Final answer:
Charge master enrichment ensures charges cover the entire cost of healthcare services including, but not limited to administrative costs. The ACA regulates healthcare expenses and mandates the use of EMRs to decrease administrative costs. Understanding the reimbursement models in healthcare and their issues, such as adverse selection, is essential.
Step-by-step explanation:
Chargemaster enrichment ensures that charges cover the full cost of healthcare services, not merely the administrative costs. The Affordable Care Act (ACA) has imposed regulations to control the increase in healthcare costs, such as setting a cap on the administrative expenditures that healthcare providers can make and mandating the switch to electronic medical records (EMRs), which are envisioned to lower these costs.
The fee-for-service health financing system involves healthcare providers being reimbursed based on the cost of services provided. This system contrasts with Health Maintenance Organizations (HMOs), where providers are reimbursed per patient, managing resources based on patient care needs.
Due to the presence of adverse selection in insurance markets, where the insurer has less information about the risk than the insured, there is a risk imbalance. This can lead those with lower risks to avoid expensive insurance while those with higher risks are more likely to find insurance appealing.