...Resource: Health Care Utilization Paper Grading Criteria Select either Option A or Option B from this assignment. Write a 1,050- to 1,400-word paper according to your chosen option. Option A Health care reform is part of an ongoing debate and recent substantial legislation. Address the following in your paper for Option A: In what ways have recent health care reform measures expanded or inhibited access to care? How might changes to access influence utilization? Explain the concept of what universal health care may be, and how current care reflects or contrasts with this. Who are the stakeholders involved in the movement towards a system universal health care? With healthcare expansion a goal of reform, what new roles are emerging in the industry today? Option B John Q. recently moved to a rural community. He works full-time, but qualifies for Medicaid because of his low income. John has high blood pressure and his father recently had a heart attack. Thus, he decided to call and find out which providers nearby accept Medicaid. While there are local doctors, he discovered that the closest primary care physician who accepts Medicaid is a 40-minute drive and appointments must be made 2 weeks in advance due to the number of patients at the practice. In addition, the practice does not offer weekend or evening hours. John usually catches a ride to work with a friend or relies on public transportation. According to Chapter 4 of The U.S. Health System: Origins...
Words: 496 - Pages: 2
...Health Care Utilization Paper HCS/235 July 22, 2013 University of Phoenix Health Care Utilization Paper The Patient Protection and Affordable Care Act one of the most controversial pieces legislation of the last 50 years was signed into law by President Obama on March 23, 2010. The Affordable Care Act was designed to put control of health care back into the hands of individuals, families, and small business owners. This paper will discuss the ways health care reform has expanded access to care; how these reforms will influenced the utilization of health care; this paper will explain the difference between these reforms and universal health care: and my personal experience these reforms and what are the positive of my experience with health care expansion. Ways the recent health care reform measures expand access to care. One way the Affordable Care Act will expand coverage is by allowing those with pre-existing health conditions to get health care insurance. Before this law it was almost impossible for people with these pre-existing health conditions to get affordable health care coverage. According to “Aspe.hhs.gov”(2012 “starting in 2012 Americans cannot be denied coverage, be charged significantly higher premiums, be subjected to an extended waiting period, or have their benefits curtailed by insurance companies because of some type of pre-existing heath condition.” Without the protection of the affordable health care act between 50 to129 million non-elderly...
Words: 1428 - Pages: 6
...Health Care Utilization Paper I have chosen to conduct my assignment on Option A. Obama’s Health Care Reform, commonly called ObamaCare but officially called the Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA) for short, was signed into law on March 23, 2010 (ObamaCare Facts, n.d.). According to “HHS.gov/HealthCare” (2015), “the Affordable Care Act puts consumers back in charge of their health care…under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health” (About the Law). In my paper, I will be discussing why health care reform is part of an ongoing debate and its recent legislation. In what ways have recent health care reform measures expanded or inhibited access to care? One of the ways health care reform have inhibited access to care is ending disapproved insurance coverage due to an individuals pre existing medical condition. In addition, another way recent health care reform has expanded in our society is the availability of affordable insurance to everyone. This is the most popular part of health reform: Health plans must sell coverage to everyone, regardless of pre-existing conditions, and can’t charge more based on health or gender ("Consumerreports.org", 2006-2015). Furthermore, health care reform have inhibited access to care by extending coverage for children up to the...
Words: 365 - Pages: 2
...Health Care Utilization Paper Michelle Stokes HSC/235 October 30, 2014 DR. Rose Fitchett Health Care Utilization Paper Option Chosen: 2 John Q In this paper I will be discuss John Q. and Medicaid. John recently moved into a rural community and works a full time job. John is eligible for Medicaid due to his low income and needs to see a doctor since John has high blood pressure and recently his father had a heart attack. John has local doctors but none of them except Medicaid and the closest one he can find is a 40 minute drive away and needs the appointment to be made two weeks in advance. John doesn’t have a vehicle of his own and catches rides to work and relies on public transportation. I will be discussing what factors may affect John’s health care utilization, if the factors found are mutable or immutable and some ways to change the mutable factors. What factors may affect John’s health care utilization? The factors in John’s situation that may affect John’s health care utilization are his form of insurance, the area he lives in, facilities that accept his insurance, his health condition, his level of income, and transportation. Are any of these factors mutable or immutable? John could get another job to make more money or one that provides affordable health care coverage, but in this time, jobs are scarce and he is probably lucky to have job he is in. He could look for another form of insurance; there are low cost government programs that many facilities will...
Words: 357 - Pages: 2
...Healthcare Utilization Paper Option A Tracie Y. Smith HCS/235 August 03, 2015 Mrs. Darnecia Garner Healthcare Utilization Paper The very mention of healthcare can send some people’s blood pressure up the charts. The debate over healthcare and who deserves what has been a constant ongoing issue since the early 1900s. There are some people who think medical care should be for the people who can afford to pay for it, and others think medical care should be a right to everyone. This paper will address five questions and provide the writers opinion on the matter. A recent healthcare legislation reform that has expanded access to care for individuals who otherwise could not afford it is, The Affordable Care Act. The passage of this act by the Obama administration during the early stages of his presidency puts consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights gives the American people the stability and flexibility they need to make informed choices about their health” (US Department of Health and Human Services, 2015) . This act allows individuals to gain access to insurance through a marketplace or government subsidies; therefore creating access to services such as checkups, well woman exams, and health prevention for heart disease, and diabetes that many people were not getting because of costs. One way access may inhibited would be locating a physician who will accept...
Words: 1175 - Pages: 5
...Health Care Utilization Paper Option B Svetlana Leyzerov HCS/235 May 25, 2015 Hanna Matatyaho Health Care Utilization Paper Option B The Behavioral Model of Health Services utilization was developed by Ron Andersen in 1968, and subsequently refined with his colleagues over the years. It is the most widely adopted conceptual framework for studying the use of health services, especially with regard to determining whether or not access to and consumption of health services is fair. The model underwent three revisions, or phases, the first of which was the initial Behavioral Model. Developed in the 1960s, this phase was focused on individual use of the health care services. Phase two was in 1970s, where Anderson collaborated with other colleagues in order to recognize the importance of national health policy, the resources in the health care system, and changes in those over time. A third phase, in 1990s, acknowledged changes in the environment as part of understanding the use of health care services. Although the Behavioral Model of Health Services Use was revised, the core factors that it was built on stayed the same. It is based on a function of predisposing, enabling, and need for health care. The predisposing factors are stronger in tendency for some individuals than in others. It is further subdivided into demographic factors including age, gender, and ethnicity; social factors- education, occupation, and residence mobility; health beliefs-attitude toward the...
Words: 1124 - Pages: 5
...Health Care Utilization Paper Shana Richard HCS/235 November06, 2012 Melynda Boothe Health Care Utilization Paper John Q. has different obstacles affecting his health care utilization. He works full-time, but still qualifies for Medicaid because his income is low. He has high blood pressure and family history of heart attacks. He does not have a car or his own mean of transportation and the nearest clinic that accepts Medicaid is a 40-minute drive. He has to make an appointment two weeks in advance because of the amount of other people seeking services from the same provider. He may to find ways to schedule his appointments around his job hours and the practice hours, which does not offer weekend or evening hours John is fortunate to have a full-time job and still receives Medicaid services. He is in a situation in which he has to make some major decisions. His decisions or choices or mutable factors because he can make or change things to his own ability, even if it works out in his best interest, or if it does not work out for the best, he can be alter his choice if he needs if needed. There are different tasks John may try or attempt to succeed in his struggle of help for health care. One thing John may try is looking for other means of transportation to and from the doctor. He lives in a rural area and gets a ride to and from work with friends and coworkers; there are health care providers that provide transportation to and from doctors’ appointments, hospitals...
Words: 696 - Pages: 3
...Economic Issues Simulation Paper Health maintenance organizations (HMO) are organizations that provide or organize health insurance, self-funded health care benefits plans, individuals, and other entities for the United States as a liaison with health providers or hospitals on a prepaid basis. In this simulation a virtual organization Castor Collins Health Plans presented three HMO options to two organizations. I will review one of the company’s demographics, discuss the HMO choices, explain the differences in the choices presented, and why I chose the plan I chose. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options, this is way today you are given more than one option for health care. Company: Constructit Constructit consist of a 1000 employees (550 men and 450 women) ranging from ages 26 through 42 and 60 percent of them are married. Constructit has to consider in the number of employees that would covers their spouses or children for insurance coverage. Thirty-two of the workers are physical active and 25 percent are moderately physically active. There are 170 men and 210 women approximately 38 percent with no health issues. Ten percent of men and 8 percent of the women are heavy smokers. Obesity rate is also a problem with 39 percent being obese causing a heavy absenteeism for reason of high blood pressure, diabetes, heart issues, and...
Words: 883 - Pages: 4
...|College of Natural Sciences | | |HCS/235 Version 3 | | |Health Care Delivery in the U.S. | Whenever there is a question about what and when assignments are due, please remember this syllabus is considered the ruling document along with your Instructors Policies and Course Requirements located in our Course-materials forum. You will also find our Course Calendar at the end of this Syllabus. This will assist you with when all assignments and DQ’s are due. Course Description This course provides a broad overview of the various functions of the United States health care system. The historical evolution of health care is examined. The student is introduced to the various forms of provider models and service delivery systems found in private and public health sectors, including ambulatory, acute, mental, and long-term care. The financing aspects of health care and their influence on health care delivery and quality are outlined. Policies Faculty and students will be held responsible for understanding and adhering to all policies contained within the following two documents: • University policies: You must be logged into the student website to view this document. • Instructor policies:...
Words: 3427 - Pages: 14
...Angel Gross HCS/440 Economic Issues Stimulation Paper 08/28/2014 Caryn Callahan Economic Issues Simulation Paper Introduction I am Angel Gross I am the vice president strategy and financial planning for Castor Collins Health Plan. My job description consists of on a daily basis is interacting with new patients and formulating health plans that will suit their needs also including pricing plans and setting insurance premiums. The HMO provides health insurance and health care services to enrollees through it statewide network of physicians and hospitals. Castor Collins currently has 100,000 enrollees throughout the state and is looking to increase this number. The first group constructit consist of a 1,000 people while the E-editors, comprises 1,600 people neither group has employer insurance this means that people comprising both groups will pay for they own insurance the people at constructit are willing to pay the maximum annual premium of $4,000 per person, while the people at E-editors are willing to pay a maximum annual premium of $4,500 per person. Constructit comprises 500 men and 450 women with the age group of 26 to 42 about 60 percent of the group id married. The members of E-editors comprise 760 men and 840 women in all the ages of 35 to 54 with the highest percentage of 61 percent being between 45-54 years of age. The majority of E-editors employees are listed as married. The work at E-editors is largely sedentary work sitting in front of computers...
Words: 1204 - Pages: 5
...Health Care Utilization Paper Meriecha Gaines HCS/235 Health Care Delivery in the U.S. Prof. Delores Usea Access to care tends to be a large issue across our nation especially in rural towns. It also affects who can get the care they need based on their social standings. The new health care reform has tried to expand the access for these particular groups of patients. The act has allowed for a number of things like access to care for those without insurance, increasing pay to rural providers and more pay for primary care providers. According to the HHS website, each year from 2010 through 2014 allow for new developments in the act to promote access to care. Effective July 1, 2010, “The Pre Existing Condition Insurance Plan provides new coverage options to individuals who have been uninsured for at least six months because of a pre-existing condition. States have the option of running this program in their state. If a state chooses not to do so, a plan will be established by the Department of Health and Human Services in that state (Key Features, 2010). By implementing these new ideas and plans we are allowing more Americans access to not only better quality care but care in general. Many people will say that this hinders us, but in reality it can make us stronger health wise. Allowing rural doctors to have a pay increase generates more enthusiasm to stay and or migrate to those areas. Also paying doctors based on quality not quantity will change the way patients are treated...
Words: 1162 - Pages: 5
...Health care reform in the United States is a hot topic and the source of legislation meant to make health care obtainable to Americans. Recent presidential elections have platforms used to promote health care reform. This paper will discuss ways recent health care reform measures have expanded or inhibited access to health care. This paper will discuss how changes to access influences in utilization. Concepts of what the universal health care may be and how current care reflects or contrasts with this will be discussed. The stakeholders involved in the movement towards a system universal healthcare. With healthcare being a goal of reform, the new roles emerging in the industry today. The Affordable Care Act puts consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health. Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition. If you are under 26, you may be eligible to be covered under your parent’s health plan. Insurers can no longer cancel your coverage just because you made an honest mistake. You now have the right to ask that your plan reconsider its denial of payment. Lifetime limits on most benefits are banned for all new health insurance plans. Insurance companies must now publicly justify any unreasonable rate hikes. Your premium dollars must be spent primarily on health care...
Words: 1156 - Pages: 5
...CONTROLLING HEALTH CARE COSTS WHILE PROMOTING THE BEST POSSIBLE HEALTH OUTCOMES American College of Physicians A White Paper 2009 Controlling Health Care Costs While Promoting the Best Possible Health Outcomes Summary of Position Paper Approved by the ACP Board of Regents, September 2009 What are the Major Drivers of Health Care Costs? Major drivers of health care costs include: inappropriate utilization especially of advanced medical technology, lack of patient involvement in decision-making, payment system distortions that encourage over-use, high prices for health care services, a health care workforce that is not aligned with national needs, excessive administrative costs, medical liability and defensive medicine, more Americans with declining health status and chronic disease, and demographic changes including an increase in elderly persons. This paper addresses each of these drivers of health care costs and provides recommendations for controlling them. Why Do We Need to Control Health Care Costs? Improvements in health care have the ability to provide opportunities for all people to live better, healthier lives. However, the rate of increase in U.S. spending on health care continues to exceed economic growth at an unsustainable pace. The rate of growth in health care spending is the single most important factor undermining the nation’s long-term fiscal condition. Why Should Controlling Health Care Costs be Linked to Promoting Good Health Outcomes? Increasing pressure...
Words: 26901 - Pages: 108
...A business report On Measuring Customer Satisfaction of Private Medical and Clinic-A Survey Study on Sylhet | . Executive summary In the seminar paper, we have tried to find out the satisfaction level of service taker of private hospital and problem facing by them in Sylhet region. We have collected important data through primary sources i.e. we surveyed regarding the satisfaction level of service taker of private clinic and interviewed many service takers from different private hospitals. We have collected relevant information from the website and journals. Healthcare is treated as one of the top most basic need. Healthcare strategies are vital to the ability of the third world country to achieve other development objectives. For this, we should be concerned about healthcare service provider organization. Private hospital and clinic provide large portion of healthcare service. But unfortunately, there are many problems in this sector. We have suggested some possible solutions regarding these problems. We can conclude that the service quality of private hospital and clinic is not well certified. Government should take necessary steps to ensure the quality of service. Table of Content Chapter- One: Introduction Page –No ...
Words: 5554 - Pages: 23
...HEALTH CARE UTILIZATION PAPER HCS/235 September 28, 2014 Paul Dereadt With the vast adjustment in health care which came into Law on March 23, 2012, the avenues of health care were expanded. Health Care Reform gave access to affordable Health Insurance and Health Care to the citizens and legal residents with low to middle income. For those who were already insured, the plan included measures to enhance affordability and stability. Whereas, in prior years leading to Health Care Reform millions of Americans could not afford health insurance, most people depended on their employers. Others low income individuals, families and the elderly depended on the Federal Government funded program for health insurance through Medicaid and Medicare. Approximately 32 million people can obtain Health Insurance through the Health Care Market as of October 1st, 2013 into April, 2014 (HHS.com). Small businesses, individuals and low income families are now able to shop in the health care market to compare prices from Federal, State, Local and Private health Insurance Companies. In addition, those who are enrolled will receive tax credits from the government (Austin & Wetle, 2012). One of the main avenues is through Medicare and Medicaid which is funded by the Federal government. This Health Insurance is considered as one of the most reliable coverage that assist Americans to live a more healthy life. According to Austin & Wetle for Medicare seniors 65 years and older, the permanently...
Words: 1190 - Pages: 5
