Porter's Five Forces In Health Care

Improved Essays
The U.S Healthcare has been transitioning due to the new law that’s in effect called the Affordable Care Act. This law was signed into effect on March 10, 2010 and has reformed the way healthcare previous ran in the United States. With this transformation, there have been a significant amount of trends forcing the healthcare industry to a place of competitiveness. There has been competition seen amongst physicians, hospitals, healthcare plans, and insurance company’s and physician groups. This competition is based purely on consumer demand, which in turn will affect the price and quality when it comes to services being performed or purchased. Competition amongst business and industries has always been ongoing over time and encouraged. It …show more content…
This could also ne view as a horizontal there since the possibility of a new rival, new business trying to enter the industry along with the threat of substituting products for services. This is clearly seen between insurance companies suppliers, HMO, PPO, and preferred providers. While there is several benefits when it come to competition within a health care organizations there are also drawbacks and pitfalls that comes along. As the cost of health care continues to climb the quality of care patients are receiving seems to be wavering. As the present time there are no recommendation or solutions offered as to how to solve this problem, and this is why the industry needs competition more than ever as there is clearly a need for a …show more content…
“ Research has shown that competition in the health care system occur at the wrong level, over the wrong thing, in the wrong geographic market, and at the wrong time” (Harvard Business Review , 2015) Some of these issues are surrounding the poor choices from hospital employees, insurance companies. These changes should be made not in the health plans, hospital groups and health networks, but rather in treatment, prevention diagnosis along with supplying health tips on how to live a healthy life. Only at this level will they be able to really make a difference in each individual patient. This places more emphasis and focus on the patient versus the completion and cost to cure the

Related Documents

  • Improved Essays

    The increasing trend towards ASOs mean that insurers have to compete to gain share in this business. That means they have to find ways to appeal to employers and help them reduce costs and improve care. b) Self-funded employers are demanding getting better value from their plans and they may switch to other ASOs if Aetna fails to provide the expected cost-savings. Insurers that will win in the ASO space are those who offer services demonstrating unique, long-term value by ensuring that every procedure charged for is…

    • 545 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Distributing insurer responsibility decreases transfer costs and unnecessary system costs. The healthcare industry is a dynamic and competitive market; contracts are bid out and patients are directed to the winning provider. Price is a major consideration in direct contracting. However, access and quality of care are concerns for larger employers.…

    • 216 Words
    • 1 Pages
    Improved Essays
  • Improved Essays

    References Goddard, M. (2015). Competition in Healthcare: Good, Bad or Ugly? International Journal of Health Policy and Management,4(9), 567-569. doi:10.15171/ ijhpm.2015.144 McLaughlin, C.P. & McLaughlin, C.D, (2015).…

    • 565 Words
    • 3 Pages
    Improved Essays
  • Superior Essays

    Triple Aim Analysis

    • 1254 Words
    • 6 Pages

    Triple Aim In order to improve the United States health care system, we need to aim towards improving the experience of care, improving the health of the population, and reducing the per capita costs of health care (Berwick, 2008). These three aims are known as the “Triple Aim”. According to McCarthy (2010), the Triple Aim initiative was launched by the Institute for Healthcare Improvement (IHI) in October of 2007. It was designed to help the health care organizations improve the health of the populations while lowering the cost of care (McCarthy, 2010, p. 1).…

    • 1254 Words
    • 6 Pages
    Superior Essays
  • Decent Essays

    Price competition will have their advantage and disadvantage in each hospital. An advantage to managed care is the reduced cost so that consumers are able to afford it. However, the reduced cost may distract the organization from giving the best quality of care to the patients. Thus, it is important to talk with the insurer on what is best for both the person and his or her…

    • 205 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    ICD-9: A Case Study

    • 714 Words
    • 3 Pages

    I called several different facilities to gain an insight on the process that one has to go through to get a bill paid from services rendered. After deep consideration I decided to speak with a coder by the name of Naomi at Sacred Heart Hospital her first inclination to me was the importance of their job and the steps and processes that they have to go through from start to finish making sure that the hospital and doctors get paid in a timely manner and about the changes that have occurred in regards to how the codes are set up. They no longer use the ICD-9 for CPT they have went to ICD-10 because it is a much easier process that catches errors more accurately. This is done electronically and goes directly to the provider so that their portion…

    • 714 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    SHOULD HEALTH CARE BE A PRIVILEGE OR A RIGHT? The discussions that took place before the enactment of the Affordable Care Act was engaging. There was no middle ground in the debate. Either you are for affordable health care for millions of Americans, or that health care should only be for those who can afford to pay for it. It has been five years now since the overhaul of the health care system, and the verdict is unanimous .Health…

    • 1229 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Lack Of Health Care

    • 1076 Words
    • 4 Pages

    Over the years, the rise in medical cost partial blame the emerging of chronic diseases, lifestyle behaviors, and innovation for the upsurge in health care costs that forced millions of Americans without health care coverage. As people tend to develop chronic diseases from life style behaviors it becomes a burden on health care, to ensure that these patients receive the best care possible as the demand became greater and too expensive for the insurance companies to manage. “The U.S. chronic illness burden is increasing and is felt more strongly in minority and low-income populations: in 2005, 133 million Americans had at least one chronic condition” (Bodenheimer, Chen, & Bennett, 2009, para. 2). Insurance companies were forced to change particular…

    • 1076 Words
    • 4 Pages
    Improved Essays
  • Superior Essays

    Evolution Of Managed Care

    • 1147 Words
    • 5 Pages

    As health care fees increased health care cost skyrocketed resulting in staggering raises that outpaced the Gross Domestic Product (GDP) and in ten years from 1960 to 1970 the GDP rose from 5.2% to 7.4% (Kongstvedt, 2013). In 1973 HMO’s gained speed as the HMO act was passed providing encouragement, as well as, aid to promote development (Kongstvedt, 2013). This brought a division of thought between encouraging competition of health care markets versus the idea of future health care reform. The expanding growth of HMO’s brought even more various forms and models to the managed care arena, making boundaries of what each provider offered even further…

    • 1147 Words
    • 5 Pages
    Superior Essays
  • Improved Essays

    Complex Health Care

    • 641 Words
    • 3 Pages

    Complex health care arrangements include a variety of arrangements within health care organizations to help them survive the economic constraints placed upon them by the public and the government. The consumer demands increased quality and decreased cost. Government organizations such as Medicare and Medicaid are demanding a bigger bang for the buck. When that care is not delivered payments are withheld or penalties incurred on the organization. It has required hospitals and other healthcare organizations to find ways to deliver care more efficiently and for a lower cost (Centers for Medicare and Medicaid, 2106).…

    • 641 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Managed Care Analysis

    • 863 Words
    • 4 Pages

    PPOs contract directly with providers and hospitals. As a result, PPOs are able to negotiate low, competitive, fixed rates (Saunier, 2011). The emergence of coordination of services and utilization review is also noted. These utilization controls contributed to major practice changes such as shortening hospital length of stay (Kongstvedt, 2013). Furthermore, employee wellness programs became more prevalent.…

    • 863 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Health care costs are increasing every year, for a collection of reasons that range from the boring to the scandalous. For example, there’s a new move toward crazy expensive drug prices, like the $84,000 hepatitis C drug that singlehandedly accounted for 13% of the increase in drug spending in 2014. Lots of “specialty” drugs were born when manufacturers realized they could charge whatever they want. Expensive drugs are mostly paid for by insurance, and drug companies like it that way: the patient gets free or cheap drugs, and the insurance company foots the gigantic bill. Of course, that means we all pay for it in the end, through high premiums.…

    • 597 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Managed Care Analysis

    • 957 Words
    • 4 Pages

    It takes careful decision-making and planning to ensure all chronic diseases and patients are covered. According to (CDC.gov, 2015), in the united states all chronic diseases and conditions and the health risk behaviors that cause them account for most health care costs. A staggering statistic from (CDC.gov, 2015) states, eighty-six percent of all health care spending in 2010 was for people with one or more chronic medical conditions. There are some medical issues that pertain to health care plans, coverage, and physicians. Doctor shortages are one area of concern since there aren’t nearly enough of us to care for the U.S. population, (Gupta, 2015).…

    • 957 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    With everyone having health care coverage and the ability to choose where to go for health care needs, facilities will be competing to gain the trust and respect of the public to be the most often chosen health care provider. An organization that is dedicated to putting patients and their needs first, offers the most current and precise care, focuses on prevention, has strong leadership, and is cost-effective will stand out. A facility that is managing employees in a productive manner and having happy, skilled, and proficient caregivers who provide safe, quality care is a must for achieving the best clinical outcomes. Additionally, being focused, setting achievable goals, and meeting goals is crucial for health care providers to be successful. It helps keep employees engaged, focused on the mission and values of the organization, and contributes to advancing health care as a…

    • 893 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Cost Of Health Care

    • 458 Words
    • 2 Pages

    The expense of health care in America has been rising exponentially since the creation of modern medicine. In 1900, Americans spent an average five dollars per year (about 100 dollars in today’s money) on healthcare; today, people can expect to pay an average 1,233 dollars for a single visit to the Emergency Room. But what has caused this drastic increase in cost? A great deal of the blame falls on the large health insurance agencies in America. Their attempts to bully hospitals for discounts on the care of their clients has led hospitals to jack up their prices and to make up for the amount they lose to the agencies.…

    • 458 Words
    • 2 Pages
    Improved Essays