...a Market of Emergency Departments One of the contributors to the rising cost of Healthcare can be attributed to the over use of emergency departments (EDs) for non-emergency needs. In the greater Capitol/First/Beacon Hill area there are three major hospitals (Virginia Mason, Harborview, and Swedish) with emergency rooms and no urgent care centers with the exception of Group Health which is restricted to Group Health insurance members. The question I asked myself is, “Why does Group Health have urgent care for their insurance plan members and the major hospitals in Seattle do not.” Urgent vs. Emergency Care A study by the CDC showed that approximately 70 % of emergency department visits can be treated in a typical primary care or urgent care setting and another study by National Center for Policy Analysis demonstrated that only 13% of patients that sought treatment in the emergency department were clinically appropriate. Reasons for non-emergency visits to the ED range from access issues to primary care providers (wait times, no primary care provider assigned, or no insurance) to a lack of knowledge that they could have been treated at an urgent care or primary care setting. There are good reasons to visit the emergency department: * Trauma due to an accident or assault | * A wound that will not stop bleeding | * Shortness of breath | * Vomiting blood | * Chest pain | * Sudden loss of consciousness | For true emergencies the market is...
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...The changes in medical care and insurance and how it impacts usage of emergency rooms was studied. Because of the changes in medical care and insurance, the Affordable Care Act, the emergency room has become a crowded doctor’s office. Lacking on the number of how much availability there is for patients in emergency rooms already, the need for emergency rooms continues to increase. The significance of this study is to see how the current changes in health care insurance have impacted how often or how many people visit the emergency room seeking medical attention. This study will help health care administrators with how to plan for the future when it comes to being most efficient in seeing patients in a timely manner and having the more serious patients visit the emergency room and less serious patients visiting primary care physicians. The social problem that is addressed is that there are many uninsured and underinsured individuals who turn to the emergency room seeking medical attention instead of having the opportunity to see a primary care physician. That contributes to the crowdedness of emergency rooms overall. This is an exploratory study because exploratory research is based off secondary research. For example, by reviewing available literature, data, or using qualitative approaches, which is how this study is conducted. The unit of analysis in this study is the effect of changes in the Affordable Care Act on the usage of emergency rooms. A theory that guides this research...
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...Phoenix Material Case Study Comparisons Part 1 Complete the chart below that differentiates the following insurance types. |Plan Type |Characteristics of Plan (5 to 7 characteristics) |Target Audience for Plan | |Indemnity Plan |No referrals needed, can see any doctor or specialist, No primary |Someone that wants the freedom to choose which doctor they want| | |doctor needed, fee-for-service plan, Sometimes does not cover |to see, does not want to have to get referrals | | |preventative care. | | |Preferred Provider Organization (PPO) |Freedom to choose your provider, encouraged to use in-network |Most employers may offer this benefit to their employees. This| | |providers, may have a small copay, annual deductible before |will give employees a variety of physicians that they can see | | |insurance will pay, and in-network will be covered at a higher |for any ailment. ...
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...across the world are being affected financially. Rural communities are less wealthy; the majority of the residents are uninsured. They tend to use the emergency room as their primary care, putting a financial burned on the hospital. In 1986 the Emergency Medical Treatment and Labor Act (EMTALA) was enacted by congress as part of the Consolidated Omnibus Reconciliation Act (COBRA). EMTALA allows uninsured patients to receive care with an emergency condition regardless of insurance status or the ability to pay. The law states the patient may not be turned away and care cannot be delayed due to pay concerns. EMTALA requires the hospital to stabilize the patient before transferring or discharging the patient (Encyclopedia of Everyday Laws, 2013). According to The Center for Disease Control (CDC), about 135 million people visit the emergency room each year and hospitals lose approximately $34 billion in unpaid medical bills. With the passing of the Patient Protection Affordable Care Act many unnecessary or preventable emergency room visits will be eliminated. My action plan for Ashe Memorial Hospital is to design a program to decrease the number of uninsured patients using the Patient Protection and Affordable Care Act (PPACA). By decreasing the number of uninsured people, it will also: • decrease the number of emergency room visits • increase the number of people to receive preventative care • increase the quality of patient care A comparative analysis was done on two other...
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...Free Medical Clinic for those without Insurance Assignment 2.1: Informative Paper January 29, 2014 Free Medical Clinic for those without Insurance Assignment 2.1: Informative Paper In today’s world, healthcare availability is a major concern for many people. Whether it is due to income, specific health concerns or resources many people find themselves without the ability to seek treatment at a facility they can afford. To help communities with these issues, if resourced properly, a free or low cost clinic as an alternative can greatly benefit the community in addressing the economic and special needs of the patients. Healthcare in the United States has proven costly to patients. There options for treatment can be limited by their insurance, location, available of care and lifestyle. “Health care is a limited resource for which there is unlimited demand. In 2005 health care expenditures were 16% of GDP, with projected increases from $2 trillion in 2005 to $4 trillion in 2015. For the past forty years, demand for health care has risen each year without indication that the market for health care is satiated” (Crowe, 2010, p.455). Premiums for those with coverage has increased drastically over the years while what is being covered has decreased or has had increased copays and deductibles applied. “In 2007, the established system of payment for services and access to the health care system was impacted by an economic recession resulting in a loss of 5.1 million jobs...
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...Unemployment rates and the overall costs of living have been at an all-time high over the past few years. As more citizens struggle to make ends meet, guaranteeing good health becomes secondary to them. More people are concerned with providing food for their families and paying essential bills than adding on the burden of costly medical insurance. A large number of residents in America choose to overlook their sickness and bad physical conditions due to the high cost of a doctor visit. The government has been focusing on fixing this problem by proposing the Affordable Care Act, otherwise known as Obama Care. It was created in large part to provide all Americans with affordable medical care and health insurance. Currently 15% of Americans are uninsured in regards to healthcare. What happens when these 32 million people get extremely sick or physically injured? Recent studies show that a large amount of them use the emergency room as their primary care facility which, in turn, increases costs for everyone. “In a May 2012 report, The Centers for Disease Control and Prevention cited a National Health Interview Survey that found that almost 80 percent of adults who visited ED's over a 12-month period said they did so because of a lack of access to other healthcare providers" (Doyle, 2013). Because of the increase in emergency room visits, hospitals have started requiring higher upfront fees such as co-pays before receiving treatment. Those who are uninsured can generally not afford...
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...University of Phoenix Material Case Study Comparisons Part 1 Complete the chart below that differentiates the following insurance types. |Plan Type |Characteristics of Plan (5 to 7 characteristics) |Target Audience for Plan | |Indemnity Plan |Able to choose hospital and doctor, Fee for service, deductible, |Individuals and Families | | |co payments, | | |Preferred Provider Organization (PPO) |Able to choose any medical facility or provider, Out of network |Individuals and Families | | |claims, No need for referrals to visit specialist, Annual | | | |deductible, Premiums | | |Health Maintenance Organization (HMO) |Fixed monthly fee, Focus on wellness and preventive care, For |Individuals and Families ...
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...injury. Common examples of preventative care are immunizations and yearly physicals. In fact, any screening test done in order to catch a disease early is considered a preventative service, such as routine Pap tests for women or prostate exams for men (http://health.howstuffworks.com/wellness/preventive-care/preventative-care.htm). Preventive health care services are so important that some are offered to patients at no cost. Since some of these preventative care options are offered for free to the public more people are taking advantage of the services offered and preventing health issues. The services that are often offered for free are flu shots, physicals, and dental checkups. Although some people take advantage of preventative health care some choose not to take advantage and the delayed access to health care will have a negative effect on an individual’s health status. The individuals with preexisting conditions would be at risk for their conditions to worsen or cause new health issues that could be dangerous and life threatening which then results to a visit in the...
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... Health insurance is a luxury. This is something that has become apparent listening to the ongoing debate about healthcare reform. The Center for Disease Control and Prevention reports that in 2013 there were 44.3 million uninsured people under age 65 in the United States. The purpose of this paper is to discuss how these 44.3 million are able to access healthcare and how there lack of access is detrimental to everyone. The Uninsured Two-thirds of people who are uninsured are between the ages of 18-65, have a job and more than half of these older adults have an increased risk of serious health problems. Being uninsured breaks all gender and ethnicity barriers and affects mainly the poor or near poor (Mason, Leavitt & Chaffee, 2014). Uninsured people have less access to preventative services and have more trouble finding a doctor or finding one that will take them as a new patient than those with public or private insurance (Gindi, Kirzinger & Cohen, 2012). When they do seek out medical attention many times it is in an emergency room and there illness may be in more advanced stages which means that there treatment will be more expensive. According to the Agency for Healthcare Research and Quality (AHRQ) the average ER visit can cost around $1500, the subsequent bill for these visits can be difficult to pay when that is more than you make in a month. These unpaid costs are absorbed by hospitals and then portions are passed on to insured patients increasing costs for the 270...
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...for State Farm, I called a friend in Underwriting and was told that he was ineligible due to his preexisting condition. This was when I started comparing Hospital Income (HI) to the Affordable Care Act (ACA) wondering when all insurance will be on the same accord. What good is it when the people that need it most cannot use it? Where the curiosity originated? In the past two years I have become more educated on insurance products. Since I am pursuing a degree in Health Care quite naturally I was drawn to Health Insurance. An opportunity presented itself in a State Farm Agent’s office so I transitioned from sales to a more in depth position, which gave me the opportunity to expand upon my understanding of health products. Hospital Income was the first product that my new Agent taught me. This was where I was shown the statistical data behind why parents buy HI and why people do not buy it until it is too late. This curiosity lead to me purchasing a policy for my daughter and myself and pivoting to HI each time it was appropriate. Basis for my research Although there are several preexisting conditions to choose from, I decided to choose asthma because it yields the most data. Asthma is easily diagnosed and more patients are treated in the Emergency Room from asthma each year. Upon researching several conditions, asthma has the most patient trends and seems to be one of the most common reasons...
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...Asthma What is Asthma? Asthma is an incurable lung disease in which the airways of the lungs swell and narrow making it difficult to breathe (National Institutes of Health, 2011). Symptoms of Asthma include: • Shortness of breathe • Tightness in the chest • Coughing • Wheezing Causes The exact cause of Asthma is still undetermined but researchers believe genetic and environmental factors may play an important role in the diagnosis (Mayo Clinic, 2011). Some of those factors are: • An inherited predisposition to have allergies • The parents have Asthma • Mother smoked while pregnant • Exposure to airborne allergens or viral infections while the immune system is still developing • Being overweight • Low birth weight A person living with Asthma can function normally; they do not experience symptoms on a daily basis. Although daily activities are not compromised in any way, people with Asthma must be aware of conditions that can cause the airways to narrow and swell (Mayo clinic, 2011). Some things that can trigger Asthma symptoms are: • Allergens from dust, mold, pollen, etc. • Irritants like cigarette smoke and chemicals such as cleaning products • Physical activity • Respiratory infections like colds Diagnosis Asthma is diagnosed by a primary care doctor and the diagnosis is based on family history, medical history, a physical exam, and test results (National Institutes of Health, 2011). The tests commonly used to diagnose Asthma...
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...Georgia 30122 770-942-3199 weecare.com Monifa Mwangi January 4, 2011 Executive Summary One of the top complaints of individuals seeking non-critical emergency services is wait time. For emergency room visits, a patient may spend 2-3 hours in an emergency waiting room for non-critical treatment such as fever, cough, sprains, etc. Quick2treat is an online concept developed to allow consumers access to WeeCare’s current office wait times and allows the patient to schedule an appointment, or hold their place in line for urgent care treatment. Once the patient has confirmed the appointment time, the patient is guaranteed to be seen within 15 minutes upon arrival. Internet registration for non-life threatening emergency department services that allows patient and family to avoid dreaded time in a waiting room. The concept of Quick2treat follows current technology for real-time online status reporting used by the airport industry, amusement parks “fast pass” system and online reservation services in restaurants. The market indicates that there is a significant need for quality “urgent” care other then emergency services provided by area hospital’s emergency rooms. Currently, the clinic employs competent, well-educated physicians and support staff to respond to the current needs of patients, however, there is room for growth. WeeCare has developed an excellent reputation with many of patients, through the work of our staff over the past three years, through successful marketing...
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...With the emergence of urgent care clinics, consumers have begun to have more choice in medicine. But with this additional choice has come some confusion as to the differences between urgent care and emergency medicine. This distinction is very important to consumers, especially families who tend to have multiple urgent care needs each year and are concerned about being able to afford that care. This article will break down the main differences between emergency rooms and urgent care, including what can be expected at both in terms of costs. Emergency Rooms The Centers for Disease Control and Prevention (CDC) states that Americans visited the emergency room roughly 136.1 million times in 2012. Nearly 20 million of these individuals arrived...
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...since the passage of Medicare and Medicaid. Obama Care is aimed primarily at decreasing the number of uninsured Americans and reducing the overall costs of health care. It provides a number of mechanisms, including mandates, subsidies, and tax credits, to employers and individuals in order to increase the coverage rate. Additional reforms are aimed at improving healthcare outcomes and streamlining the delivery of health care. Obama Care requires insurance companies to cover all applicants and offer the same rates regardless of pre-existing conditions or sex. The Congressional Budget Office projected that Obama Care will lower both future deficits and Medicare spending. Despite all that has been written about it, many people are still confused or unaware of how it affects them and their family. If you already have health insurance Obamacare improved the benefits you already receive in the following ways; it allows you to add your children up to age 26 to your health insurance plan. Your insurance company can no longer drop you if you become sick, even if you made a mistake on your health insurance application. It can't limit the coverage you receive over your lifetime. If you have a child with a pre-existing condition, you no longer have to worry about losing coverage if you change your insurance. That's because the new insurance plan can no longer deny coverage to children with pre-existing conditions. If you or another adult has a pre-existing condition,...
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...Reflection Essay Andrea Van Hoever HCS/567 Stephanie Holcomb May 4, 2015 Health care has grown considerable in the last few decades and with the growth has come a rise in the cost of providing this health care. Health care in America is much more expensive than it needs to be. The control of health care cost has become a priority for Americans. Consumers are looking for cost savings and health care is not the exempt from this search. This comes at a time when the consumer is looking for health care savings. Entrepreneurs are always trying to find new and improved ways of delivering services to the consumer. Entrepreneurs bring innovation and new ideas to the health care market. The purpose of this essay is to look at the effect of entrepreneurship on health care and present the positive and negative ways is has effected health care. New technology has the potential to improve patient care and improve outcomes for the patient. Entrepreneurs search for new and improved products and services to bring to the consumer. By making changes in the way health care is delivered and the quality of health care can be beneficial to the consumer. People are looking for and expecting new technologies within the health care industry. Entrepreneurs have the potential to bring this to the consumer at a lower cost. Positive ways entrepreneurship can affect health care through new and improved technology. The internet and smart phones have opened a vast amount of opportunity for tech savvy...
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