Reimbursement In Healthcare

856 Words4 Pages

The modern healthcare sector remains one of the most important aspects of the evolution of our society. The fact is that the health of the nation depends on the efficient functioning of the given sphere and its ability to provide care to all individuals who have need for it. However, the peculiarities of the modern healthcare, medicines, technologies used to examine patients and diagnose illnesses, precondition the extremely high price for certain services. In this regard, the question of reimbursement becomes extremely topical for the healthcare sector as there are numerous attempts to improve the existing approach and attain lower prices along with better results. Anyhow, the current system peculiar to the USA could be considered extremely …show more content…

The given system is imperfect; however, there is still no other alternative for care providers to obtain money. For this reason, the following patterns could be used. For instance, in case a patient has a medical insurance, a care provided will be paid by the company that cooperates with an individual and guarantees that in case some medical problem appears, funds will be transferred to a medical care unit to assure that the needed treatment will be initiated. Moreover, when a patient falls into a certain category that gives a right to use medical benefits, all spending should be covered by the government that is responsible for the introduction of such special conditions for people with different problems ("Hospital health care payment mechanisms," n.d.). Finally, a person might pay by himself/herself; however, it is the rarest way to pay care providers as traditionally the sum is …show more content…

The fact is that very often the question of payment and reimbursement comes along with ethical concerns. In case a patient is not able to afford treatment, he/she could be deprived of an opportunity to obtain care. For this reason, an ethical dilemma appears ("Healthcare reimbursement & changing rules," n.d.). Thus, a nurse manager always works close to patients aligning cooperation with them and determining their main needs. At the same time, this specialist is also responsible for determining the payment model that could be chosen to pay caregivers and guarantee that treatment will be initiated. In this regard, they should be ready to consider the most appropriate way of reimbursement and whether a patient could use it or not. The given task is very important for the functioning of any healthcare unit as it guarantees that funds needed for its further development will be