Prolacta Bioscience’s Post

Health spending in the U.S. increased by 4.1% in 2022 to $4.4 trillion or $13,493 per capita. This growth rate is comparable to pre-pandemic rates (4.1% in 2019). Although government spending to manage the pandemic led to substantial increases in NHE, these expenditures significantly declined in 2021 while utilization of medical goods and services rebounded. By 2022, top-level patterns in health spending more closely reached that of the pre-pandemic period. https://lnkd.in/gu_a2Ytk

This is very telling ... Labor costs are seen as a top pressure for health systems to the tune of 96% HFMA: Top Causes of Operational Margin Pressure Among Health Systems 1. Higher labor costs: 96% 2. Lower reimbursement from payers: 84% 3. Higher supply costs: 47% 4. Lower inpatient volumes: 25% 5. Lower outpatient volumes: 17% 6. Lower patient collections: 10% 7. Other: 8%   Notes: Based on survey responses of 135 health system Chief Financial Officers and qualitative interviews with CFOs conducted in the first quarter of 2024.   Source: "Health Systems near their breaking point. Labor costs continue to increase while dollars collected from payers decrease." Healthcare Financial Management Association (HFMA) press release, March 6, 2024.

Good Insight

What are your thoughts on the current Professional Services Guideline? Do you feel it effectively addresses the needs of healthcare providers and injured individuals, or is there room for improvement to better reflect the true costs and quality requirements of specialized care? Should the guideline set standardized rates, or should providers have the flexibility to set their own rates and let the market determine the balance? What factors, like inflation or unforeseen circumstances, do you think the guideline should consider in its rate-setting process? Should it include adjustments for rising operational costs, regional variations, or economic shifts to ensure providers can sustainably offer quality care?

Ever stopped to ponder the flow of money in healthcare? Trust me, it's not always where you'd expect it to be—especially when it comes to reimbursements. 💸 As the system continues to devalue the very experts who keep it running, the effects are creeping closer than you might think. 🤔 Think it won't affect you? Think again. #HealthcareEconomics #PhysicianValue

What are your thoughts on this? During the pandemic, numerous factors significantly impacted costs in healthcare and rehabilitation services. How can on justify the SABS imposing strict rate restrictions when the government acknowledges the potential for increased uncertainty in the future? I think that the guideline needs to allow for flexibility to adapt to changing circumstances. In fact, all rates set out by the SABS need to be flexible and allow for the market to determine current rates. What do you think? I'd love to hear your thoughts/opinions!

2024 Hearing - 3/14 at noon... Under the framework set forth in Chapter 224, from 2023 through 2032, the health care cost growth benchmark will be set equal to potential gross state product (PGSP), or 3.6%, unless the HPC determines that an adjustment to the benchmark is reasonably warranted. In that case, the HPC Board may choose to modify the benchmark to any amount. https://lnkd.in/gTg9dS2t

Finance models in the healthcare sector are critical for ensuring the sustainability and efficiency of health services. These models encompass various methods of funding, expenditure management, and financial planning within healthcare organizations. **Fee-for-Service (FFS)** is a traditional model where providers are paid per service rendered. While it encourages high service volumes, it can lead to overutilization and higher costs without necessarily improving patient outcomes. **Value-Based Care (VBC)** shifts the focus from quantity to quality, rewarding providers for the effectiveness and efficiency of care. This model aims to improve patient outcomes and reduce costs by emphasizing preventive care and chronic disease management. **Capitation** involves paying providers a set amount per patient, regardless of the number of services provided. This model encourages cost control and efficient resource use, but may risk under-provision of care. **Global Budgets** allocate a fixed total dollar amount for all services delivered to a population over a specific period. This encourages healthcare systems to stay within budget and promotes integrated care. **Bundled Payments** combine payments for multiple services during a patient’s treatment episode, incentivizing coordinated care and cost management. Each model has its pros and cons, and often, a hybrid approach is utilized to balance efficiency, cost control, and quality of care in the healthcare sector. #HealthCareFinance #FinancialModels #HealthCareEconomics #HealthCareBusiness #FinanceAnalysis #HealthCareManagement #FinancialPlanning #HealthCareIndustry #FinanceStrategies #HealthCareInvestments

The recent The Commonwealth Fund report showing the U.S. ranking near the bottom in healthcare efficiency isn’t surprising. Efficient markets require transparent information, yet hidden prices in healthcare make it impossible for patients and employers to know what they're truly buying or paying for. This lack of transparency leads to higher costs and worse outcomes compared to countries with more open systems like the UK and Australia. Until we demand price transparency, we’ll continue to rank low and pay more for less.