 Words   |  5 PagesThe Value of Health Care The development of value based healthcare reimbursement systems between healthcare payers and healthcare providers is evolving from the need to provide patients with beneficial healthcare technologies under conditions of significant economic uncertainty. The concept examined centralizes on shifting the focus of the healthcare system from volume to value. Value is measured by outcomes achieved based on a full cycle of care not volume of services rendered based on eachRead MoreThe Market For Generic Drugs1663 Words   |  7 Pagesâ€Å"the fraction of drug spending paid for by public and private payers has grown from 34% in 1980 to nearly 80% in 2000, and 92% in 2010. Thus cash-paying consumers currently account for only 8% of payments†1. Consequently, consumers play little role in generic price competition, leaving public and private payers to account for the lion’s share of payments to pharmacies, as the main driving force3. The large presence of third party payers as final purchasers may distort prices at the retail level relativeRead MoreThe Classification Of E M Services1308 Words   |  6 Pagesby an APRN fall within the APRN’s scope of practice under their state law. Commercial third-party payers do not consistently provide reimbursement for the APRN; however, their rates and policies differ (Buppert, 2005). The APRN submits either current procedural terminology (CPT) codes or evaluation and management (EM) codes for Medicare reimbursement. CPT codes are a systematic listing and coding of procedures or services performed by the APRN. The American Medical Association (AMA) establishesRead MoreSingle Payer Health Care Essay1057 Words   |  5 PagesIs The U.S. Ready for Single Payer Health Care? The beginning of the article started off very strong with the Republican views on how replacing theAffordable Care Act/ Obamacare seems to be beneficial because Americans believe that the government needs to provide healthcare for all which is â€Å"Medicare for all.† Throughout government; the left and right sides do not see eye to eye but in this discussion, they both seem to acknowledge the likelihood of this new system. Republican Senator Jerry Moran