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Introduction
Health economics is a crucial aspect of the health care system, even though it is a branch of economics. Health economists often assess the quality of health by determining the effectiveness of the health policies that are put in place. Therefore, good health care should be effective and efficient, while poor health care can be determined through poor pricing and untimely delivery of the required services. However, there are three main types of financing: government financing initiatives, employee financing, and individual funding.
Economic Evaluation Analysis
The economic evaluation analysis is primarily used for decision-making. An economic evaluation of the health care system involves comparing the cost of health care and the outcome. Five types of economic evaluation analysis models can be used to determine the outcomes of health care plans. However, all the models aim to determine the best alternative after consideration of the factors involved; some of them have been written off. The expected cash flow, opportunity cost, rate of return, profitability, and capital/investment are key factors in determining the valuation model to be used while conducting an economic valuation in the health sector. It is important to consider the investment involved and opportunity cost, knowing when to forego and choose one option over another. Therefore, according to the economic evaluation analysis, quality health care should implement an economic valuation model.
Evaluation Analysis Models
The major advantage of using this model is that it provides a wide range of decision-making options which decision-makers can choose from. However, the demerit of the application of this criterion is that decision-making is limited to a single person or team whose decision might be welcomed and appreciated by the subjects or recipients of the decision. This analysis process is easy as cost (in monetary units) is compared directly to outcomes (also in monetary units). Thus, easy comparison and apprehension of beneficial options are easier. The major shortcoming of this analysis model is comparing human life to money. Thus, the model might not be recognized as the best evaluation for determining suitable healthcare plans. The model does not apply medical terminology; thus, the interpretation of outcomes may not be accurate.
The major merit of using this analysis is that it compares the effectiveness of outcomes from different sectors, for example, comparing the effect of different types of drugs that have been developed to treat or cure a disease. It attempts to understand the longevity of a given drug or medical technology. This economic evaluation model of healthcare has been appreciated and adopted by the Federal Government and various states to find the best healthcare plans (Nussbaum et al., 2018). When implementing this model, the outcome with the best outcome is chosen. This is beneficial to the citizens who will benefit from quality health care and the government, which benefits quality service delivery to the public.
For instance, for the treatment of a given disease, say influenza, different treatment approaches are performed, and that with the least cost is picked. However, the demerit of this technique is that comparison is based on the cost of health care, and though it is difficult to compare the outcomes, that is, as long as the outcome is achieved. In the event that outcomes from different health care plans have been estimated as equal, then the cheaper option will be chosen. The major disadvantage of the analysis model is that it ignores auxiliary risks involved before achieving individual outcomes for the health care plans. Whereas the outcome can be almost similar, the path followed to attain them are often different (Papanicolas et al., 2018). A shortcoming of this model and the reason for limited implementation is that it does not factor and cost input to achieve the outcome.
Application Of Outcomes And Evaluation Analysis
QALYs is a measure of health outcomes under the CUS evaluation analysis. It focuses on determining the length of life that is achieved out of a specific health plan. When healthcare decisions are based on QALYs, the best options and decisions are likely to be made. Information and data from the model of evaluation factor possible uncertainties through systems such as Parameter uncertainty to categorize different uncertainties and risks involved in health care. From the categories, it becomes easier to formulate action plans to counter and curb the occurrence of such. Different evaluation analysis models are significant depending on the situation at hand. For this reason, universal health care plans, technology, or procedure for fighting given diseases, either through prevention or cure, are formulated. Various evaluation models aim to find cost-effective approaches to achieving positive healthcare outcomes (Papanicolas et al., 2018).
Health Care funding and Financing
Government financing comes in different criteria, directly or indirectly, allocation from the federal budget to the health care department and sourcing from government insurance programs. The insurance industry plays a major role in the health care system as they are among the top contributors to health care funding and financing. Compulsory and voluntary premiums and contributions from the government to the federal insurance department pool funds from government employees. Private insurers pool funds from employer-employee remittances in the form of contributions and premiums. Some of the popular federal healthcare funding include Medicare, Medicaid, and The State Childrens Health Insurance Program (SCHIP), which funds the majority of the vulnerable children who need care.
Trends in Health Care Systems Funding
The government, international organizations, and the private sector are improving the healthcare sector by adopting newer trends, aided by evaluation analysis to develop healthcare through funding, technology, and workforce. The trends are in line with policies and healthcare regulations. The current trends in the healthcare system include expanding insurance coverage, which the federal and state governments usually handle by diversifying healthcare coverage. The second trend is the new revenue-sourcing platforms that are being initiated to lobby funds for healthcare improvement. The third trend is merger and integration, which requires the incorporation of both large and small organizations with a common goal. Usually, insurers pool more funds to fund increased financial resources for the health care systems.
Health Care Funding Legislations and Reimbursement
In association with states and international organizations such as the WHO, the federal government has formulated policies and regulations that consider favorable financing and funding of the healthcare sector. The policies revolve around fair pricing, technological advancements, and ethics in the healthcare system. The insurance industry plays a major role in the health care system as they are among the top contributors to health care funding and financing. Compulsory and voluntary premiums and contributions from the government to the federal insurance department pool funds from government employees. Private insurers pool funds from employer-employee remittances in the form of contributions and premiums.
Conclusion
To conclude, the quality of health care in the USA and globally can be improved by implementing the right evaluation analytical models. The models will equip the government and health sector with the right plan to employ and the cost-efficient one. The CUS evaluation model is the most efficient because it focuses on health care quality and how long it will last. It provides lasting remedies to halt care challenges. Insurance companies play a major role in health care funding by diversifying premiums and contributions to accommodate a large mass of the population. Information gathered from analysis and evaluation is vital in developing strategies to curb risks and uncertainties in the future.
References
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.
Jeffery, M. M., DOnofrio, G., Paek, H., Platts-Mills, T. F., Soares, W. E., Hoppe, J. A.,& & Melnick, E. R. (2020). Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US. JAMA internal medicine, 180(10), 1328-1333.
Patel, S. Y., Mehrotra, A., Huskamp, H. A., Uscher-Pines, L., Ganguli, I., & Barnett, M. L. (2021). Trends in outpatient care delivery and telemedicine during the COVID-19 pandemic in the US. JAMA internal medicine, 181(3), 388-391.
Nussbaum, S. R., Carter, M. J., Fife, C. E., DaVanzo, J., Haught, R., Nusgart, M., & Cartwright, D. (2018). An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value in Health, 21(1), 27-32.
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