Question

Which of the following individuals and groups are considered intermediaries in the healthcare industry? Choose one or more:

A. pharmaceutical companies

B. professional doctors’ associations

C. health maintenance organizations

D. government provided Medicare and Medicaid

E. insurance companies

F. home healthcare providers

Answer 1

ALL OF THE FOLLOWING OPTIONS ARE CONSIDERED INETRMEDIARIES IN THE HEATHCARE INDUSTRY-

• PHARMACEUTICAL COMPANIES-Pharmaceuticals make their way from manufacturers to distributors to retailers to patients . Distributors play an intermediary role in the supply chain between manufacturers and retailers. They purchase products from manufacturers, provide warehousing services, and ship drugs to retailers. By doing so, they reduce the number of transactions that would occur if each retail pharmacy or health care practitioner or center had to order products directly from manufacturers.
• PROFESSIONAL DOCTORS ASSOCIATIONS-Medical decision making is an organizational process. Even at the level of individual clinical judgment, a myriad of prior "organizational" decisions have been made that affect what appears to be an autonomous clinical judgment made by a trained professional. For example, a surgeon's choice of a given technique for a particular operation has been conditioned by prior decisions, such as the number and types of operating rooms available, types of equipment purchased, the quality and mix of surgical assistants and nursing staff, and the organization of the operating room schedule itself. The surgeon's decision may also be influenced by prior decisions made by the hospital's quality assurance committee
• HEALTH MAINTENANCE ORIGANISTAIONS-A health maintenance organization (HMO) is an organization that provides health coverage for a monthly or annual fee. A Health Maintenance Organization (HMO) is a group of medical insurance providers that limit coverage to medical aid provided from doctors that are under the contract of HMO. These contracts allow for premiums to be lower since the health providers have the advantage of having patients directed to them; but these contracts also add additional restrictions to HMO's members.
• GOVERNMENT PROVIDED MEDICARE AND MEDICAID- GOVERNMENT  created Medicare and Medicaid, which became two of contained provisions for both wage replacement and medical services, such as .... There should also be no commercial or other intermediary agents between the .Federal Government became involved in the field of health care finance.
• INSURANCE COMPANIES- The insurance companies is tightly interrelated with other parts of the health care system. Consequently, many parties play a role in the health insurance market. Health insurers are intermediaries in the transaction of the provision of health care between patients and providers— health insurers are a third-party who reimburse providers on behalf of patients. Health insurers not only reimburse providers, but also typically have some control over the number and types of services covered and negotiate contracts with providers on the payments for health services— most health insurance plans are managed care plans rather than indemnity or traditional health insurance plans that provide unlimited reimbursement for a fixed premium.
• HOME HEALTH CARE PROVIDERS- Home health care includes skilled nursing care, as well as other skilled care services, like physical and occupational therapy, speechlanguage therapy, and medical social services. These services are given by a variety of skilled health care professionals at home.  The home health staff provides and helps coordinate the care and/or therapy your doctor orders. Along with the doctor, home health staff create a plan of care, which is a written plan for your care. It tells what services you will get to reach and keep your best physical, mental, and social well-being. ​

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