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Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. [1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.
This is an accepted version of this page This is the latest accepted revision, reviewed on 9 December 2024. Economic sector focused on health An insurance form with pills The healthcare industry (also called the medical industry or health economy) is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive ...
The term "Professional Caregiver Insurance Risk" [39] [40] explains the inefficiencies in health care finance that result when insurance risks are inefficiently transferred to health care providers who are expected to cover such costs in return for their capitation payments. As Cox (2006) demonstrates, providers cannot be adequately compensated ...
According to a study paid for by America's Health Insurance Plans (a Washington lobbyist for the health insurance industry) and carried out by PriceWaterhouseCoopers, increased utilization is the primary driver of rising healthcare costs in the US [143] The study cites numerous causes of increased utilization, including rising consumer demand ...
The insurance company is an individual health care provider under the Affordable Care Act (ACA) and has continued to expand its availability in the marketplace for those who aren’t getting ...
The two companies together had more than 36% of the national market for commercial health insurance. The AMA has said that it "has long been concerned about the impact of consolidated markets on patient care." A 2007 AMA study found that in 299 of the 313 markets surveyed, one health plan accounted for at least 30% of the combined health ...
Health insurance failure can be attributed to market failure or government failure. [24] Underinsurance can arise when the cure of disease is very expensive, such as cancer or a wide spread of new diseases such as HIV/AIDS or COVID-19. In such cases either private insurers require a high premium as the risk factor and costs are high or they may ...
The discussions came six years after regulators blocked mega-deals that would have consolidated the U.S. health insurance sector. Cigna, however, on Sunday announced plans to do an additional $10 ...