One primary key to a successful health care organization is having a strategy to achieve the mission of the organization. This is particularly true in reference to creating a budget and generating revenue for a profitable bottom line of a hospital. Executives are experiencing a gap that is continuously widening between technology and hospital demands, which is causing additional conversation around pricing. According to Nugent (2004), there are three major themes to consider when it comes to strategic pricing. These themes include pricing at the margin (pricing new business to cover variable costs and margin, if capacity exists), cross-subsidizing (funding one service with profits from another service) and testing what the market will bear …show more content…
“Will demand drop if prices are increased, if so, by how much?” This is the question that is asked when speaking of price elasticity, however, this can be hard to evaluate due to price sensitivity. Outpatient services are assumed to be more elastic due to the method of payment with all or a large portion being collected prior to service. When prices are being determined, it is expected that reasonable costs and ROI (typically 8%), and losses from patients are covered. Establishing a price can be done by a method called “across-the-board” which was mentioned earlier or selective pricing which lends to the overall goal of a charge increase by increasing or decreasing each line item code. According to Cleverley (2003), utilizing selective pricing can display a 20-50% improvement in places where recovery is …show more content…
Prices are structured by the concept of supply and demand. Another strategy and even taking strategic pricing further is cost based pricing. This is the act of pricing based on an organizations cost to produce a product (boundless.com). How projects subject to funding are defined, rules for price calculation and rules for updating the prices are another set of standards that should be examined. Accurately estimating the cost of services is pivotal in preventing consequences in the quality of healthcare. This is especially true of diagnosis related groups DRGs. Not only does the United States use DRGs but it has also spread throughout other countries (European countries refer to DRGs as healthbaskets or Euro
The current health care landscape has been characterized by large scale consolidation and vertical integration of payers and providers. This has led to a handful of dominate players with substantial influence, and an increasing overlap in responsibilities between payers and providers. Although payers and providers have traditionally been on opposing sides, battling each other about quality of care versus cost-effective care, they are shifting to working together to achieve better value.
A recent phenomenon in the health services is the burgeoning of outpatient healthcare centers. Particularly vigorous growth has been observed in centers that perform diagnostic tests and simple surgeries and procedures like colonoscopies. At the current state, outpatient care centers outnumber hospitals in Pennsylvania. Furthermore, these centers now perform one of every four surgical and diagnostic procedures in the state (Levy 2006). However, the trend applies nationwide, and other states could easily follow suit. Many critics have commented on the negative and positive aspects of this trend. What remains to be determined are the long term effects (on health and the economy) of this paradigm shift, in terms of the wellness of the community as well as economically. Proponents of the movement have pointed to the lower overhead for these clinics trickling down to lower costs for patients. However, critics skeptically question whether the real benefits are for the patients or simply as a mechanism to stuff physicians' wallets. When considered as firms in the marketplace, it is evident that these two groups, both servicing the health needs of the community, have vastly different balance sheets and income statements. This transfers over to a difference in operational functionality, profitability, and cost structure. Furthermore, the disparity of financial motivations that is visible in the varying profit margins is of concern to the community. All of these are important considerations to be made when considering the economic implications of this new phenomenon.
Pay-for-performance (P4P) is the compensation representation that compensates healthcare contributors for accomplishing pre-authorized objectives for the delivery of quality health care assistance by economic incentives. P4P is increasingly put into practice in the healthcare structure to support quality enhancements in healthcare systems. Thus, pay-for-performance can be seen as a means of attaching financial incentives to the main objectives of clinical care. However, reimbursement is a managed care payment by a third party to a beneficiary, hospital or other health care providers for services rendered to an insured or beneficiary. This paper discusses how reimbursement can be affected by the pay-for-performance approach and how system cost reductions impact the quality and efficiency of healthcare. In addition, it also addresses how pay-for-performance affects different healthcare providers and their customers. Finally, there will also be a discussion on the effects pay-for-performance will have on the future of healthcare.
It would be necessary for a hospital administrator to look closely at ways to lower healthcare costs and provide more efficient care when a large employer like BRPP states they are thinking of relocating their employee inpatient hospital services to a company like InduShealth. InduShealth is offering substantially lower prices for several surgical procedures and a U.S. hospital administrator would not want to lose this large consumer population if it was possible to find more efficient methods of providing healthcare to their patients (McLaughlin & McLaughlin, 2008). One pricing strategy that a hospital administrator could advocate for is a bundled...
Formed in 1998, the Managed Care Executive Group (MCEG) is a national organization of U.S. senior health executives who provide an open exchange of shared resources by discussing issues which are currently faced by health care organizations. In the fall of 2011, 61 organizations, which represented 90 responders, ranked the top ten strategic issues for 2012. Although the issues were ranked according to their priority, this report discusses the top three issues which I believe to be the most significant due to the need for competitive and inter-related products, quality care and cost containment.
Competitive advantage matters greatly to those responsible for the management of healthcare institutions. Together with rapidly escalating healthcare costs, increasingly complex medical technologies, and growing regulatory and legal pressures, healthcare organizations face a critical need to improve the quality of care at reduced costs (Cu...
By early 1988, Augustine Medical executives were actively engaged in finalizing and marketing the program for the patient warming system named Bair Hugger Patient Warming System. The principal question yet to be resolved was how to price this system. Several considerations are required in terms of organizational objectives, demand for the product, customer value perception, buyer price sensitivity, the price of competitive offering, and direct variable costs. The company has two alternatives to price this system, either the skimming pricing strategy or the penetration pricing strategy.
Health care systems rely heavily on good business principles to be successful. Business principles outlines the structure of how a business will be managed and operated. More importantly, it sets standards and establishes core values for consumers. In a health care system, business is sought from patients. This discussion board will discuss three business principles that are necessary to uphold safe, quality, patient-centered care that is financially sound, if the principles are exercised at my current facility, the reasons why the principles are pertinent in health care, and an explanation of why the principles are of significance.
Varying in size, these companies act as a middleman between the patient and the medical facility finance office. All having slight variations, the abundance of insurers can cause confusion and often times incorrect billing. Insurance companies unlike individuals are able to negotiate a discounted payment with the hospital, but at a steep price. Of the considerable amount of money the United States put into the health industry, 35% of it went to paying for administration cost of both the insurer and the hospital (Brill,Steven, pg.34-43, Time). It should be no surprise then that the United States leads the world in every category of health care cost, often times charging twice more than the second most expensive country.
Hospitals were reimbursed using a fee-for-service standard, sanctioning all insurance companies to pay the same prices for hospital services offered by different providers. Due to removing restrictions on hospital prices, hospitals now negotiate reimbursement rates for each payer, thus, causing a substantially difference in prices among payers.
reimbursement determinations. As a result, the camaraderie among physicians has developed into a more aggressive approach to impede competition (Shi & Singh, 2012). Little information is shared with patients in regards to procedures or disease control. The subjects are forced to rely on the internet for enlightenment on the scope of their illnesses (Shi & Singh, 2012). Furthermore, the U.S. health care system fails to provide adequate knowledge on billing strategies for operations and other medical practices. The cost in a free system is based on supply and demand and is known in advance of hospital admission (Shi & Singh, 2012). The need for new technology is another characteristic that is of interest when considering the health care system. Technology is often v...
How Supply, Demand and New Policies Affect the Costs of Medical Supplies, and Healthcare Just like other markets, the costs of medical supplies, healthcare services and insurance premiums are affected by supply and demand. In general, when there is high demand for a product or service and supplies are limited, costs rise. That said, there are other factors responsible for influencing the costs associated with healthcare: These factors include tax increases, additional regulations placed on medical devices and/or healthcare services. The Journal of the American Medical Association (JAMA)
From the A12 redesign proposal, it shows that the current standard cost system is unable to link the reduction in the number of parts to activity reductions and cost savings. The labor-direct-based standard cost system reflects the cost of A12 is distorted. Using the ABC system, according to the activities of A12 allocate the overhead cost to A12 that could find that the current overhead cost of A12 was overstated by the standard cost system. At last, A12 Junction Box could be identified it is an attractive and profitable product, at the same time, it demonstrates the value of ABC.
Another aspect of effectiveness and strength that this system has is to minimize costs. For this reason, doctors only prescribe the necessary medicines or treatments, and patients share costs with other members of the network. So managed to reduce what they have to pay. The Health Care Strategies Center conducted a study in 2003 that established that the average costs of $ 20.46 for pharmacies were the fee-for-service system and $ 17.36 for the capitation
The causes of the increase in cost are new medical technologies, doctor and hospital visits, lab test, and drugs. The cost of these services increasing is causing an increase for both insurances and patients to pay. In order to accommodate for this increase in cost, health insurances raise their premiums to individuals that have to pay directly to them in order to receive the medical services provided without paying full cost. Creating a way to consolidate medical services can lower health care cost and make it more affordable for the public. Also, instead of waiting until a patient needs to visit the doctor or go to the hospital, prevention should be the main focus and not treatment alone.