...PATIENT-CENTERED CARE 1 Patient-Centered Model in Primary Care It was 8 years ago that I lost my father suddenly to Coronary Artery Disease, so when my mother began to complain recently to me about mild shortness of breath, fatigue, and indigestion I took it very seriously. I immediately performed a nursing assessment. She did not appear in apparent distress and her vital signs were stable, so I opted to take her to the primary care physician rather than the ER. I believe this was in the best interest of my mother. Not only were her physical complaints addressed, but also the emotional affect that heart disease has on our family. Stewart (as cited in Hart, 2010, p.8) states that “effective patient care requires attending as much to patient’s personal experiences of illness as to their disease.” My mother has been a patient of her primary physician’s office for many years. The physician understands how losing my father suddenly at a young age has affected my mother both physically and emotionally. Though at the time I was unfamiliar with the 6 Components of Patient Centered Care Model introduced to me in Chapter 1 of the Hart book, I now see that the physician’s office did an excellent job addressing all six components of this model. The 6 Components of Patient Centered Care Model was developed at the University of Western Ontario as a way of integrating exploration of disease with the other physical and psychological components of the patient’s illness they may experience (Hart...
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...PRIMARY HEALTH CARE CLINICS IN WILLIAMSON COUNTY, TEXAS MARKET RESEARCH AND ANALYSIS AUSTINTATIOUS CONSULTING, LLC PREPARED FOR: DR. CHAU NGUYEN TABLE OF CONTENTS I. PURPOSE AND SCOPE OF ENGAGEMENT ........................ 1 A. YOUR CLINIC ........................................................................... 1 B. OUR EVALUATION.................................................................... 2 II. THE EVOLUTION AND CURRENT STATE OF THE HEALTH CARE INDUSTRY IN THE UNITED STATES............................... 2 A. THE IMPACT OF MEDICARE ...................................................... 3 B. IMPACTS OF THE THIRD-PARTY PAYER SYSTEM ........................ 3 C. THE AFFORDABLE CARE ACT AND BEYOND .............................. 5 III. MARKET STRUCTURE........................................................... 5 A. QUALITATIVE ASSESSMENTS .................................................... 5 B. QUANTITATIVE MEASURES ....................................................... 7 IV. COMPETITIVE ENVIRONMENT .......................................... 9 A. THE FIVE FORCES ................................................................. 10 B. SYNTHESIS ........................................................................... 11 V. LEGISLATIVE AND REGULATORY CONCERNS ............... 12 VI. CONCLUSION .................................................................... 12 ABSTRACT This analysis and memorandum were prepared by Marshall Coover, Chau ...
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...US through individual and employer markets. Humana is the fifth-largest company in terms of medical membership in the country. Humana is particularly strong in the Medicare market and has developed deep expertise over its 25-plus year experience with the program. Humana currently has Medicare offerings in all 50 states and offers Medicare Advantage plans and standalone prescription drug coverage for approximately 5.8 million members. In addition to selling insurance products, Humana also delivers primary care, urgent care, wellness, and other healthcare services through its operation of medical centers and worksite medical facilities via its Concentra subsidiary, CAC Medical Centers in South Florida, wellness company LifeSynch and other affiliated businesses. Humana’s president and CEO is Bruce Broussard, who was named president in late 2011 and appointed CEO in 2013.The company reported $41.31 billion in annual revenues for 2013. Humana says its strategy is to “offer its members access to quality, affordable healthcare services through a consistent, best-in-class member experience.” One of the key ways this is accomplished is through Humana’s “Integrated Health” approach, which places the primary care provider at the center of a coordinated care process that is “consistent, cost-effective...
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...Assignment 3: Persuasive Paper Part 1: A Problem Exists “Regulating the Regulators” Written By: Christine Roccasalvo Professor Holly Sprinkle Research & Writing ENG 215 Sunday, August 05, 2012 Statistical figures of the accidental deaths of minors due to negligence in supervision have soared; emergency departments have called such overdoses “accidental.” “Should minors take their mental health prescriptions without parental supervision; should these medications be left at their reach?” According to G. Randall Bond, Randall W. Woodward, and Mona Ho (Journal of Pediatrics, 2011) children are at great risk due to the sheer ubiquity of accessible prescription pill bottles in their homes. According to WebMD ("Drug overdose," 2005) children younger than 5 years of age tend to place anything and everything into their mouths. WebMD specifies that unsupervised children tend to swallow medications by accident due to their innocent curiosity; these statistics also include parental negligence of leaving the drug at the child’s reach. It is commonly seen that if one child has unintentionally swallowed the drug there is a great chance that the child would often share the drug with other children. The scope and outline of this research is to examine statistical figures of children and adolescents overdosing and prematurely dying due to mental health medications. According to J. Setlik, Mona Ho, and G. Randall Bond (Clinical Toxicology, 2010) between 2001 and 2008, the amount of...
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...NEGOTIATOR INSTRUCTIONS: CANDIDATE This is a task that involves a negotiation between two people during a job interview. One person will play the role of the recruiter; the other will play the role of the candidate. You are the candidate. You have interviewed for a project manager position. You have four years of experience in this field and are completing your MBA this semester. The project manager job description is: • Responsible for the coordination and completion of projects. Oversees all aspects of projects. • Sets deadlines, assigns responsibilities, and monitors and summarizes progress of project. • Prepares reports for upper management regarding status of project. • Relies on extensive experience and judgment to plan and accomplish goals. • Performs a variety of tasks. o Interfacing with other areas of the company o Works with clients o Leads and directs the work of a team of six. • A wide degree of creativity and latitude is expected. • Reports to the head of the unit. • The job requires a little travel (approx. 1-2 days of travel/ month) You have interviewed for a number of positions. This job is your first choice. There are 8 issues of concern in this negotiation: Signing Bonus Job Assignment Vacation Time Starting Date Moving Expense Coverage Insurance Coverage Salary Location Your goal is to reach an agreement with the other person on...
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...Perspective on Health Care Lawrence Booker HCS/235 June 18, 2011 Dennis Phelps Abstract In my paper today I will be presenting my perspective on health care. I will describe what the word “health” means to me. I will describe my current position in health care and what new opportunities a bachelor’s degree in Health Administration will present in my current organization. It mentions my perspective on the career opportunities that a bachelors’ degree in Health Administration may offer. It describes the frequency of my access, cost, and experiences to health care. It explains my alternatives for care, and the cost associated with those visits. In paper the subject to describe is two other employers who are overlooked as part of health care that offer career opportunities. I will also describe one aspect of health care in the United States that I would change. In this paper health will be defined as the condition of being sound in body, mind, or spirit; freedom from physical disease or pain (Merriam-Webster, 2011). An individual health is usually considered good or bad depending on how well he or she can physically perform normal daily tasks like running, walking, breathing, eating and other activities associated with the five senses; sight, hearing, taste, smell, and touch. As a Director of Imaging (DI) without a bachelors’ degree the career opportunities are restricted to DI. The employment trend in DI requires that all individuals seeking employment as...
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...Dr. Martin’s Office Seeking a Referral The professor was not feeling well. In fact, on that Tuesday afternoon, he had felt tired and generally “down” physically. During the fifteen-minute drive home from work, he developed slight nausea and gastric discomfort. When he reached home he headed for the bathroom. For the next several hours, he experienced severe diarrhea and recurring waves of nausea and vomiting. After a few hours, the nausea had subsided somewhat, but the gastric distress persisted through most of what proved to be a long night. On the following morning, the professor called the office of his primary care physician, Dr. Martin. Dr. Martin’s nurse, Betty, came on the line. The professor detailed his physical problems of the previous night. “Betty, the nausea is pretty much gone, but the gastric discomfort is quite severe. I really feel that I need to see a doctor.” Betty replied, “Dr. Martin is booked solid all day, so it would be hard to see him.” “Betty,” the professor said, “I really feel that I need to see a doctor. Suppose I go to the HealthCheck Clinic. It’s close by, and I’ve always gotten good service there. Could the doctor refer me so that the University’s insurance would cover the visit?” Betty’s voice took on a doubtful and clinical tone. “The doctor would not refer you to the clinic. However, I can ask him to prescribe something for the diarrhea. We’ll call your pharmacy and place the prescription.” Slightly perturbed, the...
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...The perceptions that I have about a patient’s quality of life and their care has changed dramatically over the past few years. I have had the opportunity to be a home health and hospice nurse and care for patients and families. Through this experience I have gained a new understanding of how to care for homebound and dying patients. I used to not see what a patient’s home life was like. I would stabilize patients or get them to an acceptable level of health and send them home. I knew that some of them would die soon but never really understood what went on in the home. When I first got the home health and hospice job I felt that the patients needed the care of the nurse and that the family was there for support and to help the nurse. After doing hospice for a while I soon realized that I was not just treating the patient but their family as well. The patient’s quality of life was my main concern but health promotion among the family members was in my mind as well. I saw that if the family was well taken care of and were not burnt out on caring for the patient then everyone had a much better quality of life. By providing resources for the families I was better able to keep them in good health and therefore have them provide better and more loving care for their dying family member. The first thing that I would try to implement with the Thomas family is to get Mrs. Thomas’ pain under control. Pain is very debilitating and it is hard for loved ones to see each other in...
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...Health Patterns: The Taylor Family Amber D. Yancoskie Grand Canyon University: NRS-429 Family Centered Health Promotion December 9, 2012 Gordon’s Functional Health Patterns is a system that was created by Marjorie Gordon in 1987. This system served as a guide to establishing a broader nursing database. Gordon’s 11 functional health patterns consist of values/health perception, nutrition, sleep/rest, elimination, activity/exercise, cognitive, self perception, role relationship, sexuality, and coping. Assessment is the first tool in the nursing process in formulating health care plans for the individual as well as the family. A thorough assessment lays groundwork to promote family health (Edelman & Mandle, 2010). The patterns of functional health can be used to determine how a family interacts with one another and deals with their everyday life. According to Catherine Ross, a professor at the University of Illinois; “It is in the family that the macro-level social and economic order affects individual physical and emotional well-being” (Mirowsky, Goldsteen & Ross, 1990 para.1). This essay will describe the health patterns of the Taylor family by using specific questions personalized to each of the 11 functional health patterns. The Taylor family is comprised of Judy, 52 years old and David, 53 years old. The two have been separated for more than fifteen years and have three adult children and five grandchildren. Joshua, the eldest is 28 years old and engaged...
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...nonsmoker and drinks wine on rare social occasions. Lilly has a history of asthma, triggered by environmental changes, and it typically requires antibiotic therapy for bronchial infections 2–3 times per year. This presentation will review the following: 1. Priority care needs of the patient at the center of the case study 2. Priority care needs of the family care providers 3. The disruption that this acute illness has caused for the patient, family members, and clinical microsystem 4. The experiential features of acuity 5. The elements that the clinical microsystem 6. Potential barriers to providing care 7. The communication strategies that were used in the delivery of care 8. Well-defined (but flexible) roles within the clinical microsystem 9. Potential strategies for unexpected changes 10. The Deployment Flowchart Priority care needs of the patient require the organization to take good care of the patient in a timely manner to find the cause of the pain being experienced. The patient’s pain has to be kept at minimum, have direct communication with the patient and their family and try to find the cause of the pain in a timely manner and provide follow up instructions for the patient. Priority care needs of the family. It is vital that they contact Lilly’s husband Tom...
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...HSMA 4075-Managed Care in Health Systems Gynecologists as the Primary Care Physician? Sonya M. Artis September 11, 2008 Gynecologists as the Primary Care Physician? In managed health care the primary care physician has a role that is very significant to the delivery of care. A primary care physician serves as the initial contact for a person with an undiagnosed medical concern and they are responsible for the continuum of care for varied existing medical conditions. These conditions are not limited by diagnosis, organ system, or cause. Ordinarily, a primary care physician does not specialize in any medical specialty, such as neurology, oncology, pulmonology, or gastrology. However, the concept of the gynecologist as the primary care physician remains arguable. In comparison to the primary care physician the obstetrics/gynecologist also plays a vital role in the health care treatment plan---for women. As a result, some managed care organizations (MCOs), health maintenance organizations (HMOs) and indemnity health insurers may allow the gynecologist as the primary care physician. According to Kongstvedt, many obstetrics/gynecologists (OB/Gyn) feel as if they indeed deliver primary care. They make this assertion because “they are often the only physician a young woman sees for many years” (66). Healthy women do not always have medical concerns until problems arise with their female reproductive systems. Therefore, care provided by the...
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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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...plans designed to meet different needs. Some types of plans restrict or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network.” (Comparing health plans). However choosing the best form of medical coverage and being able to pay for it can be stressful to some. Each person and family may need different types of coverage and finding one that suits everyone in the household and accepts all family members due to their medical needs can be hard to find. This case study will look at such a family. A family with multiple medical issues to include, two members having diabetes and being obese, one of which has COPD and a child with asthma. We will look into different health care options and cost, a recommended plan for the family and then take a look at what the family will need within a year. Health care costs & coverage options Health Maintenance Organization Plans (HMOs) have a low out-of-pocket cost, which makes them a good choice if you want to avoid spending a lot of money. Also, since your co-pay commonly covers services outside the basic office visits, it is rather wide ranging. On the other hand, there are disadvantages for the reason that your choices are much more limited versus other plans such as, having to choose one primary care doctor and receiving referrals to see any specialists. There are some doctor’s offices that...
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...Material Insurance Matrix Directions – Matrix For each type of insurance listed in the matrix, identity three functions, three coverage characteristics, and three companies that offer this type of insurance. |Type of Insurance |Functions |Coverage Characteristics |Companies That Offer It | |Auto | |Comprehensive: Covers damage to your vehicle. You can|Geico | | | |pay for it to cover as much or as little as you care to|American Family | | |Auto insurance covers your car, the car or property of |by electing your deductible. |Allstate | | |someone else involved in an accident. And it will also|Liability: Covers damages to other people’s property | | | |cover any injuries to people involved. |or vehichle. You do not usually have a choice of | | | | |coverage...
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...under title xix of the social security act of 1965 to pay for health care for individuals and families with low incomes. Applying for Medicaid benefits a person must meet minimum federal requirements of the state in which they live, also call or write the local office to request for an application. Factors that determine eligibility for Medicaid are people with low incomes and few resources who receive financial (TANF). People who receive faster care or adoption assistance under title IV-E of the social security act, Children six years of age who meet (TANF) requirements or families who income is below 133 percent of the poverty level. Pregnant women whose family income who is income is also below 133 percent of the poverty level, and infants born to Medicaid eligible pregnant women however, people who are age sixty five and over, legally blind, or totally disabled and who receive supplemental security income(SSI) are also eligible for Medicaid. Medicaid offers two types of plan fee-for-service and managed care plan. Fee-for-service plan allowed patient to choose a provider of their choice, as long as that provider accepts Medicaid. These providers submit the claim to Medicaid and are paid directly by Medicaid. Managed care plans restrict patient to a network of physicians, hospitals, and clinics. Individuals who enrolled in managed care plan must obtain all service and referrals through their primary care provider (PCP), if a patient need to see a specialist, the PCP must provide...
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