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07_finance.md

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Healthcare Financing

  • Economics of healthcare or healthcare economics
    • Economics benefits from data analysis
    • Health Informatics supports Health Economics
  • Financing determines:
    • Who has access, who does not have access to, healthcare
    • Who gets more, who gets less, healthcare
  • Health equity/equality or inequality/inequity
  • ESRD is the only disease with universal coverage in US
    • On 30 oct ober 197 2 President Richard Nixon signed the Social Security Amendments of 1972, one provision of which extended Medicare coverage to persons with chronic renal failure.
    • ESRD patients, who constitute 1 percent of the Medicare beneficiary population, consume 7 percent of all Medicare expenditures.

  • US Health Insurance

  • Influence of Financing on the delibery of healthcare

  • Question: Does more resources (% of GDP spent on healthcare) lead to better health?
  • Market: supply and demand
  • Moral Hazard
  • Adverse Selection
  • Payment Models
    • Fee for Service
    • Bundled Payment (e.g., ESRD)
    • Value-based purchasing
  • Options : Public and Private
  • Public
    • Medicare
    • Medicaid
    • Indian Health Service
    • DoD
    • VA
  • Healthcare Fraud and its prevention