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Medical Care for an Aging Population

#Sample College Research Paper

Description of the Issue

            Medical care for an aging population is greatly associated with high costs that pose serious economic challenges to the U.S. Moreover, recent reports have shown a rather peculiar trend that is expected to impact the health care economy in terms of increased expenditure. For instance, it is projected that life expectancy would continue to rise in the coming years. On the other hand, birth rates would decline owing to the fact that most American couples are showing preference for smaller families (National Institute on Aging, 2015).

            The aforementioned trend has serious economic impacts. Firstly, there is high likelihood that the aging population will strain the existing federal programs such as Medicaid, Medicare and Social security. This is especially true considering that most senior citizens lack retirement savings hence; they would have to rely on these programs. Secondly, there is a smaller portion of the population contributing taxes owing to the rising life expectancy rate and decline in birth rates, which means it would be a challenge to sustain the elderly who in general are less productive and consume more (Dall et al., 2013).

Methods and tools common to addressing economic challenges in the health care industry

            There are various methods and tools available for addressing economic challenges in the health care industry. Some of the notable tools and methods include; trend analysis, cost benefit analysis, reimbursement control and payer mix analysis (National Institute on Aging, 2015). To begin with trend analysis, it is a tool used by the federal government to analyze data on health care spending, health insurance market, access to care and pharmaceutical expenditure growth. Cost benefit analysis on the other hand is an important decision making tool that is used to evaluate a given intervention to determine whether the benefits outweigh the costs. As for the payer mix analysis, this is a method used to determine the dominate payers for a particular medical condition in a bid to advance education and other intervention methods to reduce the prevalence of the medical condition in question.

How the methods and tools identified relate to health care reform

            There is indeed a relationship between the methods and tools identified and health care reform. For instance, trend analysis relates to health care reform in the sense that it analyzes patterns in services and derive action plans to address health care spending. Cost benefit analysis also relates to health care reform in the sense that it affects the allocation of funds and benefits rendered. It also helps in eliminating expenditures that are considered non-beneficial. As for the payer mix, the relationship with health care reform is that it affects reimbursement schedules (National Institute on Aging, 2015).

The most effective method(s) and tool(s) that could be used to resolve the economic issue selected

            The most effective method and tool that could be used to resolve the issue of medical care for an aging population is cost benefit analysis. This will enable caregivers to determine whether the benefit of proposed solutions or interventions outweigh the costs (National Institute on Aging, 2015). For instance considering the proposed solution of home and community based services as opposed nursing home placement, cost benefit analysis could help to determine whether the benefits of advocating for home and community based services outweigh the costs and hence make the right decision regarding the method.

Payment sources and mechanism used in the health care industry

            Generally, there are three payment mechanisms used in the health care industry. They are; direct private financing mechanisms, direct public financing mechanisms and indirect payment mechanisms (National Institute on Aging, 2015). Under direct private financing mechanisms, payment sources include; uncompensated care, self-pay, fee-for-service/indemnity insurance and managed care’s transformation of commercial insurance. Payment sources under the direct public financing mechanisms on the other hand include; Medicare, Medicaid and managed Medicaid. In addition to direct funding of health care services by both public and private payers, hospitals have other sources that can be classified as other operating and non-operating income. Other operating income include discounts from purchases and leased land rental revenue whereas non-operating income comprise of unrestricted gifts, gains on the sale of hospital properties and unrestricted income from endowment funds among others (National Institute on Aging, 2015).

The most effective payment source(s) and mechanism(s) to resolve the economic issue

            Narrowing focus to the issue of medical care for an aging population, the most effective payment source and mechanism would be self-pay under direct private financing mechanism. This is because Medicare does not cater for all health care expenses hence, there’s likelihood that the elderly will run out of out-of-the-pocket expenditure and choose to rely on Medicaid hence, causing serious economic strains. On the other hand, Home and Community Based Services (HCBS) have the potential to reduce long-term costs of care and to delay or prevent nursing-home placement (Spillman & Lubitz, 2000). Their cost is also relatively low as compared to receiving care in a nursing home. With this choice, the federal programs will be less strained due to increase in adult population and also the elderly will be in a position to acquire affordable and timely services that will prevent serious issues.

Steps needed to implement the proposed solution

            Implementing the proposed solution is not an easy task hence, the need to follow a number of steps. First and foremost, there is need to carry out an initial assessment of the cost benefit analysis to ascertain whether the benefits of the proposed solution outdo the costs. Once this has been determined, the next step is to expand lower-cost HCBS in the public to ensure both the elderly in the metropolitan and rural areas access services. Next, health care providers need to conduct awareness to educate the elderly on the benefits of Home and Community Based Services. Lastly, the proposed solution needs to be evaluated for a considerable amount of time to ascertain its effectiveness in addressing the economic issue at hand.

Conclusion

            In conclusion, it is worth noting that while medical care for an aging population is expensive and negatively affects the economy, there are methods that can be used to salvage the economic situation. One such method is choosing effective method(s) and tool(s) to resolve the issue and another method is to choose effective payment source(s) and mechanism(s) to resolve the same. This could really have a positive impact on the U.S economy and therefore, should be taken into consideration by the relevant stakeholders.

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References  

Dall, T. M., Gallo, P. D., Chakr, R., West, T., Semilla, A. P., & Storm, M. V. (2013). An Aging Population And Growing Disease Burden Will Require ALarge And Specialized Health Care Workforce By 2025. Health Affairs, vol. 32 no. 11.

National Institute on Aging. (2015, January 22). Assessing the Costs of Aging and Health Care. Retrieved March 5, 2016, from National Institute on Aging: https://www.nia.nih.gov/research/publication/global-health-and-aging/assessing-costs-aging-and-health-care

Spillman, B. C., & Lubitz, J. (2000). The effect of longevity on spending for acute and long-term care. New England Journal of Medicine, 342(19), 1409-1415.

 

 

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