create a case study from the interview with Dr. Steven Safyer, President & CEO Montefiore Health...

create a case study from the interview with Dr. Steven Safyer, President & CEO Montefiore Health System.

• How does financing and reimbursement affect delivery of care? Health insurance affect health care delivery in the us that it makes providers less aware of the actual cost of health care it creates provider induced demand, this financing greatly influences how much health care is delivered.

• How does reimbursement differ in the delivery of outpatient vs inpatient care? Reimbursement varies most significantly by insurance company, more insurance compaines do reimburse inpatient and outpatient serrves very differently, but some smaller insurance companies may reimburse according to simple criteria, medicares inpatient prospective payment system reimburses a weighted fee schedule of rates by diagnosis related group based upon the average cost of cost across the mations providerrs for that particular set of health issues, and medicare outpatient reimbursement fits into one of two scenarios that is clinic( a freestanding primary ) and hospital( procedures performed wither at the hospital or at a clinis located within 35 miles of the hospital that own and operate the clinic) there reimbursed accordingly to the ambulatory payement classification.

• How do Managed Care and Integrated Systems impact the cost, access, and quality of health care delivery? Managed care and integrated systems has positive impact on the cost and access and quality of health care delivery.

• How has Legislative Health Policy impacted the delivery of care? Legislative health policy impacted the delivery of care:the health care delivery system continue to evolve by the market forces, and as do legal and regulatory changes resulting from health reform leggislation.

• What is the future of health services delivery? The future of health service delivery: insurances drop individual plans because they do not comply with some of the mandates and employers cope by reducing worker hours and negotiating new health plans and the us healthcare system will continue to evolve but no one knows the destiny.

Solutions

Expert Solution

Health policy and health care delivery

Purpose

The case study focuses on the effect of health insurance or health policy on the delivery of health care.

Scope- This case study will help to understand the effect of health insurance policy on quality of health care as discussed by Dr steven safyer, president and CEO Montefiore health system.

Findings-

- Health insurance affect the health care cost, as the provider is unaware of the actual cost of health care. Demand for the health supplies increases more than its need, which can lead to wastage.

- Integrated and managed care can reduce the cost of care by providing all the needs in one setting

- Also the access to the health care facilities can be easier with an integrated and managed care

- legislative health policy changes according to the market demand and ao the legal and regulatory changes takes place according to health reform legislation

-Future of health services will continue to evolve and no one knows the destiny

-Reimbursement for outpatient and inpatient differ from insurance company to company. Some provide inpatient reimbursement according to the fixed price structure based on the diagnosis. There is no reimbursement for some outpatient services while some provide according to the ambulatory payment classification.

Nightingale answered 1 year ago

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