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Third Party Payer Systems and Reimbursement Methods

Research the internet, the OCLS, and other sources, including the Bible, to support your position for your discussion.
Locate articles highlighting some of the financial implications and comparisons of the different healthcare entities.
Find an article that discusses a real-world case similar to the Mayo case discussed above.
Navigate to the threaded discussion and respond to the following:
In regards to the real-world case example that you found, what were the findings? Discuss your opinion on the findings and if the health care organization in your case was given an unfair advantage or if it was failing to meet the amount of charity care.
Should not-for-profits be given tax breaks when it comes to charity care? Given the disparity in what constitutes charity care, what do you think should count as charity care?
What are the financial and ethical implications to local communities of providing tax benefits to not-for-profits and not-for-profits?
Your initial response should be 150 to 200 words in length for each question and include at least one academic source that is properly cited.

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Third Party Payer Systems and Reimbursement Methods 

In 2019, the University of Virginia Health System (UVA) sued thousands of patients claiming more than $100 million in unpaid bills. The institution resulted in what many victims claim as unfair such as seizing paychecks and claiming homes to recoup their money, forcing many families into bankruptcy (Hancock & Lucas, 2019). However, the institution defended its move claiming the unpopular approaches were the only way the institution could generate positive operating income. Judge William Barkley of the District Court supported the move.

In the US, charity cares run partially funded programs that offer allow uninsured or under-insured individuals to receive healthcare services at a subsidized cost. If the patients fail to afford the subsidized rates, charity care might resort to different approaches to recoup their investment on unpaid debts. In UVA's case, the court did not give them an unfair advantage but an opportunity to recoup their investment on unpaid debt since the institution was failing to fulfill its objectives to other individuals who relied on the facility for health care.

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Without a doubt, charity care is expensive. Therefore, not-for-profit care facilities should receive tax breaks. The tax breaks would confer great benefits to the qualifying entities not only through tax breaks but also through favorable tax treatment when receiving contributions and securing financing. I believe that the only facilities that should qualify as charity care are those that should offer free care to specific groups of people that cannot afford particular services. However, the amount of free care should be up to a specific rate to ensure that the concerned facilities can continue offering services to the needy.

The provision of tax benefits to not-for-profits raises significant financial and ethical implications. For instance, sometimes the public lacks public confidence in their performance by feeling that the organizations could not be putting taxpayer’s money into the right use (Bezboruah, 2020). Such a situation leads to significant ethical and financial concerns. However, I believe that not-for-profit organizations should continue fulfilling their mandate to the public by adhering to the Biblical teachings in Proverbs 19:17 that “whoever is kind to the poor lends to the Lord, and he will reward them for what they have done.”

 

 

References

Hancock, J., & Lucas, E. (2019, September 10). ‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes. https://khn.org/news/uva-health-system-sues-patients-virginia-courts-garnishment-liens-bankruptcy/

Bezboruah, K. C. (2020). Ethics and accountability in nonprofit management curriculum. In Teaching Nonprofit Management. Edward Elgar Publishing.

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