Tag: REIMBURSEMENT

Reimbursement

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Janice has been invited to appear on a home improvement show for the remodel of her summerhouse in Maine. Janice asks Mary to wallpaper her house in anticipation of the home improvement, and requests expensive custom wallpaper and a very intricate design application, for which the wallpaper would cost $5000, plus labor. Mary, excited for a very large job for her solo business, orders the intricate wallpaper and blocks off her calendar for the amount of time it will take to complete the job. After the paper has been ordered, Mary asks some friends to be available to complete the job in time for the show. Janice is informed that she will not be on the show and notifies Mary that she will not need the wallpaper.

In your discussion post, address the following questions:

Does Mary have a case for reimbursement?
Under what legal theory might she prevail and what are her damages, if any?
What ethical theories might be applicable?

OPERATING REVENUE, REIMBURSEMENT, COST-VOLUME-PROFIT, AND BREAK-EVEN

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In recent years, healthcare pricing has come under much scrutiny. Calls for price transparency have been made, loudly and clearly. Discounting prices to some recipients or payers occur, but how and why does this happen? Patients with insurance typically pay an insurance-negotiated discounted rate, while patients without insurance can be asked to pay the full amount that is charged by the provider or facility. Why can’t you simply look on each provider’s website to see the exact cost of your office visit, or your x-ray? With the many methods of cost-setting available to us as healthcare managers, we see how there is a high degree of variability in the amount charged per service from person to person, and state to state. In moving towards either voluntary or state-mandated transparency in healthcare pricing, we consider the following Case assignment questions.
Case Assignment
After completing the required background readings, please complete the following questions:
1. Describe the recent scrutiny of the methods of healthcare pricing. Is this scrutiny justified, or unjustified?
2. What can healthcare managers do to be best prepared for increasing future calls for transparency (either voluntary, or state-mandated)?
3. How have state transparency laws affected healthcare pricing in your home state, or state of current residency? Can you locate the exact costs of healthcare services you or your family may need in the near future?
4. How is cost-shifting implemented within the healthcare settings? Do you believe this ethical?