Healthcare Utilization and Finance Essay Example | Topics and Well Written Essays - 1000 words

Healthcare Utilization and Finance - Essay Example Medicare Part B Essentially, this part covers healthcare services that are not provided for in part A of the Medicare. In Mrs. Zwick’s case, the cost of the different diagnostic tests that she underwent during her hospital stay and time of rehabilitation would be paid for in this part. Medicare Part D This last option of insurance cover deals with payment of the cost of drugs that are prescribed during a hospital stay. The antibiotics that were prescribed during the initial hospital stay will be catered for here. Moreover, the medication that prescribed upon her discharge will be also paid and by extension the walker that she required to walk around. Medicare policies and Reimbursement of Additional Care The policy by Medicare not to pay additional costs emanating from hospital acquired infections means that these cases have to be HAC (hospital-acquired complications) in terms of high cost. This in turn means that a patient with such a problem would have to be assigned to paym ent of higher premiums to cover the whole cost. It is however predicated upon the premise that the complication was due to secondary diagnosis and could have been prevented through utilization of evidence based guidelines. These additional policies of Medicare on hospital acquired infections means that the hospital will not get reimbursement for them (McNair, Luft, & Bindman, 2009). For instance, the antibiotics that were prescribed to her and these drugs were for urinary tract infection (UTI). With UTI being one of the complications that are not catered for by Medicare, then Mrs. Zwick and her daughter would have to pay from their pockets. Ethical Implications for Incurring Costs Related To Her Hospital-Acquired Condition The ethical implication for costs that emanate from hospital acquired infections to the concerned patients is that they have to pay for the additional cost. This is regardless of whether the infection was due to negligence on the part of the hospital or the infect ion just arose spontaneously. In order for clients to be shielded from this, they are forced to pay more so that in the advent that the complications that occur due to a person being hospitalized may be reimbursed by Medicare. Such a proactive move is quite unfair to the payer and the extra charge is quite punitive bearing in mind that these infections are completely out of a payer’s control when they happen. Another ethical implication is that it has to be proved beyond doubt that the hospital acquired infections were not due to negligence on the part of a hospital. This may arduous and quite challenging and it takes time (Zhan, Friedman, Mosso & Pronovost, 2006). Scenario 2 Consolidated Omnibus Budget Reconciliation Act (COBRA) Since COBRA insurance was designed to cover for people who have lost their job due to legitimate reasons, the cover is usually paid by the former employer but it is not subsidized. It follows then that the payments for health coverage premiums are re mitted by the former employer in full and an additional administrative cost of two percent. However, coverage is considered under group coverage which therefore means that the cost of the premiums is still low although they are slightly higher than when the employee was working. Many of the individuals that invoke the COBRA coverage usually have a big time difference between their last day at work and

Financial Statements & Ethics Assignment Example | Topics and Well Written Essays - 500 words

Financial Statements & Ethics - Assignment Example The Securities and Exchange Commission (SEC) in alliance with the United States Congress in 2002 created the Sarbanes Oxley Act (SOX). Starbucks Cafà © hired an external auditing firm to perform an independent audit of its 2010 financial statements. The Sarbanes Oxley Act mandates that all public firms hire an accounting firm to audit its annual financial statements. There are many bylaws of the Sarbanes-Oxley Act that ensure auditor independence is followed. Section 201 of the Act prohibits auditors to perform other non-audit services on clients the company audited (Findlaw). The Sarbanes-Oxley Act also created the Public Company Accounting Oversight Board (PCAOB). All public accounting firms performing auditing work must be registered with the PCAOB. On November 2, 2010 the accounting firm Deloitte & Touche performed the Independent Auditor Report of the financial statements of Starbucks for fiscal year 2010. The findings from the audit were that the consolidated financial statements present fairly, in all material aspects, the financial position of Starbucks Corporation and its subsidiaries as of October 3, 201 0 and September 27, 2009 (Annual Report: Starbucks, 2010). My opinion is that contracting the services of outside firms for auditing and fraud detection services is a sound managerial practice. Based on SOX it is mandatory for public firms to hire external accounting firms to perform annual independent audits. The use of external consultants to prevent fraud can increase the efficiency of a system. The external consultants will look at the company from a fresh perspective. An employee might be closed minded and biased and may miss things due to overconfidence and carelessness. One of the cons of the use of external auditors and consultants is that they can very expensive. Consultants can not monitor the daily activities of a firm otherwise they would become full-time employees. There is a need to create internal controls to prevent fraud. These