Healthcare Third-party Payment from insurance companies Discussion Comment
Healthcare Third-party Payment from insurance companies Discussion Comment
Purpose: Comment on the Discussion
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- Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.
- 1 References, find resources that are 5 years or less
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To Comment:
Discussion Topic 1: Third-party Payment from
Healthcare is driven not by patient care but by insurance companies. The patient is no longer considered the customer, insurance companies and our government are the customers (Stafford, 2012). Private insurance companies are often referred to as third-party payers (U.S. Department of Veteran Affairs. (n.d.). According to Stafford, “Third-party payers have so many requirements and expectations that they crowd out whatever time, energy, and resources might otherwise be focused on patient care” (2012). The third-party payment system has also made it difficult for some physicians to remain in practice because of rising costs and demands associated with third-party payers (Stafford, 2012). A study showed that third-party payers complicated the discharge process when the hope was that it would make things smoother and more efficient (Drew, Angeli, Dave & Pavlova, 2016). Basically when a third-party payer is involved, there is no specifics about costs for treatments and supplies.
Medicare somewhat sets the standards for reimbursements for other private insurance companies to follow (Nickitas, Middaugh & Aries, 2014). It is also the plan that provides health insurance coverage for our elderly aged 65 and older. Unfortunately, our elderly population deal with many different health conditions that can be very costly to the private insurance sector (Nickitas, Middaugh & Aries, 2014). Another factor is that most elderly are retired and not working anymore which does not qualify them to take in employer sponsored health insurance plans that help offset costs to the consumer.
Drew, B., Angeli, F., Dave, K., & Pavlova, M. (2016). Impact of patients’ healthcare payment methods on hospital discharge process: evidence from India. International Journal
of Health Planning & Management, 31(3), e158-e174. doi:10.1002/hpm.2310
Nickitas, D. M., Middaugh, D. J. & Aries, N. (2014). Policy and politics for nurses and other health professionals. (2nd ed.). Jones & Bartlett.
Stafford, K. (2012). Patient-centric? Third-party payers interfere…J Fam Pract. 2012 Feb;61(2):70. Journal of Family Practice, 61(4), 187.
U.S. Department of Veteran Affairs. (n.d.). VHA office of community care. Retrieved from https://www.va.gov/COMMUNITYCARE/revenue_ops/payer_info.asp
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