PUBHLTH 129 Lecture Notes - Lecture 13: Standard Cost Accounting, Unnecessary Health Care, Managed Care

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Administrative costs are very high in the us compared to other national systems. How we get our healthcare payed for: public, government- one payer, medicare, medicaid, private, several varying insurance plans. Attempt to control cost involved bending the cost curve. Key terms: balance bill, beneficiary, benefit period. Third party payers: insurance companies, managed care organizations, blue cross, government. Reimbursement: payment made by third party payers to the providers of services. Fee for service: (cid:272)harges set (cid:271)y pro(cid:448)iders (cid:894)pro(cid:448)iders do(cid:374)"t k(cid:374)o(cid:449) the true (cid:272)ost of their ser(cid:448)i(cid:272)es(cid:895), services are billed separately, providers could balance bill (reimbursement methods), led to cost escalation. Put us in a bad place for healthcare cost, came from long ago and still is with us today. Charges are set by the providers that determine what the cost should be. The incentive that fee for service has set up providers will earn more for the more that they do.

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