I’m working on a health & medical discussion question and need support to help me study.
please respond to this 4 peers’ Discussion Prompts
- Your responses should include elements such as follow-up questions, a further exploration of topics from the initial post, or requests for further clarification or explanation on some points made by the classmates.
- APA 7th edition formatting and citation.
- (50-100 word each)
Assisted living centers play a vital role in caring for the elderly and the disabled. Here, a businessman wants to open an assisted living center because his mother has Alzheimer’s disease and will need a higher level of care. To achieve stability and profitability, however, entrepreneurs need to create a well-researched marketing strategy. For an effective marketing strategy, the marketer needs to understand how consumers decide to select a doctor or an organization (Berkowitz, 2010).
There are several risks associated with opening a new assisted living center. In this case, the businessman is opening this organization for his gain. This attitude might create issues in decision-making, especially in deciding the location for this organization. He might want to start the assisted living center near his mother’s location as that makes traveling easier for his mother. However, for the organization’s success, they should look at the town’s demographic profile, including the population’s age, income, net worth, and assisted living in that location.
For any business plan to succeed, one should consider the buyer’s or targeted population’s behavior. In addition to psychological influences, socio-cultural factors can affect consumer decision-making (Berkowitz, 2010). These socio-cultural elements include family life cycle, social class, reference groups, and culture (Berkowitz, 2010). In this case, the businessman would concentrate more on his mother’s likes and needs than considering the whole population. This can harm his business venture.
Starting a facility is a complicated process, and It is also a difficult market to break into and be successful in one of the fastest-growing industries around. By opening an assisted living facility, one is sure to have plenty of competition before settling down. To manage this, one should make a business plan researching more about the target consumers. This can help the new business to succeed.
One risk factor that can affect the businessperson’s assisted living venture is the cost of capital. For small facilities, the cost of capital will always be high (Grant, 2006). Another risk factor is an increased marketing budget should the businessperson looks to expand (Grant, 2006). To mitigate these risk factors and ensure the success of the businessperson’s venture in assisted living, the marketing team must be aware of consumer decision models in order to generate business. One model is the compensatory decision model. This model involves “a consumer choosing from an array of alternatives, such as selecting among several possible pediatricians available in their community, the person will trade one particular attribute for another because positive attribute evaluations or reactions can compensate for weaker attribute reactions” (Berkowitz, 2010 p. 162). In the case of assisted living facility location, quality of care, and cost are attributes that can be marketed. For example, if there is adequate capital, investing in highly trained and adequate staff and investing in location infrastructure will compensate a higher price for consumers. This type of business model could be marketed to consumers who are willing to pay for higher quality of care. There is also the Noncompensatory Model. This model involves “an individual choosing a product or service based on one attribute regardless of the value of other attributes” (Berkowitz, 2010, p.162). If the businessperson so wishes, low cost could be the sole focus of the marketing team. Spend just enough capital to meet legal requirements, driving down the cost, and thus market a low cost, but still adequate, assisted living option.
Before this assignment, I really didn’t understand Medicare and Medicaid.
Medicare is a federal health insurance program that serves the needs of individuals 65 years and older, and some individuals with certain chronic or long-term disabilities regardless of age. Medicare is the second largest program in the federal budget. In, 2019 it provided health coverage to nearly one quarter of the nation’s population. Medicare is financed through payroll taxes, premiums and the governments general fund (Peter G. Peterson Foundation, 2020).
Medicaid is a joint state and federal health insurance program that serves the needs of low-income individuals and includes the Children’s Health insurance Program (CHIP). In 2020, it provided health coverage to about 73 million individuals in the U.S. It represents approximately 20% of all healthcare spending and is the largest single payer of long-term care. Medicaid is funded by states with matching payments from the federal government based on individual state spending (Peter G. Peterson Foundation, 2021). Because Medicare and Medicaid play such a huge role in the healthcare market, the way they calculate reimbursement for services provided affects payments to healthcare organizations and how those outside the government plans are charged.
The Patient Protection and Affordable Care Act ACA (2010) includes “provisions to reduce waste, fraud and abuse in Medicare and Medicaid”. Fraudulent Medicare and Medicaid claims can cost the government millions of dollars per year. In the first half of 2013, OIG reported almost 4 billion dollars in fraud and overpayments billed to Medicare and Medicaid. Investigations into violations not only prevent future loss, but also generate fines to recoup losses incurred by fraud and abuse. The ACA also reduces Medicare and Medicaid spending by implementing quality initiatives that restrict payment/impose penalties for overuse, unnecessary hospital readmission or preventable hospital acquired infections (Nowicki, 2015). This not only encourages providers to reduces costs, but also increases the quality of patient care.
Changes in the way healthcare is funded and delivered is desperately needed. Future legislation to control healthcare costs requires consensus, collaboration and long-term planning. All difficult to find among legislators who have to answer to the needs and expectations of many different constituents. Government change is generally reactive, not proactive. Technological advances may also prompt change in healthcare costs.
To understand Medicare and Medicaid and why associations need to comprehend them, you first need to know what they mean:
Medicare is a governmentally financed program that gives health care coverage to Americans at age 65. Medicare was extended in 1972 to incorporate inclusion for individuals more youthful than 65 with handicaps who meet all requirements for Social Security inability benefits and those with end-stage renal sickness. Federal medical care additionally covers Medicare-covered seven fundamental administrations, including inpatient emergency clinic administrations, outpatient demonstrative administrations, doctor and other clinical benefits, and outpatient therapeutic administrations.
Medicaid is a program made by the government and state to be managed by the state government to give free or minimal effort medical care to low-pay beneficiaries. OBRA of 1986 extended qualification for low-pay pregnant ladies, youngsters, and babies, paying little heed to their staff for a state’s AFDC program. Medicaid-related qualification for two government money help programs: Aid to Families with Dependent Children (AFDC) and Supplemental Security Income.
The two past authoritative endeavors to control Medicare and Medicaid costs. As I would see it, the two of them were exceptionally successful:
Omnibus Budget Reconciliation Act (OBRA) of 1980
Killed the “earlier hospitalization” prerequisite for home health administrator’s repayment and dispensed with the limit on the all-out number of home wellbeing administration visits. It assists with rewarding low-pay families that cannot stand to get the appropriate medical care. The repayment gives accounts back in the families to take care of or even put garments something their kids’ bodies. The issue is some will exploit the outpatient therapeutic attempts to help.
Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982
Inpatient clinic administrations and supplanted PSROs with peer audit associations. Medicare inclusion to hospice care for those guaranteed as in critical condition made Medicare the optional payer for working recipients covered by their managers. This Act is very successful because most people cannot afford significant surgeries and costs.