...Medicare will be improved through a quality payment program which helps Medicare to target the goal for care quality and making patients healthier which is the most important part of the mission. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) discontinued the Sustainable Growth Rate formula, which made doctors and primary care physicians who participated in Medicare worried about possible payment cliffs for 13 years. The Quality Payment Program has 2 pathways to choose: 1. Advanced Alternative Payment Models (APMs) - To earn an incentive payment, you have to participate in an Advanced APM, through Medicare Part. You can be a part of the Quality Payment Program in 2017 if you joined the Advanced APM or if you have more than $30,000 worth of Medicare bill which is the allowed charges a year in Part B. The healthcare provider must also see and treat more than 100 Medicare patients a year. It has to meet both the...
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...located in Appendix C, according to the following case study: A 67-year-old Medicare patient presents to the office, exhibiting symptoms of HIV infection. After detailed examination, symptoms are determined to be advanced AIDS with manifestation of Kaposi’s sarcoma and other opportunistic infections. Name: James Brown Account Number: 080811 Insurer: Medicare Policy Number: 1098765 ID number: 12345678910 DOB: 02/01/1940 Gender: Male Insured: James Brown Address: 1600 Pennsylvania Ave. Wash. D.C. 60000 Marital Status: Widowed Patient’s Employer: Retired Nature of Condition: HIV, AIDS, Kaposi’s sarcoma Date of Illness: 06/01/2007 Referring Physician: Thomas Glassman, M.D. Physician ID: 1080808080 Federal Tax ID: 5551116679 Dates of Service: 06/01/2007, 06/15/2007, 07/07/2007, 08/01/2007 Procedure: Detailed examination, screening blood panel, pathology services Patient Signature Include ICD (categories only), CPT, HCPCS, and insurance information. If you believe there is insufficient information provided to fill a required field with data, indicate this by typing N/A. Post the completed CMS-1500 form as an attachment. Final Project: How HIPAA Violations Affect the Medical Billing Process Part Two: Write a 1,500 to 1,750 word essay in which you discuss implications of both forms of the patient’s diseases, HIV and AIDS, from the perspective of HIPAA confidentiality. Include the following in your essay: Discuss why...
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...Running head: CASE STUDY 4 FINAL ESSAY Jessica Miller CJ430 Conflict Management March 4, 2012 CASE STUDY 4 FINAL ESSAY 1 What is this world all about? Is it the money, power, fame, intellect or politics? If you ask me, I believe that in terms, it is all the above. If you have a lot of money, which it basically says “money talks and bull crap walks” and to be power and politics goes hand in hand. There isn’t one without the other. This world that we live in today is all about politics, where it seems that you have to bend over and kiss butts just to get by or to keep your job. In order to get this or that in life, sometimes you have to know the “right” people in “higher” places. It’s not right but unfortunately that is how it is. With politics, comes along with conflicts. There are debates when it comes down to it. During the Presidential campaigning, there are debates between two people address the nation with a lot of problem solving concerning the issues of the world. One party is stating what they believe that is better for the world while the other party will beg the difference. Both parties will make each other out to be liars but in all reality, Politian’s are just that; liars. Debates are great to have to know which party will win, back down and which party will get caught up in a lie. My all time favorite of listening to Politian’s is that when they are debating, they will refuse to answer a question and will...
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...care organization’s approach as well as support for risk management and, ultimately, patient safety. Access information from your own employer/organization or using the Internet to find an allied health care organization located in your city or region, and identify the goals and objectives, scope, and functions of an existing risk management plan. How does the plan “measure up” in terms of meeting ethical and legal responsibilities to stakeholders? How might you improve it? Explain. You are required to use and cite a minimum of two references from the GCU Library to support your response. HLT-313v Week 2 Topic 2 Discussion 2 Using the GCU Library, locate and summarize an allied health malpractice or negligence case study. If possible, select your chosen field of study. What went wrong? What workplace safety, risk management, or quality improvement steps were involved? What could have been done differently? If you were in charge of making sure this type of event never occurred again, what steps would you implement into the risk management plan? You are required to use and cite a minimum of two references from the GCU Library to support your response. HLT-313v Week 2 Assignment – Provision and Reimbursement of Health Care Services The areas of provision and reimbursement of health care services have each undergone considerable changes in the past several years, with the following current trends identified as being the most significant contributors to change: 1. The Patient...
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...such as pneumonia, cholera, and massive heart attacks, have been replaced by chronic and, often, degenerative diseases such as advanced cancers, diabetes, lung disease, and Alzheimer’s, leading to a slow death for most (Gardner, 2012). This places a great financial burden on the Medicare system as well as patient’s families. Atul Gawande (2010) reports that twenty five percent of all Medicare spending is for the five percent of patients who are in their final year of life, and most of that money goes for care in their last couple of months, which is of little apparent benefit (p. 3). Even more concerning is the suffering that many patients are forced to endure due to the lack of other options. Patients must have the right to make autonomous decisions regarding the end of their lives. They need to be confident that those decisions will be upheld, even if they conflict with the wishes of their families or physicians. However, patient confidence in knowing that their final wishes will be met is complicated by a lack of education and empowerment for those who face these difficult decisions (Frank & Anselmi, 2011). The purpose of this essay is to discuss the benefits to patient autonomy and the Medicare budget, by the legalization of physician-assisted suicide and voluntary euthanasia. Legalizing Euthanasia: A Practical Approach Imagine that your beloved pet suffered a stroke and could no longer eat, drink, walk, or care for itself the way it had been able to do previously...
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...1960’s Essay by Hailey Kotz The Nineteen Sixties was a decade that changed America forever. The topics that arose during the sixties were not small. When they were accomplished or challenged, the outcome changed American society forever. Most legislative bills passed in the sixties still remain today. The Office of Economic Opportunity (OEO) was created in August of 1964 by the Economic Opportunity Act. The OEO was a part of President Lyndon B. Johnson’s social and economic plans known as the “Great Society” and the “War on Poverty”. When it was created, the OEO coordinated the Job Corps, Neighborhood Youth Corps, work training and study programs, community action agencies including Head Start, adult education, loans for the rural poor and small businesses, work experience programs and Volunteers in Service to America. In the 1960 presidential election campaign John F. Kennedy argued for a new Civil Rights Act. The Civil Rights bill was brought before Congress in 1963 and in a speech on television on 11th June, Kennedy pointed out that: "The Negro baby born in America today, regardless of the section of the nation in which he is born, has about one-half as much chance of completing high school as a white baby born in the same place on the same day; one third as much chance of completing college; one third as much chance of becoming a professional man; twice as much chance of becoming unemployed; about one-seventh as much chance of earning $10,000 a year; a life expectancy...
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...To locate your exam number, go to www.hamline.edu and follow the steps below. A graphic guide to locating your exam number is attached to these instructions. Click on Logins in the header. Go to Piperline Log in to the secure area Enter your Student ID and PIN Click Student Services Click Registration Click Student Detail Schedule Select the appropriate term from the drop down menu Exam Numbers are listed below Total Credit Hours at the top of the page 2. Confirm that you are using and have typed the correct exam number on your exam document. 3. You may download the exam from the course TWEN site any time after 12:01 a.m. on Monday, April 29, 2013. All exams must be submitted within 72 hours of download. But, in any case, all exams must be submitted by the end of the final exam period, i.e. by 11:59 p.m. on Monday, May 13, 2013. Therefore, you will want to download your exam no later than 11:59 p.m. on Friday, May 10, 2013, to ensure that you have the full allowed 72 hours to complete your exam. 4. Write your answers to BOTH parts of the exam in a word processor. Save your document as a single PDF file before uploading to TWEN. Use your exam number as the name for the PDF file. Instructions Specific to This Examination GENERAL INSTRUCTIONS:...
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...Health Management: Overcoming Canadian Health Care Issues Canada is a country well known for many things, among the list of things it is known for would its universal health care system. Canada’s universal health care is known around the world. Unlike neighboring countries health care in Canada is share amongst all citizens, from rich to poor and young to old. If you ask many Canadians about their health care system they do address the fact that they are fortunate and happy to have universal health care but do have some issues with it. To fully understand Canada’s health care you must start to understand it from its core. The mismanagement of health care has resulted to long wait times and made it the biggest political issue facing Canadian health care (Rachlis, 2005). Wait times in Canada has become a major issue in the health care system and a major set back in providing good quality health services to Canadians. Along with addressing the issues of wait times I will also include the problems of packed emergency rooms, what exactly these wait times are and how it can improve. When ill or in pain, there is nothing more frightening or frustrating than having to wait for treatment. Many Canadian face long wait times for health services such as waiting to see a specialist, having a transplant or simply getting a check up at their local doctor office. Wait times in the Canadian health care system has become a problem for Canadians, despite polices which states equal access to...
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...Financial constraints, type of health care coverage, lack of health care providers and quality of care, transportation difficulties, existing health problems, and complete isolation of living in remote rural areas all act together to hinder rural residents in their struggle to live healthier lifestyles. The purpose of this essay is to present the categories of health care barriers that may affect John Q.’s health care utilization, identify factors that are mutable or immutable, and some of the ways the mutable factors can be change. There are many factors that affect John’s health care utilization; one example is the disparity in incomes for rural residents that cause financial constraints. According to the National Rural Health Association, the average per capita income is $7,417 lower than in urban areas and the rural residents are more likely to live below the poverty level (2013). John Q. has a full-time job but his income is still not enough to allow him to shop around for a better health care coverage that meet his needs. John’s employers are less likely to provide health care coverage which is why he is relying on Medicaid. According to the Centers for Medicare and Medicaid Services (CMS), Medicaid is a “government insurance program for persons of all ages whose income and resources are insufficient to pay for health care” (CMS, 2010). At least John is still fortunate enough to have Medicaid because other rural low income people do not have coverage at all. On the contrary,...
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...Can We Capture Potential Health Care Savings Without A Federal Takeover? by David V. Axene Most proposals for reforming the U.S. health care system of today focus on reducing the high cost of care. The standard thought process assumes that reducing costs will increase ac- cess to care by improving the affordability of health care and perhaps funding more care for the uninsured. An endless num- ber of proposals focus on this issue. In fact, most of today’s initiatives are based upon lowering costs and/or “bending the trend.” Too few proposals address the core of this essay, “How do we capture those savings?” Most insured and/or government run programs directly capture savings since the programs are directly and indepen- dently funded by premiums and/or taxes and savings result in surplus that can be readily captured. Self-funded, most experi- ence-rated and self-pay programs create much more challenging issues. The reduced cost flows directly back to the entity or individual without being captured for broader public policy uses. Who owns these “saved” funds? Is it the employer, the covered employees, the labor union, the individual? The plan sponsor very much considers these dollars as its own. After all, it reduced its cost of care; therefore, it is the plan sponsor’s money! Plan sponsors cringe during discussions about potential taxes on such programs since they view their right to self-fund the coverage an important freedom. Capturing Savings The challenging public policy...
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...Improving Quality and Value in the U.S. Health Care System By: Niall Brennan, Nicole Cafarella, S. Lawrence Kocot, Aaron McKethan, Marisa Morrison, Nadia Nguyen, Mark Shepard and Reginald D. Williams II Share on email Share on twitter Share on facebook Share on linkedin More... Share on google_plusone_share Share on stumbleupon Share on reddit Share on print Executive Summary The U.S. health care system faces significant challenges that clearly indicate the urgent need for reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps — even for those with access to insurance coverage. There is broad evidence that Americans often do not get the care they need even though the United States spends more money per person on health care than any other nation in the world. Preventive care is underutilized, resulting in higher spending on complex, advanced diseases. Patients with chronic diseases such as hypertension...
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...Essay for Universal Health Care Universal Health Care is something long overdue in America. With this system, every citizen would be able to have health care coverage. This system means that health care can still run independently, so it does not have to be government run like in socialized medicine. Universal Health Care should be put into place so everyone has the chance to stay in good health. A big problem with the health care system we have now is that people with pre-existing health conditions have a hard time getting health coverage. Someone who has had a disease in the past often cannot get affordable health insurance. Some insurance companies will cover everything but the medical conditions they were diagnosed with before because the insurance companies are afraid of having to spend more for the medical bill. This is because a lot of times a person is at a greater risk of having the disease again, like cancer. This could be the one disease a person needs help with, but their insurance won�t help them with that problem at all. The insurance companies save money at their customer�s expense. The patients are left with two options: leave the disease untreated at risk of making the illness even worse and living in discomfort; or pay the expensive costs to get treated, which could leave that person in debt. This scenario would not occur if the United States had Universal Health Care. No citizen could be denied of health care, no matter what their situation is. �����������...
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...Malone Introduction Stress is a part of everyday life and, to a certain degree, is healthy for an individual. Chronic stress, however, is not healthy for an individual, and chronic stress results in burnout. Burnout is defined in lay terms as physical or emotional exhaustion, especially as a result of long-term stress. Researchers have commonly found that individuals in the human services professions, such as health care, are more susceptible to burnout than individuals in other professions (Maslach, 1982; Pines and Aronson, 1988; Patrick, 1984; Weber, 1991). Today, the economic, political, and regulatory pressures in the healthcare industry have made an already stressful environment even more so (Dubnicki, 1991). The purpose of this study is to determine what burnout is, why it is so prevalent in the healthcare sector, and what human resources management can do to prevent burnout. Burnout Defined Pines and Aronson (1988) define burnout as a state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding situations. Physical exhaustion comes in the form of low energy, chronic fatigue, and weakness. Emotional exhaustion is characterized by the development of negative attitudes toward oneself, work, and life itself. Maslach (1982) defines burnout as a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who work with people. Emotional exhaustion is...
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...Introduction The essay will focus on the subject of rich and poor countries; it will distinguish between four classifications based on income levels. These include low-income country, lower-middle income country, upper-middle income country and high income country. It will provide an analysis and explanation for observed differences and trends. Each category will provide a practical example by comparing the levels of development indicators of the four countries as well as the trends over time. The development indicators include: Health – This is a state of the whole physical, mental and social well-being and not merely the absence of disease. A person can be in good health and poor health. Health is not just a feature of the daily life; it also appears frequently on the political landscape (Bury, 2005). Education – this is the act of teaching or getting general knowledge, developing the powers of reasoning and judgment, and generally of preparing oneself for developed life. Poverty and inequality- it refers to a social phenomenon under which the standard of living of individuals and households in a community or country is persistently below a certain level required physically for sustaining human life according to some accepted social norms (Bhalla & Qui, 2006). Inequality is the gap between the rich and the poor. GDP per capita- this is a core indicator of economic performance and commonly used as a broad measure of average living standards or economic well-being...
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...Writing to Convince Argumentative and Persuasive Essays Sometimes we write to defend an opinion, to argue against somebody’s point of view, or to convince readers why and how we think a certain problem should be settled. The argument we develop should be a logical, properly thought-out presentation of ideas that makes a claim about an issue and supports that claim with evidence. Within this general frame, our argument consists of four basic components: (1) an issue, (2) a claim, (3) support, and (4) a recognition and refutation of the opposing view. A. The Issue. An argument is concerned with an issue – a case (like war, smoking, cloning, etc.) on which people hold opposite or different opinions. To build a convincing argument about an issue, it is essential that we be aware of the audience we are addressing: • Agreeing audience: When you write to people who already agree with your claim, the focus is usually to urge them to take a specific action and build emotional ties with them. • Neutral audience: In writing to a neutral audience, try to emphasize the importance of the issue and offer explanations that clear up your readers’ questions or misunderstandings about, or lack of interest in it. • Disagreeing audience: The most challenging audience combines people whose viewpoints contrast with yours; they may be hostile to your claim and have strong feelings about the issue. In writing to a disagreeing audience, your goal is to convince readers to consider...
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