...The Future of Medicine Andrew Hovey GEN 499 Eric Fox 03/03/14 In theory, the Affordable Care Act is a great plan but the execution has been terrible because People do not understand what the ACA even actually allows them to do. The ability to keep insurance that was already owned was a fallacy, and the ability of people to actually get insurance via the ACA has been mediocre at best. It does however, represent our best shot at a country where everyone has access to medical care at an affordable rate and moves us toward what I believe to be an eventuality and something that is sorely needed, socialized medicine. The reason that I believe it is sorely needed is due to the fact that the fiasco with the website marketplace rollout involved with the ACA has shown us that even the government is not capable of keeping track of all of the different insurance providers and quite frankly the only thing they have done is confuse people as to what coverage they can receive. This would not be necessary if there were one non-private entity that handled insurance for the people. Many European countries use socialized medicine and admittedly, there are varying degrees of success but our system is broken. Competing healthcare companies, different degrees of care and skyrocketing costs have made healthcare un-palletable for many. Just shopping for healthcare on the Heathcare.gov website, one can see how confusing and frustrating the search...
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...affordable health care under the updated health insurance reform legislation passed by the House. "The Affordable Health Care for America Act or H.R. 3962, blends and updates the three versions of previous bills passed by the House committees. "(Kruger, M. 2010) This bill is expected to ease the out-of-control costs of health insurance, introduce competition into the health care marketplace that will help maintain coverage affordability, protect people’s choices of doctors and health plans, and guarantee all Americans access to quality, consistent , affordable health care. The Association of American Medical Colleges stated in a Mar. 21, 2010 article; "we have taken the first step towards truly transforming health care in this country. This historic vote by the House of Representatives sets into motion long-overdue efforts to cover 32 million uninsured Americans and to assure their access to high-quality care. The nation's medical schools and teaching hospitals have expressed their full support for this bill to President Obama, and now stand ready to work with the administration and Congress to carry out these significant changes to our health care delivery system." (AAMC, 2010) The health care reform bill creates a shared responsibility for health care among individuals, employers and the government to ensure that all Americans have affordable essential health benefits. Two of the key components, and possibly the most debated or criticized of the Affordable Health Care for America...
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...affordable health care under the updated health insurance reform legislation passed by the House. "The Affordable Health Care for America Act or H.R. 3962, blends and updates the three versions of previous bills passed by the House committees. "(Kruger, M. 2010) This bill is expected to ease the out-of-control costs of health insurance, introduce competition into the health care marketplace that will help maintain coverage affordability, protect people’s choices of doctors and health plans, and guarantee all Americans access to quality, consistent , affordable health care. The Association of American Medical Colleges stated in a Mar. 21, 2010 article; "we have taken the first step towards truly transforming health care in this country. This historic vote by the House of Representatives sets into motion long-overdue efforts to cover 32 million uninsured Americans and to assure their access to high-quality care. The nation's medical schools and teaching hospitals have expressed their full support for this bill to President Obama, and now stand ready to work with the administration and Congress to carry out these significant changes to our health care delivery system." (AAMC, 2010) The health care reform bill creates a shared responsibility for health care among individuals, employers and the government to ensure that all Americans have affordable essential health benefits. Two of the key components, and possibly the most debated or criticized of the Affordable Health Care for America...
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...Why do we need the health insurance industry? Need for health insurance The health insurance industry (XLV) mainly provides a risk management tool for an individual. People cannot predict the extent and timing of their future healthcare expenses. By paying regularly for health insurance, people can get protection against financial losses resulting from high health care expenses. It also enables them to better manage their cash flows as most health insurance plans specify the maximum amount an individual will need to pay in excess of the charge paid for buying the insurance, in a calendar year. Risk pooling According to study by the Congressional Research Service, the top 5% of the total population accounted for about 50% of the health expenses in 2011 and 2012. This uneven distribution of spending forms the basis of risk pooling, where people contribute an amount of money, at least equal to the per capita cost of medical services, expected to be used by the group of insured people. Risk pooling in insurance is essentially a cross-subsidy paid by low-risk members to high-risk members of the insurance plan. The above diagram shows that the performance of healthcare system or the efficiency of health insurance and effectiveness of risk pooling increases as the size of the group increases. However, the benefit of reduced risk resulting from the increasing size of the insured population reduces as the size increases a certain optimal size, S*. As size increases, the probability...
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...1. Read and study information related to: Integration of technology in health care evaluation and planning. Planning of health care services. Effectiveness of the delivery of health care services. 2. Prepare an outline of the most relevant aspects of the readings to be discussed in class. A. Integration of technology in health care evaluation and planning. a. As part of the strategy for the nation to put information technology to work in health care. This includes a variety of electronic methods used to manage information on health and health care of people 1.- Clinical decision support 2.- Diseases computerized records 3.-Computerized provider order entry 4.-Electronic medical records (EMR, EHR and PHR) 5.-Telehealth b. It makes it possible for health care providers to better manage patient care through secure use and sharing of health information. By developing records and private insurance for most Americans and provide electronic health information electronic health when and where needed, can improve healthcare quality, even as it makes health care be more profitable. B. Planning of health care services. a. Health care plan means a plan that promises to make arrangements for the provision of health care services to enrollees, or to pay or reimburse any of the cost for these services, in exchange for a fee paid in advance or periodic paid by or on behalf of the subscribers or enrollees. Also known as the service plan specialized medical care. C. Effectiveness...
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...Obama Care Obama Care Obama Care is thought by most people to be a US law aimed at reforming the American health care system. The main focus for this care is to provide more Americans with access to reasonable health insurance, improving the value of health insurance, regulating the health insurance industry, and decreasing health care spending in the US (Government, 2012). Many people have mixed feelings about Obama Care and how it is used in the US. In this paper, I will discuss the origins and the history of how Obama Care got started and its difficulties. Then, I am going to talk about the pros and cons dealing with Obama Care and the ways it will affect our economy. Next, I will discuss how Obama Care is funded and how there are still missing pieces that the administration needs to clear up. Lastly, I will argue how some of the American population thinks Obama Care is a scam. Then, to wrap up my paper I will be giving my opinion on this complex matter. Steps in the process of Obama Care The history of Obama Care is very complex but the name is the unofficial name for The Patient Protection and Affordable Care act, which was singed into law on March 23, 2010. The major requirements went into effect in January 1, 2014 even though significant modifications had happened before this date. Many Americans were opposed to Obama Care before it was even passed because they didn’t like the idea of the government taking over the healthcare polices. Now, I am going to...
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...Reporting Practices and Ethics Paper HCS405 July 29, 2012 Professor C. Brew Reporting Practices and Ethics Paper Financial accounting and financial management are the basis for health care accounting. The GAAP is a cornerstone of all accounting practices. Financial management aides and guides health care accounting practices in today’s health care settings. These two elements are the building blocks for a solid health care organization. Without the two, there is risk of fraud and unethical practices within health care. In financial accounting there are four elements of financial management. The first element is planning. In the planning element of financial management, the objective is determined and then the steps needed to reach that objective are identified so that the goal of accomplishing the objective can be met. The second element of financial management is controlling. In controlling the goals set in the planning element are monitored to ensure that the goal is on track. In the controlling stage of planning, managers use reports to track the goals, compare information and to gain feedback on the status of the goals. Organizing and directing is the third financial management element. In this element the manager works daily to track the progress of the goals, reviews daily the results of the organizing and is active daily in the progress of the goals. The final element of financial management is decision making. In the decision making element the financial...
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...volumes would otherwise incapacitate markets. Instead, it's the traditional role and public perception of safety-nets that's poised for the biggest transformation. "These hospitals don't always set out wanting to be the safety-nets, but it's a position they get forced into," says Igor Belokrinitsky, a strategy consultant with Booz & Company in Chicago. "They become a hospital of last resort, but they really want to be a hospital of choice. Do you want to stay a safety-net hospital or find something else that will set you apart?" One safey-net's approach Newspaper editor Henry W. Grady founded Atlanta-based Grady Health more than 120 years ago, concerned about a lack of quality healthcare for Atlanta's poor. Today, Grady's payer mix is roughly 34 percent uninsured, 32 percent Medicaid and 17 percent Medicare, with the rest covered by commercial insurance and workers' compensation. Grady provided roughly $200 million in uncompensated care to 100,000 uninsured patients in fiscal year 2011, and the system also trains roughly one-quarter of Georgia's physicians. Like many safety-nets, Grady is facing questions about patients'...
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...Your Business Fair? (The Impact of Affordable Care Act on Small Business) On March 23, 2010 President Obama signed into law the comprehensive health reform known as the Patient Protection and Affordable Care Act informally known as Affordable Care Act. According to the Executive Office of the President, Council of Economic Advisors (EOP/CEA), “the key goals of health care reform is to reduce the growth rate of costs while maintaining choice of doctors and health plans and assuring quality, affordable health care for all Americans.” (The Economic Case for Health Care Reform, June 2009) The ACA is created to improve the overall quality of health care delivery and its’ systems while adding new consumer protections. In the ACA there is a clause known as the individual mandate. This mandate requires most U.S. citizens and legal residents to obtain qualifying health care insurance coverage, and if not will be required to pay a tax penalty. Effective January 1, 2014 employers with fifty or more employees that do not provide affordable health coverage will receive an assessment where for those businesses with less than fifty employees are exempt. States have created health benefit exchanges for individuals and small businesses through which health coverage can be purchased at affordable prices. The Department of Health and Human Services (HHS) published several fact sheets and brochures highlighting what the ACA means for large and small businesses, individuals, families...
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...profound problem with health care spending. Rising health care costs are stifling economic growth, consuming increasing portions of the nation’s gross domestic product, and putting added burdens on businesses, the public sector, individuals, and families. GROSS DOMESTIC PRODUCT Health care accounts for about one-sixth of the entire economy — more than any other industry. Spending on health care totals about $2.5 trillion, 17.5% of our gross domestic product a measure of the value of all goods and services produced in the United States. That's up from 13.8% of Gross Domestic Product in 2000 and 5.2% in 1960, when health spending totaled just $27.5 billion — barely 1% of today’s level, according to the Kaiser Family Foundation, a nonpartisan health policy group. (http://usatoday30.usatoday.com/news/health/2009-06-19-health-economy) A variety of factors that has contributed to the growth in health care spending relative to the GDP. These factors include the following: • rapid development and dissemination of medical technology that expanded the treatment of disease • rising expectations about the value of health care services • government financing of health services • the nature of third-party reimbursement • the growth in the proportion of elderly • the lack of competitive forces in the health care system to increase efficiency and productivity in delivery of services , and • the misdistribution of physicians and other providers of health services HEALTH CARE LEGISLATION ...
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...competitive markets in health care can offer patients greater quality, more options, and lower costs. The Federal Employees Health Benefits Program and Medicare Part D serve as two illustrative examples of competition in health care today. Proper reforms to add further competition to the health care industry would be quite significant and would further America’s position as the world’s leader in health care for years to come. KEY POINTS 1. The body of peer-reviewed academic literature suggests that health care can and should operate like a traditional market. 2. Market-oriented reforms have the potential to improve the quality and cost-effectiveness of care, as demonstrated by the Federal Employees Health Benefits Program (FEHBP) and Medicare Part D. 3. Consumer-driven health plans are viable alternatives to traditional plans, and consumers should have the option of choosing such plans. 4. Proper risk adjustment mechanisms can prevent adverse selection. 5. Migrating toward value-based payment systems will result in greater quality of care at lower costs, in part by incentivizing the health care industry to make great strides in offering integrated care, innovative treatments, and personalized medicine. ABOUT THE AUTHOR Kevin D. Dayaratna, Ph.D.Senior Statistician and Research Programmer Center for Data Analysis Over the course of the past several decades, federal and state lawmakers have proposed a variety of initiatives to reform America’s health care system and...
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...businesses (Ftc Guide To Antitrust Laws, 2008). With the current health care debate issues concerning anti trust laws are also an issue for concern. A major facet of President Obama’s health care reform is for those within the health care community from providers to drug companies to commit on some level to keeping down cost. According to the New York Times, “Any agreement among competitors with regard to prices or price increases — even if they set a maximum — would raise legal concerns” (Pear, 2006) Anti-trust laws are imperative to keep the market competitive regardless of the type of business one runs. However, especially in terms of medical care it is important that issues, such as price gouging do not take place because of the large number of people who struggle with health care cost. Unfair business practices are always a point within business constantly under monitoring and creating changes because of said monitoring. Health care is essential to the everyday lives of the American people, from those who can afford to pay cash for their medical services to those who use public assistance, and everyone in between. If any area of business needs to stay abreast of issues concerning anti trust laws and monopoly health care is number one because of the domino effect health care can have on the economy (Jost, 2009). Another aspect of anti trust laws is the ability to keep the market competitive. In the instance of health...
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...1. Point-Counterpoint State Medicaid Policy and Health Reform Harold A. Pollack University of Chicago Authors: Pollack, Harold A.1 Source: Journal of Health Politics, Policy & Law; Feb2013, Vol. 38 Issue 1, p161-163, 3p The article discusses the positive and negative implications of the new ruling that the federal government could not require states that receive federal funds under the Medicaid program to participate in the Patient Protection and Affordable Care Act's (PPACA's) Medicaid expansion. Several shortcomings like limited provider payment and associated patient access barriers have been observed in Medicaid that make its adoption not a good idea. However, families below the poverty line can benefit. In July 2012, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The Court thus ended one phase in the political and legal battle over health reform. Yet in doing so, it opened a new front. In a notable departure from post–New Deal commerce clause jurisprudence, the Court ruled that the federal government could not require states that receive federal funds under the Medicaid program to participate in the PPACA’s Medicaid expansion. In effect, the Court made states’ participation in the PPACA’s Medicaid expansion voluntary — a possibility that neither the act’s supporters nor its opponents seriously entertained during the long legislative battle of 2009 and 2010. The full implications of these...
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...EMPLOYER RESPONSIBILITIES ......................................................................... 1 General ......................................................................................................... 1 1. Is there anything we have to do immediately? .................................................................. 1 2. Will I be required to offer health insurance coverage to my employees? .......................... 1 3. When will this requirement be effective? .......................................................................... 1 4. We have between 50 and 99 full-time employees (including full-time equivalents). Will we have to do anything in order to qualify for the delay until 2016? ....................................... 1 5. Our plan is self-funded. Will we have to do anything as a result of this new law? ............ 2 6. We are a governmental entity. Do we have to comply with this legislation? ..................... 2 7. As a self funded non-Federal governmental plan, can we still opt out of the requirements of HIPAA including Mental Health Parity?......................................................................... 2...
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...Fresco Community Health Center Case Study Analysis Abstract Arroyo Fresco (AF) currently provides services through eleven clinics and four mobile service vans across western Arizona. The three counties that are served through AF provide high quality primary care and preventative services to demographic areas with diverse geography, culture, income, and other varying factors (“Arroyo Fresco,” 2006). The facility guides its decision making process for organizational strategies with the combination of FOCUS and SWOT analysis. This allows for a well-rounded check and balance system to manage and prepare for current and future strategies for short term and long term processes. The increase in financial demands, consumer expectations, partnerships and mergers, quality of care given, and health care reform restructuring have placed a lot of expectations on health care facilities (“Creating an ethical culture,” 2011). The organizational strategy proves to be an important structure in order to provide a clear definition on how AF can change over time in order to successfully deliver a strategy and action plan that will benefit the short term and long term projections within the company (“Executive Insight,” 2008). AF has an found areas to improve the job descriptions, relationships, and management processes (Miles, Snow, Meyer, and Coleman, 2013). The organization strives to establish a strategic set of goals that will monitor, advance, and demonstrate health care results within...
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