Health Care Financing
This week we will talk money and healthcare. The main concern regarding health care is what will something cost. Projections by the Congressional Budget Office (CBP) estimate that the total spending on healthcare will double by the year 2035; and will consume more than 30% of the gross domestic product (GDP) (Longest, 2012).
Medicare and Medicaid remain the biggest of the fiscal challenges for the United States (U.S.) (Longest, 2012). As stated in a previous posts, the Affordable Care Act (ACA) has created the Innovation Center (a segment of Medicare & Medicaid Services) in order to test new health care payment and service delivery models to improve quality of care; and decrease healthcare expenditures for Medicare & Medicaid beneficiaries (U.S. Department of Health & Human Services, n.d.). Currently, the Innovation Center is evaluating 18 major payment and service delivery models. Some of those models are as follows:
- Partnership for Patients: Aims for 40% reductions in hospital acquired conditions; and a 20% reduction in readmissions.
- Strong Start for Mothers and Newborns: Reduce risk of complications and long term healthcare problems for expectant mothers and newborns (U.S. Department of Health & Human Services, n.d.).
Financing and Death with Dignity
Death with Dignity participants will never receive federal monies to pay for lethal prescriptions. In Oregon, the Death With Dignity Act does not specify who pays for the services; and payment is determined upon individual insurers. Insurance companies cannot view lethal prescriptions as a suicidal act during the decision phase of payment (Oregon Public Health Division). If Medicaid is the insurer, only state funds can be utilized (Oregon Public Health Division, 2014).
Financing and End-of-Life
A saving grace for people seeking some form of comfort care at end-of-life is that Medicare Part A does pay for hospice services. The requirement for hospice services include:
- Two physicians (e.g., following and a hospice physician) confirming a terminal diagnosis (6 months or less)
- Agreement to accept comfort vs. aggressive treatments
- Patient (or MPOA) signature providing consent to hospice services
It must be stated that the ACA is now allowing that patients under 21 years of age can seek curative (aggressive) treatments while in a hospice program without the worry of being discharged or paying out-of-pocket for hospice services (Medicaid.gov, n.d.).
Final thoughts on Healthcare and Financing
According to the World Health Organization the goal is for universal health coverage to ensure that all people of the world have the health services they need without suffering financial hardship (WHO, 2015). Some staggering statistics provided by WHO:
- One billion people cannot receive needed health services
- 150 million people suffer financial catastrophe upon receiving health services
- 100 million people are pushed below poverty line upon receiving health services (WHO, 2015).
Please watch this eye-opening video about financing health care. What are your opinions about health care and financing?
Centers for Medicare & Medicaid Services (n.d.). About the CMS innovation center. Retrieved from http://innovation.cms.gov/about/index.html
Longest, B. B. (2010). Health policymaking in the United States (5th ed.). Chicago, IL: Health Administration Press.
Medicaid.gov (n.d.). Hospice benefits. Retrieved from http://www.medicaid.gov/medicaid-chip-program-information/by-topics/benefits/hospice-benefits.html
Oregon Public Health Division (2014). FAQs about Death with Dignity Act. Retrieved from http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/faqs.pdf
United States Department of Health and Human Services (n.d.). HHS FY2015 budget in brief. Retrieved from http://www.hhs.gov/budget/fy2015-hhs-budget-in-brief/hhs-fy2015budget-in-brief-cms-innovation-programs.html
World Health Organization (2011, July 6). WHO: Financing health care. Retrieved from https://www.youtube.com/watch?v=ozcRK688GMs
World Health Organization (2015). Universal health coverage. Retrieved from http://www.who.int/mediacentre/factsheets/fs395/en/