The Health Care Market Research Papers Examples
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The health care delivery system in the state of Maryland is not universally enjoyed by all the people. Such is the case with all the health care delivery systems in the various states of the US. There are various subsystems that are developed by the need of the population or by market forces. Some of these subsystems include managed care, military care, vulnerable population care, and integrated delivery (JBLearning, 2015). The state of Maryland has a diverse population that is concentrated around Washington and Baltimore. Only 10% of the population in Maryland lives in the rural areas. The people living in Baltimore face more health problems compared to the other people in other parts of Maryland. The cause of the poor health in Baltimore is attributed to use of tobacco; low access to health care; and poor education (JBLearning, 2015). Howard County is located 20 miles from Baltimore, and it is ranked as having the best health status in the state of Maryland.
The state of Maryland has 60 hospitals out of which 15 are in Baltimore City (Steinwald, Edmunds & Fairbrother, 2013). There are 18 systems are located in Federal health centers. The rural areas of Maryland have limited access to health care centers and health care providers. The state of Maryland has Health Enterprise Zones (HEZs) that fund projects aimed at improving the health conditions in the state (Steinwald et al., 2013). The state also possesses a Health Benefit Exchange that enrolls the consumers into the correct health insurance plans.
The health care structure of Maryland consists of subsystems such as managed care; military care; vulnerable population care; and integrated delivery (Steinwald et al., 2013). Managed care is a system that aims at achieving efficiency through the integration of the health care delivery functions; uses mechanisms in the management of medical services; and determines the price of health services as well as the payment of health providers (JBLearning, 2015). Managed care is the main health care delivery system in the US. A majority of Americans are able to access the managed care system. The managed care system is financed by the government or the employer. The financiers make arrangements with managed care organizations (MCO) such as PPO or HMO to provide health plans to the employees. The MCOs play the roles of insurance companies by providing health care to the employees under the health plans.
The military care system is availed to the military personnel free of charge (JBLearning, 2015). The beneficiaries of this health care system include the Navy, Coast Guard, Air Force, the US Army, NOAA (National Oceanographic and Atmospheric Association), and personnel in the Public Health Service. The military health care system is highly integrated, and well organized. The system covers both treatment and preventive services. The family members and dependants of the military personnel are also treated at the military hospitals, and can be covered in a program called TRICARE. The financier of TRICARE is the military. The beneficiaries of TRICARE can receive health care from military as well as private medical centers (JBLearning, 2015).
The vulnerable population care is available for those people who are uninsured and poor (JBLearning, 2015). The vulnerable population comprises of people who are considered as minorities and have immigrant status (JBLearning, 2015). People living in communities that are economically or geographically disadvantaged are also considered as part of the vulnerable population. These people receive health care from health providers who are referred to as “safety net” (JBLearning, 2015). Such health providers include emergency departments, physicians’ offices, health centers, and outpatient departments. The health centers are developed with the intention of taking care of the people who cannot afford health care. The safety net providers offer medical services that are aimed at enabling and caring for the needs of the vulnerable populations.
The integrated delivery system (IDS) creates links among the insurers, physicians, and hospitals. The US has taken wide efforts to encourage the integration of the various health care providers. The aim of IDS is to enable people to gain access to a health care organization that is capable of delivering a wide range of services. An IDS is defined as a group of organizations that provide services or makes arrangements for the provision of services to a specified population (JBLearning, 2015). The IDS can be held responsible for the health outcome of a population that is using its services.
The major determinants of health care market power include the private and public sectors of the economy. They influence the supply of the health care services to the consumers by financing the health care service providers. The suppliers of the health services include the hospitals, the physicians, and insurance companies. The US has provided incentives to the health care providers by encouraging interactions and integration systems. These competitive interactions affect the quality, price, and quantity of the health services that are availed to the public. The private sectors provide a higher percentage of financing compared to the public sector (Gaynor & Town, 2012). The impact of this action is that the quality, price, and quantities of these health services are determined by the buyers and sellers in the market. The public sector sets prices for the health services, but these are affected by the interactions of the service providers with the consumers.
The demand for health services is high because people are exposed to various factors that influence the conditions of their health. The type of health care service a person demands is dependent on the social and economic conditions of the person (Gaynor et al., 2012). A person with a large amount of income is more likely to demand for high quality health services. Such people buy insurance plans that are expensive so that they can have access to a wide variety of medical services. People who hold powerful positions in their communities are more likely to choose the best insurance policies that are available. Some of the powerful people get access to these insurance policies based on their position.
The main competitive forces in the health care delivery system of Maryland include the public and the private sectors. Both sectors finance the delivery of health care services, but the private sector has a higher percentage of financing in the market (Steinwald et al., 2013). The private sector is, therefore, able to influence the price, quantity, and quality of the health services. The government set up prices for the health services, but these change over time due to the forces of demand and supply in the market (Gaynor et al., 2012). The health care system operates under a market that is imperfect. The private sector is comprised of hospitals, insurance companies, and physicians. The private sector dominates the market such that there the government cannot have full influence over the market.
The supply of health care services is affected by the scarcity of resources. The production of health care services requires resources that are scarce, thus influencing the price of these services. The demand for the health care services is more than the supply; therefore, the prices of some of the services are very high (Gaynor et al., 2012). The insurance plans are designed to suit the varying income levels of the consumers. There are some insurance plans that cover only a few health services while others cover a wide range of health services. The consumers buy these plans based on their income levels. The quality of care is high depending on the amount of money a consumer pays for the health care service. Systems such as vulnerable population care provide health services that are meant to cater for the needs of the poor. The safety net providers who avail health care services to the poor are face with the pressure of a high number of patients (JBLearning, 2015). The revenues for such providers are limited because they cannot transfer the costs to insurance companies.
The health care service providers are compensated by either the government or the insurance companies. The safety net providers are not secure when it comes to compensation because the vulnerable population keeps on increasing (JBLearning, 2015). The increase in the population leads to more costs in the provision of the health care services. These safety net providers need to expand so that they can meet the high demand of the consumers of their services. The financing provided by the government is sometimes not enough to cater for the entire population (JBLearning, 2015). Consumers have the habit of acquiring services in larger amounts so that they can feel safer. Some consumers demand more health care services so that they can feel protected. The insurance companies have to come up with plans that suit the needs of these consumers. Some of the demands placed by consumers require the structuring of new policies (Gaynor et al., 2012).
The benefits of HMO managed care to the health care provider include the availability of finances at specified times; and the possibility of making profits out of the fees that the provider receives monthly (CSUS, 2015). The disadvantage of HMO to the provider include the possibility of making losses if many people who are covered fall sick; the increase in cost of service during the contracted period does not lead to increased fees until the contract period ends (CSUS, 2015). The benefits of HMO to the patient include the availability of health care service at any given time; the patient only has to present the HMO member card to receive services; and the patient does not have to worry about incurring major expenses on health (CSUS, 2015). The disadvantages of HMO to patients include the patients may have to wait for long periods to get appointments; the patients only gain access to physicians who give primary care; and the patients are not able to get specialized care unless they are referred by the primary care physician (CSUS, 2015).
The health care service providers in Maryland are provided with incentives aimed at motivating them to deliver high quality health care services. Some of the incentives include providing them with salary increments; and providing them with training on new technologies so that they can grow professionally (CMS, 2015). These incentives are effective in motivating the service providers to provide high quality health care services to the patients. Salary increment is a great motivator, and it makes the physicians work harder so that they can enjoy such benefits. The opportunity to develop their skills boosts the confidence of the health care service providers, and enables them to implement their new skills in the workplace.
The consumer-driven plan bears the financial risk of a capitation payment system. A capitation payment system is where the physicians are paid certain amounts based on the people that are assigned to them (JBLearning, 2015). The plan itself bears the financial risk by focusing on preventive measures rather than treatment. Treatment may require the use of expensive equipment and technology that may increase the costs incurred by the service provider. The system, therefore, empowers patients to use preventive measures that will help in avoiding unnecessary costs.
JBLearning, (2015). Major Characteristics of US Health Care Delivery. JB Learning. Retrieved from: http://www.jblearning.com/samples/0763763802/63800_CH01_Final.pdf
Steinwald, B., Edmunds, M. & Fairbrother, G. (2013). Transforming Health and Health Care: Focus on Maryland. Academy Health. Retrieved from: http://www.academyhealth.org/files/publications/TransformingHealthcareMtg2013.pdf
Gaynor, M. & Town, R. J. (2012, Jan). Competition in Health Care Markets. University of Bristol. Retrieved from: http://www.bristol.ac.uk/media-library/sites/cmpo/migrated/documents/wp282.pdf
CSUS, (2015). Advantages and Disadvantages of HMO Health Insurance. CSUS. Retrieved from: http://www.csus.edu/indiv/h/heflintl/group/section-1/group-5/Website/advantages_and_disadvantages.htm
CMS, (2015). EHR Incentive Programs. Centers for Medicare and Medicaid Services. Retrieved from: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms/
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