Free «Healthcare Finance» Essay Sample

The article is of the opinion that the implementation of the near-universal coverage as planned under the Affordable Care Act for 2014 and passed by the Massachusetts legislature in 2006 would tremendously increase pressure on the government to start controlling the entire spending in healthcare. Therefore, the article asserts that there would be increased concern about the amount of costs incurred by individuals in trying to access healthcare services within the state. Moreover, the government would be under pressure to monitor the costs that are incurred by individuals in accessing healthcare in order to ensure that they are not overcharged by providers.

Another significant opinion in the article is that the effectiveness of the new costs in the healthcare sector would significantly depend on the changes in the behaviors of providers and insurers. The changes in the behaviors of both private and public workers of healthcare would immensely determine the effectiveness with which the new costs would be utilized to improve the quality of healthcare within the state. Additionally, the private market activity has had a complementary impact on the pace at which the healthcare system is changing. The article also suggests that the emphasis on global payment by Massachusetts State would also affect the overall effectiveness of the costs of healthcare (Pizzi n.d.).

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The article argues that healthcare costs are increasing at a faster rate than the growth in the economy. Individuals are facing more hardships as they incur increased expenses on accessing quality healthcare within the state. Families and businesses that are unable to keep up with the high costs of healthcare have been forced to face immense difficulties. It is argued that the payment of healthcare within the state is not always value-based and the providers of healthcare within the state have continued to be compensated widely with different rates even as they provide a similar quality of healthcare services in the state.

The article states that value-based purchasing and the promotion of consumers’ access to quality healthcare can be promoted significantly. Firstly, the state could prohibit or discourage healthcare contracts that inhibit the innovation of healthcare products and consistently create market disparities. This would ensure that there is fairness within the market and access to healthcare. Additionally, standardization and transparency could be increased in healthcare payment hence boosting the provision of value-based purchasing by both employers and the consumers of healthcare (Kliff n.d.). All participants could also be engaged in the development of a value-based healthcare market by creating tools for decision-making and insurance products that encourage most employers and all consumers to make healthcare decisions in the wisest possible manner. Lastly, the function of the market could be improved by introducing reform measures that would significantly account for and do not exacerbate the market dynamics that are already existing hence ensuring that people do not incur high costs on the same quality of healthcare.

The article also argues that the prices paid by health insurance companies to physician groups and hospitals extremely differ within the same geographical area and the different health providers offering similar health services. The article reiterates that the disparities in the prices that are paid by individuals to different providers are not brought by the quality of healthcare as almost all these healthcare institutions offer the same quality of healthcare (Lizza n.d.). The variations in the prices by individuals for healthcare services are correlated to market leverage within the same geographical areas of healthcare provision. These variations among providers per member per month cannot be correlated to the methodology that is utilized in the payment of healthcare. Therefore, it is vital to note that the contracting practices in healthcare have immensely distorted the commercial healthcare marketplace hence perpetuating disparities in the amounts paid by different individuals.


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