...brought about by the health reform, Health Insurance Info (2010) notes that are a number of different types of health insurance coverage designed to meet the needs and budget of a variety of individuals. In essence, health insurance is a risk management tool that ensures you and your family has access to the healthcare you need, when you need it without causing a tremendous financial burden. The cost of health insurance (the premium) may be higher for a policy that provides a great amount of coverage and flexibility while the premium may be lower for a policy that provides less coverage or less flexibility. There are two major categories of health care insurance the Indemnity and Managed Care Plans. An Indemnity Plan, sometimes called a reimbursement plan, reimburses you for medical expenses regardless...
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...Telemedicine: An Important Force in the Transformation of Healthcare 1. Introduction As we enter the new decade, healthcare for an aging population is a top-of-mind issue for government policy makers, business leaders and consumers alike. Healthcare costs have been steadily increasing, and a growing number of healthcare providers and patients worry that the recent budget crunches faced by healthcare providers will affect patient care in the years ahead. Healthcare providers are taking advantage of the American Recovery and Reinvestment Act (ARRA) stimulus funding to launch telehealth initiatives to face down some of healthcare’s most daunting challenges. According to the American Telemedicine Association: "Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term 'telehealth,' which is often used to encompass a broader definition of remote health care that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth." Following decades of media attention focused on the potential for telemedicine to transform health care delivery, the technology has matured, as has the acceptance of its use among providers and payers. ...
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...Diabetes Working Group White Paper Avalere Health LLC on behalf of the Diabetes Working Group January 23, 2012 Table of Contents Authors.......................................................................................................................................... 3 Acknowledgments ......................................................................................................................... 4 Executive Summary ...................................................................................................................... 5 Provider Survey ......................................................................................................................... 6 Standards of Care Economic Model .......................................................................................... 7 Recommendations .................................................................................................................... 8 Care Management ................................................................................................................................ 8 Payment Reform ................................................................................................................................... 9 Workforce Supply ............................................................................................................................... 10 Background and Role of the Diabetes Working Group ............................
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...Medicaid And The Problems The Program Faces Research Paper Introduction Medicaid is the largest health insurer in the nation, providing care to more than 50 million Americans with an annual cost around $250 billion. With Medicaid being the largest insurer in the United States, they face many problems and concerns, including limited access, low quality of care, financing and reimbursement concerns, and increased costs. Medicaid Reform is in the near future and with Medicaid’s spiraling costs, mandated managed care ought to be. The Medicaid program, created by the Social Security Amendments Act of 1965, is a partnership between the federal and state governments to provide healthcare to low income and vulnerable populations. The Federal Centers for Medicare and Medicaid Services (CMS) monitors the Medicaid program and establishes broad guidelines for program eligibility, services covered, the delivery of services, and the quality. Each state administers their own program with specific eligibility standards including the type, amount, duration, the scope of services covered, and the payment levels for services provided, (Perlino, 2010). Medicaid operates as an entitlement program making the federal government, under federal law and the budget process, obligated to pay their share of each state’s Medicaid program. The federal government matches the states spending services, varying from 50 to 77 percent depending on the state. Currently the federal government finances...
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...psychiatric symptoms, assesses personality, and measures intelligence. When clinical psychologist are not conducting therapy or assessing clients many psychologist are researching mental health disorders. Clinical psychologist are often employed by universities to research and develop and test prevention or treatment of mental health disorders. Other clinical psychologist are instructors or professors who teach psychology to undergraduate and graduate students (Witmer, 1996). Clinical Psychology History The field of psychology developed during the late 1800s and early 1900s. The development of psychology allowed the foundation of clinical psychology to form. Increased interest in the study of the human mind helped psychology develop. Sir Francis Galton became of the first individuals to research and study mental ability. After only a few years Wilhelm Wundt established the first psychology laboratory in Germany. In the United States, William James developed the first psychology laboratory. As laboratories began to establish an early system of diagnosis and measuring mental ability also developed (Brown, 1940). One of the first individuals to create a formal approach to psychological treatment was Sigmund Freud. He is considered one of the founding fathers of psychoanalytical therapy. Unconscious processes and drives are emphasized in his theories. A patient’s early childhood experiences are important to...
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...business healthcare Universal healthcare coverage in Indonesia— One year on Contents Abbreviations 5 Introduction 6 Indonesia’s version of Universal Healthcare: What is the JKN? What about the KIS? 8 Challenges with Indonesia’s version of Universal Healthcare 12 Teething problems—A short-term affair? 12 Balancing the budget—Fiscal sustainability 13 Chronic undersupply—Another barrier to providing truly comprehensive services 15 How should the healthcare industry prepare in the short to medium term? 17 Healthcare service providers: Pockets of opportunity 17 Med-tech and pharma: Spotting opportunities and tailoring product offerings 19 © The Economist Intelligence Unit Limited 2015 1 Universal healthcare coverage in Indonesia— One year on Foreword Ivy Teh, Managing Director at Clearstate, an Economist Intelligence Unit business. 2014 marked a watershed year for Indonesia, the world’s fourth populous country, with the election of the popular reformist politician, Mr. Joko Widodo, as its president. The year also saw the rollout of the long-delayed universal healthcare scheme (UHC). Indonesia intends to phase-in the world’s largest single player health care insurance program from 2014 to 2019, reaching universal coverage for all Indonesians in 6 years. After a much anticipated 9 years wait since the initial law was passed, the actual UHC rollout in Jan 2014 has led many to raise concerns...
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...Reimbursement and Pay for Performance University of Phoenix Lori Stemen October 28, 2013 Reimbursement and Pay-for-Performance The United States has gone through some dramatic changes over the last forty years and currently we are in the middle of some additional changes with the Affordable Care Act. Pay-for-performance is intended to improve the efficiency, quality, and the overall worth of health care. The expectation is that these changes will provide to physicians, hospitals and other health care providers with financial incentives to finance improvements and accomplish improved results for the patient. There are positive and negative affects of the pay-for-performance programs, although we can’t predict the future and the outcome of these initiatives, the health care system will definitely feel the pressure to perform with respect to outcome accountability. With the continuous changes of government regulations the pressure to provide reliable high quality health care will increase. Pay-for-performance is the newest regulatory effort in health the insurance industry. Health care providers who participate with the insurance carrier are compensated for meeting pre-set goals for how they deliver health care services. This is an important modification from the fee for service method of payment. Pay-for-performance has been well liked by politicians as well as, Medicare, Medicaid and private insurance companies. The Affordable Care Act increases the usage of...
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...Section I of the Capital Project Christina Haralson University of Phoenix HCS/571 Ralph Gigglio July 9, 2012 Section I of the Capital Project Within the hospital system, there are many decisions and steps one must take when deciding on a capital purchase for the organization. Capital purchases are considered purchases that will benefit your organization for more than a year. For the purpose of this paper the capitol purchase discussed is one of the electronic medical record. The federal government wants all medical providers to have an Electronic medical record by the year 2014. To keep up with the growing changes in technology allotting for this purchase will greatly affect the hospital system in many ways and prove its return on investment (ROI). According to Health Revenue.com, “ The goals of the EMR are: * EMR will help to streamline the medical records process by bringing structure to how it is done * EMR will help to ensure medical records are more complete and correct * EMR will help to providers follow drug authorization more thoroughly to protect against errors and abuse * EMR will reduce transcription costs * Fewer charts will have to be pulled because physicians will have easier access to information, no matter where they are * EMR will improve clinical messaging and thus improve the work flow and care of patients * EMR will help make charge capture more accurate (2011)”. This paper will explore the management and organization goals...
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...HMA1: Trends in Healthcare Western Governors University Healthcare Management Case Study HMA1 Linda Gunn August 21, 2010 HMA1: Trends in Healthcare The American healthcare system is in the midst of change. No other time in history has the call for healthcare reform been so strong. It is the emergence of expensive new technologies with an aging population and a new call for equitable quality access of health services for all citizens that have pushed for the impending change. Successful managers will need to understand the impetus for this change. The challenges will provide many opportunities for a manager that is properly prepared to lead and guide their organization. Model trends in the United States. Historically, the United State’s healthcare system has been provider dominated. Physicians ordered and directed care without concern for cost or resources. While complex and ever-changing, the focus was on treatment of infectious diseases such as polio, influenza, small pox. (Shortell & Kaluzny, 2006) Our current model of healthcare places much of the responsibility and burden of the cost of medical care on the individual. American healthcare spending approaches 17% of our gross domestic product (GDP), the highest of any member of the World Health Organization. Our performance consistently underperforms in comparison to our peer nations in such measures as life expectancy, infant mortality and overall level of health. (World Health Organization [WHO], 2000) ...
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...Preventing Heart Failure Readmissions Henry D. Santos Purdue University Calumet I. Introduction High morbidity, mortality, and healthcare spending have been connected with heart failure management. As per Gheorghiade et al., every year, there are almost a million cases of hospitalization for heart failure, responsible for 6.5 million hospital days, and estimated expenditures of $37.2 billion here in the United States alone (2013). The incident of heart failure readmissions has increased over the last decades, distinctly related to the aging population and surpassed recovery after a myocardial infarction. Based on the Centers for Medicare and Medicaid Services (CMS) 2005 data, heart failure is the most frequent diagnosis among Medicare beneficiaries and the third highest reimbursement for hospitals (AHRQ, 2013). In 2009, CMS started the public reporting of readmission rates after being discharge for heart failure, and, the year after, the Patient Protection and Affordable Act inaugurated financial penalties for healthcare establishments with most rates of readmission within the 30 days after discharge. The elevated concern relating the want to decrease readmissions has been the biggest focused of national researchers and hospitals with the efforts of identifying and predicting which patients with heart failure are likely to be readmitted. Formulated designs and preventive strategies have been established, in order to avoid unnecessary readmissions. Heart failures risk...
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...Company profile MR.P.V.ramprasad reddy,wholetim director ,and Mr K.Nityananda reddy , voice chairman along with the team of dedicated professionals, established Aurbindo pharma limited in Hyderabad on 26 December 1986 Aurbindo pharma limited is an ISO9001;2008 and GMP certified company it is engaged in manufacturing and marketing of wide range of APL’S formulations and intermidtries in in over 102 countries around the globe with more than 100 APIs and 200 dosage forms Aurbindo pharma limited is acknowledged market leader of APIs in manufacturing and export of pencillin cephalosporins anti-viral finished dosage forms (oral&sterile)etc and made its presence in south America, Europe, Asia, Africa, middle east, CIS and specific countries . joint ventures have been established in China Brazil and USA Aurbindo Pharma limited manufactures and marketing of wide range of organic intermidatries, semi synthetic pencillins, sterile and non sterile pencillins, cepholasporins and formulation dosage forms with an assurance of quality and reliability by making availability of wide range of Life-saving Life-sustaining Life-enhancing health care products. Aurbindo Pharma limited at Hyderabad India manufactures genetic pharmaceuticals and active pharmaceuticals ingredients the companies manufacturing facilities are approved by several leading regulatory agencies like USFDA, UK, MHRA, WHO, Health Cnada ,MCC South Africa ANVISA brazil. The companies robust product portfolios spread...
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...college. The main part of the curriculum is preparing for clinical competency, but typically lacks instruction in theory and the science of nursing. The ADN level nurse was developed in response to a shortage of nurses following World War II. Mildred Montag developed the two year ADN program in response to the nursing shortage. Montag's defined the ADN as a technical nurse which included skill and some judgment to function at the intermediate level. Leadership and management were not part of the curriculum. Bachelor of Science of Nursing (BSN) programs are taught at four year colleges and universities. Clinical competency is achieved, as in the ADN program, but also additional areas of study such as: leadership and management, critical thinking and community health care. In a study by Giger and Davidhizar (1990), BSN nurses significantly outscore ADN nurses in the professional category. They are were more concerned with research, teaching and community assessment, whereas the ADN nurse was more concerned with the technical aspects of nursing care (Giger and Davidhizar, 1990). Critical thinking disposition skills of senior programs revealed that BSN students scored significantly higher on critical thinking. (Shin, 1998). Although, most people have some critical thinking skills, it is a skill that must be developed. In the BSN...
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...Principles of Healthcare Reimbursement Anne B. Casto, RHIA, CCS Elizabeth Layman, PhD, RHIA, CCS, FAHIMA Copyright ©2006 by the American Health Information Management Association. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, photocopying, recording, or otherwise, without the prior written permission of the publisher. ISBN 1-58426-070-X AHIMA Product No. AB202006 Ken Zielske, Director of Publications Susan Hull, MPH, RHIA, CCS, CCS-P, Technical Reviewer Marcia Loellbach, MS, Project Editor Elizabeth Lund, Assistant Editor Melissa Ulbricht, Editorial/Production Coordinator All information contained within this book, including Web sites and regulatory information, was current and valid as of the date of publication. However, Web page addresses and the information on them may change or disappear at any time and for any number of reasons. The user is encouraged to perform his or her own general Web searches to locate any site addresses listed here that are no longer valid. AHIMA strives to recognize the value of people from every racial and ethnic background as well as all genders, age groups, and sexual orientations by building its membership and leadership resources to reflect the rich diversity of the American population. AHIMA encourages the celebration and promotion of human diversity through education, mentoring, recognition, leadership, and other programs. American...
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...curriculum is preparing for clinical competency, but this degree lacks instruction in theory and science of nursing. The ADN program was developed in response to a shortage of nurses following World War II. Mildred Montag developed the two year ADN program in response to the nursing shortage. Montag defined the ADN as a technical nurse which included skill and some judgment to function at the intermediate level. Leadership and management classes were not part of the curriculum. Baccalaureate degree nurse or Bachelor of Science in Nursing (BSN) programs are taught at four year colleges and universities. Clinical competency is achieved, as in the ADN program, but there is also additional areas of study such as: leadership and management, critical thinking and community health care. In a study by Giger & Davidhizar (1990), BSN nurses significantly outscore ADN nurses in the professional category. The baccalaureate-degree nurses were more concerned with the technical aspects of nursing care (Giger & Davidhizar, p. 1013). Critical thinking disposition skills of senior programs revealed that BSN student scored significantly higher on critical thinking (Shin, 2006, p. 236). Although, most people have some...
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...Case Study 13 Analysis Elizabeth Sapp University of North Carolina at Charlotte The situational analysis of Emanuel Medical Center (EMC) reveals a not-for profit independent hospital located in Turlock, California that is encountering financial troubles as it struggles to remain open. Changes in federal regulations such as the implementation of the EMTALA (Emergency Medical Treatment and Active Labor Act) laws and lower reimbursement rates for federally run insurance programs, changes in service area demographics, and the evolution of the services that locally competing hospitals offer have all contributed to five consecutive negative operating margins for EMC. (Harris, Vogt, & Gilinsky, 2004). Strategic Options Strategic issues are those events that affect an organization and its position within its environment. In the case of EMC the President and CEO, Robert Moen will need to discuss the options available to the hospital with other leaders through strategic planning. This is a process of developing steps for an organization to accomplish its mission and vision through strategic strategies. To make this process a success analyzing and understanding the situation is done by performing an external and internal environmental analysis along with refining the organizations’ directional strategies. In the end, EMC has five possible strategic options including, merging the hospital, selling the hospital, closing the ED, closing the hospital, or doing nothing and trying to...
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