Case Study: The Globalization of Health Care Issue

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ANALYSIS
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CASE STUDY ANALYSIS
Case 1: The Globalization of Health Care
Issue
It has been observed that many countries do not have enough specialist doctor, and at the
same time treatment in some of the developed countries, especially in America, is very high.
Therefore, the concept of globalization in the health care sector has become essential and
prevalent. “Is there any development due to the globalization in Healthcare?”
Rule
In order to avoid corruption in the healthcare sector, several regulations have been
constructed. Among all the rules and regulations, some of the essential rules and regulations
are HIPAA (Health Insurance Portability and Accountability Act), The HITECH Act and
MACRA Act. HIPAA was enacted for protecting health insurance coverage for the workers
who change or lose their job. The HITECH (Health Information Technology for Economic
and Clinical Health) was enacted for promoting technology in the healthcare sector.
Additionally, MACRA (The Medical Access & CHIP (Children's Health Insurance Program))
Act was enacted to address payment for the doctors as well as the other employee who are
associated with the medical sector.
Application
Under the HIPAA act, the boundaries have been set on the use of the health record by the
depart of HHS that is Health and Human Services. Recently the act was amended and in the
changed rule is also associated with more privacy of the healthcare information. The act
outlines the safeguards for protecting the information of patients as well as establishes the
criminal and civil penalties for the violation. The law is applied not only in the hospital but
also in the nursing homes, chiropractors, psychologist and pharmacies. Recently is law is
implemented with more strictness. It has been observed that the over cost problem in the
healthcare sector could be reduced to a certain extent, and a particular segment of people was
benefited from the rule.
Apart from the direct healthcare sector, some of the business associated with health care like
third party administrators, pharmacy managers for different kinds of health plan and
transcription and billing companies started to increase the price for providing goods and
services to a very high amount. Therefore, the act was amended, and the maximum price has
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CASE STUDY ANALYSIS
been set for the provision of goods and services by those healthcare companies (Health and
Human Services, 2019).
The HITECH Act was enacted for the proper use of technology in the healthcare sector. The
main purpose of using different kinds of technology in this particular sector is to diagnose the
disease better, at the same time, to reduce the cost in the healthcare sector in the long run.
Moreover, the act mandates the audit of the provider of healthcare in order to determine
whether the companies follow the compliance of HIPAA privacy rules which are related to
security and privacy or not. As per the rule, the cost of non-compliance of the rule is very
high. An organization may have to pay a very high amount which is near about $2 million per
calendar in each year for the violation of the rules. A hospital can also incur a loss if
something wrong is found at the time of audits and investigations. According to the particular
act, the administrator needs to access the compliance of the security of the practice of the
organization. It also needs to be sure by the organizations to make the proper procedure of the
electronic PHI and the update all the HIPAA security and privacy policies (HHS, 2019).
MACRA is a reauthorization act which was enacted in 2015 to overcome the address related
issues. However, later, the act was amended, and changes have been made in part B of the
act, in which focus was shifted on value-based reimbursement. The main focus of the act was
shifted to the treatment of model-based on Sustainable growth rate (SGR). The act also
consists of changing the way in which Medicare rewards for the value over volume,
streamlines of the multiple quality programs, as well as giving additional payment for the
participation in the alternative payment model (CMMS, 2019).
Conclusion
From the above discussion, I think that high cost in the healthcare sector has become a
prevalent issue and therefore many peoples are now choosing different countries for the
diagnose and the problem is more prevalent in the USA. However, many rules and regulation
such as Health Insurance Portability and Accountability Act, Health Information Technology
for Economic and Clinical Health and The Medical Access & CHIP Children's Health
Insurance Program have been enacted, and later those were amended for overcoming the
high-cost issues in the healthcare sector. A more strictness in some of the rules needs to be
brought so that each can afford the healthcare service.
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