CSM The American Hospital Association a Community Hospitals Essay
- June 23, 2022/ Uncategorized
The mission of each and every hospital in America is to serve the health care needs of the people in its community 24 hours a day, seven days a week. But, hospitals’ work is made more difficult by our fragmented health care system — a system that leaves millions of people unable to afford the health care service they need. Hospitals deal with more than 1,300 insurers. Each has different plans and multiple and often unique requirements for hospital bills. Add to that decades of government regulations, which have made a complex billing system even more complex and frustrating for everyone involved. In fact, Medicare rules and regulations alone top more than 130,000 pages, much of which is devoted to submitting bills for payment. Today’s fragmented health care system leaves hospitals with a daily balancing act to maintain their mission to the community while making ends meet. However, federal laws and regulations require hospitals to maintain uniform charge structures. Payments do not correspond to those charges. What a hospital actually receives in payment for care is very different.
With this statement as a backdrop,
The AHA (American Hospital Association) identifies 6 groups of hospitals:
- Identify the different types of hospitals, and what percentage of the whole each group is.
- What is the primary mission of each group, and who is the primary patient population?
- What sources of funding each group looks for and what percentage of funding (Medicare, Medicaid, private, etc.) each group receives?
- How do payment rates get determined?