One of the biggest challenges of modern medicine is the delicate balance between efficiency and individualized care. Spending too much time on each patient creates emotional and administrative burnout, but spending not enough time with a patient greatly diminishes the quality of care. Particularly in the US, the negative effects of this are seen as […]
Despite the existence of many different insurance plans and models, there is still a significant uninsured population in the US. While there are many reasons for this, the result is a fragmented healthcare system. Insurance options in the US range from public options that you’ve already learned about, like Medicare for the elderly and CHIP […]
Managed care is one of the most popular systems of health insurance. It is designed to ensure the efficiency of a wide variety of healthcare services. Managed care aims to secure an overall high level of quality, while also reducing prices and overall utilization. This is especially true for the usage of expensive or unsubstantiated […]
Now that we have covered how enrollees pay insurers, let’s take a closer look at how insurers reimburse providers. The two methods are at opposite ends of the spectrum: fee-for-service (FFS) and capitation. With fee-for-service, the provider gets paid a fixed, agreed amount for each individual service. In this plan, the insurance company is burdened […]
Now that you’re an expert on Medicare it’s time to learn about the second tier of public insurance programs: Medicaid. While they are similar in name, these two insurance programs are significantly different. For starters, Medicaid is run by the federal government and covers uninsured Americans with incomes up to 138% of the Federal Poverty […]
Insurance if often a deciding factor in whether or not patients will seek out specific treatments. The high cost of healthcare has resulted in a reliance on insurance to make costly procedures, medications, and therapeutics more accessible to the public. As a healthcare company looking to break into the US market, you must understand the […]
The health insurance landscape in the US involves both public and private components. Typically the majority of individuals over the age of 65 use a type of public insurance called Medicare, while those under 65 use a variety of types, including private options. Private insurance has deep roots in US history, going back to the […]
The concept of federalism, or the sharing of political power between federal and state governments, is important for the American governmental system. Healthcare is no exception to this, and federalism can be seen in how regulation is divided by federal programs, regulatory bodies and state governments. The US federal government regulates overall health insurance policies, […]
Insurance is typically needed for markets that have a high amount of financial risk and high degree of unpredictability. Most types of insurance, such as for your car or for your house, do not cover routine operations, such as an oil change or everyday maintenance. Health insurance is similar in the amount of risk and […]
Compared to other similarly developed countries, the US has the greatest amount of healthcare expenditures and the worst healthcare outcomes. This is in part due to its convoluted insurance/payment systems and the degree of variation present in the country—not only is it geographically expansive, but it is also diverse in virtually every other aspect. More […]
