Revenue Trends That Affect the Healthcare Industry, Research Paper Example

One of the current trends in healthcare today is the movement of physicians from private practice into the hospital setting. They often choose this move due to the financial benefits of working for a larger entity versus working for ‘themselves’ as well as having a lower risk of liability, malpractice insurance, and overhead that normally comes with owning a private practice. Also, many hospitals in more rural areas are now catering to new graduates in the hopes of obtaining them at lower salaries but offering them assistance with student loan repayment and health packages if they commit to working for a predetermined number of years at the hospital in question. This is appealing to some new graduates who find that they graduate from medical school and often have a difficult time securing the residency they hoped for and also find themselves in insurmountable debt from the past several years. It seems like a win-win situation.

Another revenue trend affecting the healthcare industry is the implementation of the electronic medical record system. This system, while not necessarily easy to learn in the beginning, has shown great potential in being proactive at preventing and decreasing patient medical errors with medications and medication dosages from the pharmacy department to the nursing units (Yates, 2007). It will inevitable save the healthcare industry millions of dollars and thousands of lives in the long term once the system is fully implemented nationwide due to the standardization of prescription protocols and the way medications are entered into the system, dispensed to medical personnel, and administered to patients. While it is a positive benefit to the healthcare profession, the patients are the ultimate winners in this situation because they are the individuals who will reap the benefits of receiving the correct medications at the correct times in the correct dosage increments (Yates, 2007).

Identify and describe how different types of healthcare entities are affected by economic hardships:

Healthcare fraud is one of the most costly and preventable causes of hardship in the medical industry. The costs associated with healthcare fraud are exorbitant and can be avoided, unfortunately many companies and individuals would rather choose to be dishonest and commit fraud rather than actually bill clients for the services they receive and diagnose clients properly instead of misdiagnosing them in order to justify their insurance claims (Office of Inspector General, 2012). A common example of healthcare fraud would be to perform laboratory tests on an individual that are not medically necessary or even needed in order to collect money from federal and state government funding agencies.

Another example of healthcare fraud committed by physicians and hospitals or other institutions is the double billing of medical visits and routine procedures for patients that are performed every day. Many times these will be billed directly to the patient and also to the insurance company or to the state or federal government that provides assistance for the patient’s medical care (Office of Inspector General, 2012). This is fraud because the state, federal, or private insurance will pay the claim and the patient will many times be expected to pay the claim as well. Alternately, the procedure may be billed in duplicate as if two different procedures were performed when there was only one procedure performed and the insurance or government assistance agency will pay twice for one procedure.

References

Office of Inspector General. (2012). Health care fraud and abuse control program report. Retrieved from U.S. Department of Health and Human Services: http://oig.hhs.gov/reports-and-publications/hcfac/index.asp

Yates, C. (2007). Implementing a bar-coded bedside medication administration system. Critical Care Nursing Quarterly, 30(2), 189-195.