how health care costs nationally impact health care facilities?

Answer 1

Tough question to answer. Given the rising cost of health care, taking into account the escalating number of uninsured, and the aging population, there is a great pressure placed on State and Federal agencies which in turn stresses the individual health care facilities bottom line, which affects their employee's.

Some bits n pieces from the Council on Health Care Economics and Policy:

1.) The number of specialty hospitals tripled between 1990 and March 2003, and the number of ambulatory surgery centers (ASCs) doubled between 1991 and 2001. These specialty providers focus their efforts on specific medical procedures and are thus often referred to as "focused factories." Because of their specialization, they claim that they can perform higher quality medical procedures at lower cost than general hospitals. Some focused factories have demonstrated impressive clinical results.

However, general hospitals are claiming foul! They contend that specialty facilities cater only to the most profitable patients, draining revenue away from community hospitals that need those patients to cross subsidize care for the poor and uninsured as well as other unprofitable services that specialty hospitals don't have to provide.

Complicating the issue is the fact that most of these specialty centers are at least partially owned by physicians who can financially benefit from referring or not referring patients to their own facilities.

Mired in controversy, the federal government has instituted an 18-month moratorium on payments for physician services in cases where physicians have an ownership interest in new specialty hospitals - a policy that effectively halts the development of any new specialty facilities.

2.) With escalating costs, purchasers of health care - principally health plans and employers - are seeking new ways to deliver and measure effective health care. Evidence-based medicine, information technology, pay-for-performance, and the "empowered consumer" all have the potential to reshape the health care delivery system. This conference examined and debated whether each or a combination of these strategies could lead to increased efficiency, quality, or value. We also considered how government and private sector purchasers can encourage promising developments.

3.) Health care spending in the U.S. continues to increase at over twice the rate of general inflation, while, at the same time, deficiencies in quality of care become more apparent. Latest research shows that adults receive approximately half of recommended care for their medical conditions. In response, employers, insurers, and providers have been trying to implement changes in the delivery system to ameliorate cost increases and to improve quality. Many have focused on chronically ill populations, implementing disease and care management programs and structuring the reimbursement system to pay for performance. Some have tried to make consumers more cost and quality conscious through a variety of consumer driven health plans.

4.) The Evolving Federal Role in Medicaid." The Medicaid program is the nation's largest public health insurance program, surpassing Medicare in both the total number of people served and total dollars spent. Declining state and federal revenues, rising health care costs, and increased utilization has led to what many have termed a fiscal crisis. Legislation is pending to increase the flow of federal dollars to the states. In addition, a recent GAO report has called into question whether the new federal waiver policy violates Congressional intent.