...Evolution of Health Care: Effects of the Health Insurance Portability and Accountability Act HCS/533 AHMED JAMAL The Health Insurance Portability and Accountability Act (HIPAA) have been under a continuum since it was signed during the Clinton administration in 1996 (Schwartz, 2003). Policies have been implemented to protect patients’ privacy. What the establishment of HIPAA has enforced is that patients’ information must be protected from all unauthorized parties. Patients’ information is being stored electronically. The electronic form will protect the patient’s record from all parties involved with any change that a patient is involved with including insurance companies, employers, and health care providers (Degaspari, 2011). HIPAA has become a routine function in the health care system. Safeguards have been installed on facilities that have computers that store or have access to patient information. HIPAA’s involvement with the electronic system has improved the transmission of patient data while decreasing the number of errors which by comparison improves efficiency. Organizations must implement specific security objectives under HIPAA to be compliant. Under HIPAA standards any unauthorized exposure regardless of the circumstances to which the violation takes place is harmful to the patient. The continued changes have revisited the liability of violators which suggests any organization that is involved or responsible for such actions will be held accountable regardless...
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...Abstract The Affordable Care Act (ACA) brings a myriad of changes to the healthcare system and hospitals must adapt accordingly or face dire financial challenges. Some of the financial challenges will originate from the influx of Medicaid patients due to the Medicaid expansion. Based on these changes, there is an increased tendency for hospitals to engineer ways to reduce costs such as patient selection and staff reduction. However, for a hospital to participate in Medicare, which accounts for more than 50% of hospital budgets, certain laws and regulations must be followed. This paper discusses these laws and regulations and offers suggestions on how to adjust successfully to the upcoming changes. The Affordable Care Act (ACA) and Hospital Compliance In light of the current changes in the healthcare industry, it is imperative for every healthcare organization to adapt accordingly or face dire financial challenges. A major change included in the Affordable Care Act (ACA) is the expansion of Medicaid, which will provide coverage to millions of formerly uninsured US citizens and permanent residents (Rosenbaum, 2011). However, Medicaid is notorious for much lower reimbursement compared to Medicare and private/commercial insurance (M. Schmitt, personal communication, October 7, 2013). In addition, hospitals are now required to prove that the services they bill for actually improve and maintain patients’ health (Leonard, 2013). Hospitals are also required...
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...design, data collection, data management and collation analysis, interpretation, dissemination, and finally the application to public health programs. Like most new technologies; robust changes to processes can be delivered, but are met with opposition. Health information technology can defeat a lot of the lethargic processes comprised in healthcare management, but arguably by some as the use of terms such as unintended consequences can slow growth to the field and prospects of health information exchange http://www.amia.org/amia2012/panels. It is believed that while the Electronic Health Record would be composed and stored within secured database systems that there is huge risk which exist; patient privacy, as mandated by the Health Insurance and Portability and Accountability Act (HIPPA). The opposition that some have towards health informatics are that we do not know how to regulate the content and the management of the same. Impediments include laws and regulations that preserve different data collection and sharing rules, privacy and security concerns, and academic and economic disincentives to sharing and collaboration http://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a5.htm. The questions are where do we end and begin with whom,...
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...design, data collection, data management and collation analysis, interpretation, dissemination, and finally the application to public health programs. Like most new technologies; robust changes to processes can be delivered, but are met with opposition. Health information technology can defeat a lot of the lethargic processes comprised in healthcare management, but arguably by some as the use of terms such as unintended consequences can slow growth to the field and prospects of health information exchange http://www.amia.org/amia2012/panels. It is believed that while the Electronic Health Record would be composed and stored within secured database systems that there is huge risk which exist; patient privacy, as mandated by the Health Insurance and Portability and Accountability Act (HIPPA). The opposition that some have towards health informatics are that we do not know how to regulate the content and the management of the same. Impediments include laws and regulations that preserve different data collection and sharing rules, privacy and security concerns, and academic and economic disincentives to sharing and collaboration http://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a5.htm. The questions are...
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...Patient Protection and Affordable Care Act Diana Gonzalez Perez Florida International University Introduction The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010 by President Barack Obama. The PPACA was enacted to address the lack of quality health care delivery to the 49 million uninsured Americans, a number which has grown with the slow economic growth our country is experiencing (Rattue, 2011). As part of this legislation there are ten provisions, all which are important to comprehensive healthcare reform. Each provision addresses specific functions of the current healthcare delivery system including insurance, reimbursement, medications, and taxes. In this paper, specific provisions of the PPACA will be discussed as well as the legal implications of the legislation. Provisions The PPACA has ten provisions which supply legal guidance for the health care reforms expected to take place from 2010-2014. These provisions will continue to affect the Nation as healthcare continues to evolve. Title I. The quality, affordable health care for all Americans provision includes subtitles A-F. Title I sets the basic guidelines required to implement the PPACA legislation. Subtitle A. Subtitle A sets specific guidelines to be followed by health plans including the prohibition of establishing lifetime limits or annual limits for any participant or beneficiary after January 1, 2014, but permits a restricted annual limit for plans...
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...Running head: REHABILITATION CARE IN A SPECIALIZED SETTING Rehabilitation Care in a Specialized Setting: A Multidisciplinary Concept Analysis Dorota M. Loney University of Texas at Arlington school of Nursing In partial fulfillment of the requirements of N5327 Analysis of Theories in Nursing Rhonda Mintz-Binder, RN, MN, DNP April 29, 2012 Rehabilitation Care in a Specialized Setting: A Multidisciplinary Concept Analysis First we need to understand what Rehabilitation is to be able to focus on its concept analysis. It is a part of the continuum of care as it focuses on increasing a patient’s function for self care and mobility. The need for a rehabilitation care concept in a specialized rehabilitation hospital increases as the length of stay decreases in acute hospitals after surgery or procedures due to the financial burden on insurances, Medicare, Medicaid, and the acute hospitals themselves. No longer do we see in the United States two week long acute hospital stays after major surgeries, strokes or other injuries that affect the activities of daily living (ADL). The hospitals discharge patients back home much sooner than before or transfer them to facilities for further recovery. Unfortunately some of these facilities are long term acute care hospitals or nursing homes where continuing daily therapy is very limited. The fortunate ones get admitted to a specialty hospital called a rehabilitation (rehab) hospital that this paper will focus on. Here, nurses, occupational...
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...while keeping healthcare affordable, and returning value to its shareholders. Those are three very different goals. What may benefit their customers may not benefit their shareholders. Additionally by keeping costs lost their institutional plan members may benefit but at the expense of the patients or physicians. This paper will outline the various steps Magellan will take to deliver on all three of these principles. Target Outcomes and Measuring Results The most obvious thing a business can do to be successful is to maintain its profitability. Without turning a profit and maintaining cash flow the business would be forced to close its doors. Therefore, financial objectives are one of the most important considerations. With the recent passage of the Affordable Care Act, an insurer can no longer deny coverage for pre-existing conditions. Additionally all members of the public are required to be insured by 2014 as there are penalties for, not purchasing health insurance. This influx of new additional clients has created a boon for the healthcare industry, (La Monica 2015), insurance companies will face rising costs as more people join plans with pre-existing conditions. To ensure that the risks associated with new and existing members of their plans appropriately match their rewards, Magellan health has partnered with Informed DNA. This partnership will allow Magellan Health to provide genetic screening for susceptibility to disease, providing patient value. However, it will...
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...Consulting LLC, we truly believe that our employees are the most important elements that provide success to the organization. This is the reason why our organization is taking into account of the employee related expenses as solid investments, which can yield a healthy return for the future of the company. We call this investment the Return on Employee Investment (ROEI). This type of investment will assist a company in providing the best possible work environment in attaining the employee and their allegiance to the firm. The utilization of ROIE will bolster the company’s effectiveness, competitive edge, profit and success. The workforce today is confronted with changing economic trends, such as the implementation of the Patient Protection and Affordable Care Act of 2009 and the evolving changes in technology advancements. Blue Waves Consulting LLC policy aligns with our mission, vision statements, and values. Our mission is to be the most renowned, and trusted licensed professional business company sought out by our clients for delivering excellence in financial consulting. Our vision is to deliver service to...
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...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 The...
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...stands for Health Insurance Portability and Accountability Act. It was enacted by the U.S. Congress and signed by President Bill Clinton in 1996. Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. I will also discuss the differences, if any on how HIPPA is applied at military and civilian hospitals. History of Tricare In 1884, Congress set the stage for a program to serve the Armed Forces' medical needs. It was a very simple statement: “Medical officers of the Army and contract surgeons shall whenever possible attend the families of the officers and soldiers free of charge.” In 1943, Congress gave the go ahead for the Emergency Maternal and Infant Care Program (EMIC). This program provided maternity and infant care up to one year of age for wives and children of Service members in the four lowest parts of the pay table. Then, in December of 1956, the Dependents Medical Care Act gave authorization to the DoD so that it could contract medical care out to civilian health care providers in order to insure adequate health care to family members of active duty and retired Service members. Amendments to this Act laid the foundation for what would be called the...
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...Federal Health IT Vision and Mission Federal Health IT Principles Goal I: Achieve Adoption and Information Exchange through Meaningful Use of Health IT Goal II: Improve Care, Improve Population Health, and Reduce Health Care Costs through the Use of Health IT Goal III: Inspire Confidence and Trust in Health IT Goal IV: Empower Individuals with Health IT to Improve their Health and the Health Care System Appendix A: Performance Measures Appendix B: Programs, Initiatives, and Federal Engagement Appendix C: HIT Standards and HIT Policy Committees Information Flow Appendix E: Statutes and Regulations Appendix F: Goals, Objectives, and Strategies Appendix G: Acronyms ONC Acknowledgements Notes 3 6 7 8 21 28 36 49 51 65 67 70 74 77 77 78 Goal V: Achieve Rapid Learning and Technological Advancement 43 Federal Health IT Strategic Plan 3 Introduction he technologies collectively known as health information technology (health IT) share a common attribute: they enable the secure collection and exchange of vast amounts of health data about individuals. The collection and movement of this data will power the health care of the future. Health IT has the potential to empower individuals and increase transparency; enhance the ability to study care delivery and payment systems; and ultimately achieve improvements in care, efficiency, and population health. However, these technologies – including electronic health records (EHRs), personal health records (PHRs), telehealth devices, remote...
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... Camille Debi 1.0 Introduction In 2006, the state of Massachusetts initiated a health care overhaul by passing a reform law with the central tenet of providing healthcare to all of its residents. Widely popular and objectively successful, the law has been dubbed “Romneycare,” named after then Governor Mitt Romney who signed the legislation into action. The law mandates that nearly every resident of Massachusetts obtain a minimum level of insurance coverage and provides free health insurance for residents earning less than 150% of the federal poverty level. It also mandates employers with more than 10 full-time employees to provide health insurance. Among its many outcomes, the law established an independent public authority with the official title of “the Commonwealth Health Insurance Connector Authority”. However, it is commonly referred to as “the Connector”. The Connector acts as an insurance broker, essentially, offering free, highly subsidized and full-price private insurance plans to residents. The website serves as a portal for Massachusetts residents that allows them to access many of the Connector’s resources, as well as the ability to register online for an insurance policy. Although it has been amended significantly since its inception, many of the fundamental building blocks are inherently similar to those found in the Affordable Care Act, signed into federal law by President Obama in 2010, as will be explored in this research paper. In...
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...Accountable Care Organization is a healthcare organization characterized by a payment and care delivery mode. lt seeks to tie provider reimbursements to a quality metrics and reductions in the total cost of care for an assigned population of patients. A group of coordinated health care providers form an ACO, which then provides care to a group of patients. The ACO may use a range of payment methods, (e.g. capitation, fee-or-service with an asymmetric or symmetric shared savings). The ACO is accountable to the patients and the 3rd party payer for quality, appropriateness, and efficiency of the health care provided. The Centers for Medicare and Medicaid Services (CMS), an ACO is considered an organization of health care providers that agree to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program. This paper identifies the differences between HMO’s and ACO’s but also correlates the similarities between ACO’s and Patient Center Medical Home (PCMH). The ACO’s place a degree of financial responsibility on the providers in hopes of improving care management and limiting unnecessary expenditures while continuing to provide patients freedom to select their medical services. The success and challenges of ACO are identified and explored. By increasing care coordination, ACO’s can help reduce unnecessary medical care and improve health outcomes, leading to a decrease in utilization of acute care services...
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...Workplace wellness programs have gained an increasing spotlight in recent years with the introduction and eventual rollout of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare. These types of programs are organized, managed or sponsored by employers with a focus on enriching the lives and wellbeing of employees by improving their physical, mental, emotional and occupational health through education and awareness. The design of these incentive-based programs encourage and reward health conscious behavior such as healthy dietary habits, physical activity, stress management and smoking cessation as well as other disease prevention measures by providing financial incentive or other type of rewards for changing health-related behavior or improving measurable outcomes. Providing or endorsing these types of programs and absorbing the costs associated with the products and services, there must be an incentive for the company as well. It has been touted that these programs have long-term, positive implications for companies such as reducing healthcare costs associated with workplace injuries and occupational complications, increasing productivity, reducing absenteeism, improving employee morale and enhancing the general culture and environment within the workplace. The American Heart Association has reported that by 2030, 40% of Americans will have a diagnosed cardiovascular disease and direct medical costs to society will rise from $278 billion to...
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...experience, Dalene founded TB Proof, dedicated to raising awareness of TB among health care workers. Read more at 2013annualreport.jnj.com/stories/ New-Hope-for-MDR-TB-Patients CONTENTS CHAI R MAN’S LETTE R S UCCE SS E S & CHALLE NG E S Advancing Human Health & Well-Being Leading a Dynamic & Growing Business Responsibly Safeguarding the Planet H EALTHY FUTU R E S 2015 GOALS & PROG R E SS U.N. G LOBAL COM PACT DATA S U M MARY G R I I N DEX 2 Letter from Our Chairman & CEO 52 Labor Practices & Workforce Guide to the Icons 4 Successes & Challenges 55 Employee Retention, Development & Recruitment 9 Organizational Profile 58 Compensation 10 Report Profile 58 Diversity & Inclusion The icons below help to communicate the scope and boundary for each topic covered in our report. They represent the audience and locations throughout the world impacted by our business segments or enterprise. 11 Citizenship & Sustainability 59 Political Contributions, Public Policy & Lobbying Citizenship & Sustainability Strategy Our Strategic Framework 62 Intellectual Property 13 Our Citizenship & Sustainability Materiality Assessment Process 62 Stakeholder Engagement 15 Advancing Human Health & Well-Being 16 Global Health 18 Access to and Affordability of Health Care 21 Product Pipeline 22 R&D and Clinical Trials 24 Innovation 26 Market...
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