Certificate of Need Laws Christopher Rice Econ 309 Economic Problems and Public Policy George Mason University Introduction: A certificate of need, in the United States healthcare industry, is a legal document that is required before any acquisition, expansions, or creations of facilities. These regulations exist in many States and even in some Federal jurisdictions. All new hospitals, psychiatric facilities, rehabilitation facilities, nursing home facilities, adult care homes, kidney disease treatment centers, intermediate care facilities for mentally retarded, rehabilitation facilities, home health agencies, hospices, diagnostic centers, oncology treatment centers, and ambulatory surgical facilities must first obtain …show more content…
The intent of certificate of need regulation is to control healthcare costs by limiting the building of unnecessary health services and facilities based on geographic, demographic, and economic considerations. Proponents of these laws believe that unregulated market competition creates incentives for producers to overinvest in equipment and facilities leading overutilization of equipment and over hospitalization of patients in order to cover the increased capital input costs. Medicare and Medicaid make such a large portion in the healthcare marketplace and the pricing of both of these healthcare programs rely on the costs of production in order to compensate physicians and healthcare organizations. Because of how these programs pay for services, regulators believe there is an incentive for providers too build or expand facilities, or acquire more healthcare …show more content…
For their data, they looked at just hospitals in Pennsylvania, three years prior to and three years after 1996, the year the state terminated it certificate of need requirements. They observed that there was a 25% increase in the expansion of cardiac programs in the state but no commensurate increase in the number of coronary bypass graft surgeries performed. Quality, as measured by mortality rate had no significant change. This study from the American Journal on Medical Quality is more focused on the effects of certificated of need laws on the quality of medical care being consumed compared to the previous two studies from the Journal of Applied Econometrics and The Southern Economic Journal. These studies tended to focus on supply aspect of the market and whether or not certificate of need laws had any effect on entry into the market, or the speed at which technology diffuses into a
Strengths Long-standing reputation Provision of quality healthcare Highest rank in patient satisfaction Recipient of Joint Commission accreditation Serving a diverse population Weaknesses Smaller than other four hospitals Decrease in net profit Increase in expenses Significant increase in long-term debt Not-for-profit status Opportunities Changes in government regulations Change in lifestyle Influx of patients due to higher patient satisfaction Cost savings Opening of some outpatient clinics and surgery centers Threats Too much competition
use as a hospital with an obligation to care for any patients regardless of race, color,
In this assignment I am going to describe three different Health and Safety legislations that promote the safety of individuals within a health and social care setting.
Davidson, Stephen M. Still Broken: Understanding the U.S. Health Care System. Stanford, CA: Stanford Business, 2010. Print.
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
The U.S. healthcare system is very complex in structure hence it can be appraised with diverse perspectives. From one viewpoint it is described as the most unparalleled health care system in the world, what with the cutting-edge medical technology, the high quality human resources, and the constantly-modernized facilities that are symbolic of the system. This is in addition to the proliferation of innovations aimed at increasing life expectancy and enhancing the quality of life as well as diagnostic and treatment options. At the other extreme are the fair criticisms of the system as being fragmented, inefficient and costly. What are the problems with the U.S. healthcare system? These are the questions this opinion paper tries to propound.
The United States health care system is one of the most expensive systems in the world yet it is known as being unorganized and chaotic in comparison to other countries (Barton, 2010). This factor is attributed to numerous characteristics that define what the U.S. system is comprised of. Two of the major indications are imperfect market conditions and the demand for new technology (Barton, 2010). The health care system has been described as a free market in
Stephen Jonas, Raymond G, Karen G, “An Introduction to the US healthcare System” 6th Edition, Page 118, 25 May 2007
Doenges, M. E. & Moorhouse, M. F. Nursing Care Plans 3rd ed. 1993 F.A. Davis Company, Philadelphia
The state is responsible for the overall regulatory, supervisory and fiscal functions as well as for quality monitoring and planning of the distribution of medical specialties at the hospital level (Schäfer et al., 2010). The 5 regions are responsible for hospitals and for self-employed health care professionals, whereas the municipalities are responsible for disease prevention and health promotion rel...
According to Harry A. Sultz and Kristina M. Young, the authors of our textbook Health Care USA, medical care in the United States is a $2.5 Trillion industry (xvii). This industry is so large that “the U.S. health care system is the world’s eighth
Healthcare is considered of one of the most complex business models in the American Industry because it is one of the only industries where the consumer actually does not technically pay for the service he or she receives (Kudyba, 2010, p. 2). When consumers go to nail salons or hair salons, he or she pays the beautician for the specific service he or she asks for. In the healthcare industry it is totally different and most consumers do not understand the complexity of this business model. The consumer actually pays insurance companies and the insurance companies pay the provider/hospital based on negotiation arrangements from the data exchanges they receive (Kudyba, 2010, p. 2).
Capitation is “a system that paid doctors a set fee from which they had to care for all of their patients, the sick and the well.” (Mark David, 1999) Managed care became in existence and produced changes in the consumer’s roles in the healthcare field it caused a great emphasis on preventive medicine and being accountable for your own health. By the 1990’s communications added more consumer advancements offering information through the World Wide Web. This grew into an alternative medication for most Americans. Computers allowed patients to practice “telemedicine” which is a system that used the Internet so that patients could be diagnosed and sometimes even treated by doctors at a distance.
In today’s healthcare system, there are many characteristics and forces that make up the complex structure. Health care delivery is a complex system that involves many people that navigate it with hopes of a better outcome to the residents of the United States. Many factors affect the system starting from global influences, social values and culture. Further factors include economic conditions, physical environment, technology development, economic conditions, political climate and population characteristics. Furthermore the main characteristics of the Unites States healthcare system includes: no agency governs the whole system, access to healthcare is restricted based on the coverage and third party agencies exist. Unfortunately many people are in power of the healthcare system involving multiple payers. Physicians are pressured to order unnecessary tests to avoid potential legal risks. Quality of care is a major component; therefore it creates a demand for new technology. A more close investigation will review two main characteristics and two external forces that currently affect the healthcare delivery system. Furthermore, what will be the impact of one of the characteristics and one of the external forces in review with the new affordable care act 2010? The review will demonstrate the implications to the healthcare delivery system and the impact on the affordable care act 2010.