MH0054 – Finance, Economics and Planning in Healthcare Services

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DRIVE	SPRING 2015
PROGRAM	MBA (Sem 3), MBADS (Sem 3 / Sem 5), PGDHSMN (Sem 1)
SUBJECT CODE & NAME	MH0054 – Finance, Economics and Planning in Healthcare Services
BOOK ID	B1215
CREDIT & MARKS	4 Credits, 60 marks

1. Discuss the importance of financial information in healthcare organisations. Add a note on elements of the financial reports.

Answer :  Financial information :

Data such as credit card numbers, credit ratings, account balances, and other monetary facts about a person or organization that are used in billing, credit assessment, loan transactions, and other financial activities. Financial information must be processed in order for business to be conducted, but it must also be carefully handled by businesses in order to ensure security for customers and to avoid the litigation and bad publicity that can stem from negligent or improper use

Importance of financial information in

2 Explain the claims process in healthcare organisations.

Answer: Cashless hospitalisation

To avail cashless hospitalization treatment at network hospitals:

Step 1: The insurance company provides the list of network hospitals offering cashless facility for treatment.

Step 2: The claimant needs to produce the insurance healthcard at the hospital.

Note: In case the healthcard is not yet issued, the hospital should contact the insurance company (usually a toll free no.) and refer the policy no. at all times.

Step 3: Hospital sends pre-authorization request with the treatment details; past history and clinical notes along with estimate of hospitalization

4 Explain different methods of evaluation of healthcare services.

Answer: There are many methods to evaluate healthcare services are:

Marginal analysis

This is the one of simplest method of micro-economic evaluation. In this method, there is no need to know the total exact costs or benefits of the various services or treatments. It involves a comparison of the marginal costs and benefits of the alternative services, and it leaves much to the judgements of the decision-maker. It provides estimates of the implications of redeploying resources within, to, or from a programme where alternative patterns of care are possible. If there is no budget restraint, then a programme should be expanded or contracted to

Q.5: Discuss the role of economics and economists in healthcare.

Answer:  Issues surrounding the availability and affordability of medical care and health insurance have made health economics one of the most significant specialties in economics. As a result, this has created job opportunities in research, teaching and policy analysis for individuals with a background in health economics and related fields. Just as economics examines the allocation of scarce resources, health economics applies the same principles to the provision of health care.

6 Explain the importance of healthcare planning. Add a note of types of healthcare planning.

Answer:  Importance of healthcare planning

Health systems in most high-income countries aim to provide a comprehensive range of services to the entire population and to ensure that standards of quality, equity and responsiveness are maintained. Although approaches vary widely, responsibility for developing the overall framework for financing and organizing health care usually lies with the central government, while governance of the health system is often shared by central and regional authorities.

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