...ASSIGNMENT 2 HSA 500 FINANCING AND STRUCTURING HEALTHCARE JULIUS AKINGBEHIN JANUARY 28, 2012 INTRODUCTION For more than seven decades, the United States healthcare system has improve significantly, compared to century ago and more has been done in terms of providing good healthcare an an antidotes to many disease process, this has been able to achieve due to the new healthcare technologies to tackle many diseases that were affecting citizens. In this modern day, it is apparently clear that the healthcare is one of the largest employer of labor according to the text (Williams and torrens, 2010) introduction to health services organization and management. The United States federal government have spent significant amount since the advent of Medicare in the country, in the late 1960s to date and this has rapidly grown to date. 1 – Identify and describe the three main types of health insurance in the U.S. The three main types of health insurance available in the U.S. today are voluntary health insurance, social health insurance and welfare...
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...Abstract Whether you are an economists or the average consumer, Health Care costs and spending seems to always be a hot topic. From my initial research I found that Health Care costs are steadily rising both in the private and public sectors. From what I have read I believe some sort of Health Care reform is required. There are vast numbers of people suffering and even dying because the cost of Health Care is too expensive. Unfortunately people skip doctor appointments and ignore ailments, just because they cannot afford it and it some cases people are paying the ultimate price. I’d like to look a little deeper into the Pros and Cons of Private and Public Healthcare and delve a little into some of the Health Care reform Bills that are in play or will be implemented in the near future. Specifically I want to look at Obamacare, as I hear it in the news, but do not know what impacts it has to the economy, good or bad. List of Figures Figure 1 6 Figure 2 6 Figure 3 7 Figure 4 7 Health Care Reform In recent years, a fair amount of attention has been geared towards Health Care. There has been a number of Economists that have voiced concern that rising health care spending could hurt the economy and lower employment. A December 2004 survey of CEOs found that employee health care costs are the greatest cost concern of America’s business leaders. (via aspe.hhs.gov). Due to the ever rising cost of healthcare, I found that approximately 53 Million...
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...Should Children’s Ear Infections Be Treated With Antibiotics? University of Washington, Tacoma THLEAD 350: Joane Moceri Should Children’s Ear Infections Be Treated With Antibiotics? There has been controversy about whether to treat children’s ear infections with antibiotics or just do an initial observation. Therefore, the issue to be analyzed in this paper is: Should children’s ear infections be treated with antibiotics? Terms & Definitions The purpose of this paper is to evaluate primary research articles by using methods of critical thinking and asking the right questions. This paper will discuss the treatment options for acute otitis media (ear infection) in children with either initial observation/watchful waiting (observing the child first before deciding to prescribe medications) or antibiotic treatment (form of medication usually prescribed to rid the body of infection). There are ten questions that I will be using from the book “Asking the Right Questions (ARQ)” by Browne and Keeley (2010), in order to do a critical analyses of six articles. For each question I will first present views from authors who are against the use of antibiotic treatment for acute otitis media (AOM). Then I will present views from authors who would rather treat acute otitis media with antibiotics. The first and main ARQ question that will be brought up and answered throughout this paper is, “What are the issues and the conclusions?” (Brown & Keeley, 2010, p. 10). There are two...
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...Telemedicine (telehealth care) Pros and Cons Before adopting the framework or infrastructure for Telemedicine, it is necessary to consider the pros and cons for the patients and the providers. An article published by Susan McQuillan for quality health reviewed by medical advisory, retrieved 2015-11-03 from Mayo Clinic identified these for pros and cons of using cyberspace for telemedicine. According Susan McQuillan (2012), these are the pros and cons. Pros: • You can use the Internet to get specialized health care information from medical centers and join group forums to get support and information from patients with similar problems. • If you live in a remote area and need medical care from a specialist who is located hours away, your local...
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...in health care spending and increasing the value of care have largely focused on insurance-based solutions. Consumer-driven health care represents the most recent example of this approach. However, much of the growth in health care spending over the past twenty years is linked to modifiable population risk factors such as obesity and stress. Rising disease prevalence and new medical treatments account for nearly two-thirds of the rise in spending. To be effective, reforms should focus on health promotion, public health interventions, and the cost-effective use of medical care. Disease prevention/health promotion approaches are key to slowing the rise in health care spending (Thorpe, Kenneth 2014). Over the past five years the cost of health insurance has risen 54 percent. This persistent rise has recently been attributed to the low out-of-pocket costs paid by consumers. Being oblivious to not knowing the full costs associated with health care, consumers demand more and “overuse” it (moral hazard). The growth in spending has also been linked to the rising use of prescription drugs and new medical innovations and treatments. Many others believe the rise can be traced to the lack of competition in the health care marketplace and have proposed new approaches for health plans to compete on price and outcomes. Economists thinking about rising health care spending note that there are only two approaches for slowing its growth: reduce spending on high-cost medical care that produces...
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...University of Phoenix Material Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care worker. Fill in the following matrix. Each box must contain responses between 50 and 100 words using complete sentences. Include APA citations for the content you provide. | |Origin: When was the |What kind of payment |Who pays for care? |What is the access |How does the model affect patients? |How does the model affect providers? | | |model first used? |system is used, such | |structure, such as |Include pros and cons. |Include pros and cons. | | | |as prospective, | |gatekeeper, open-access, | | | | | |retrospective, or | |and so forth? | | | ...
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...With a dawn of a new era in American healthcare history came the highly controversial Affordable Care Act. This act will create an estimated 16 million newly insured people by the end of 2014. However, there are public policies that need to be resolved. The public policy question that warrants further inquiry and needs to be addressed is section 3502 of PL111-148 does not include nurse practitioners. The public policy question is: Should the federal government mandate inclusion of nurse practitioners. The resolution to the public policy problem is to amend section 2703 of PL 111-148 to say: Section 3503 would include nurse practitioners provided they are practicing with and/or under a licensed health care professional. “Coupled with an estimated shortage of over 60,000 primary care physicians, the country's public health care system will be at a challenging crossroads, as there will be more patients waiting to see fewer doctors. Nurse practitioners (NPs) can help to ease this crisis” (Hansen-Turton et. al, 2013). Nurse practitioners are health care professionals who are more than capable of providing and critical access to primary care, particularly for vulnerable populations. Nurse practitioners are vital resources to help rural hospitals, create more financial sustainability by reducing costs to per patient, and maximizing patient outcomes. It would be extremely advantageous to expand the roles of NPs to include preventive services (Marsh, Diers, & Jenkins, 2012). It is...
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...| Affordable Care Act | What is in store for the future? | Caitlin Dulon 6-14-2015 | According to Medicaid.gov “The Affordable Care Act was passed by Congress and then signed into law by the President on March 23, 2010. On June 28, 2012 the Supreme Court rendered a final decision to uphold the health care law.” (P. 1) the affordable care act brought about a lot of changes to the way American’s were able to get health Insurance. Many American’s could not afford health insurance even though they were working jobs, or their place of employment did not offer insurance benefits. After the Affordable Care Act was put in place American’s had a place to get health coverage no matter what their current situation was. According to Medicaid.gov “The Affordable Care Act actually refers to two separate pieces of legislation — the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of that, together expand Medicaid coverage to millions of low-income Americans and makes numerous improvements to both Medicaid and the Children's Health Insurance Program (CHIP).” (P.1) The Affordable Care Act has given many low-income families the chance to have health insurance and be able to afford this insurance. These families are now able to get the preventative care that they need and be able to try and stay healthy so that they do not burden the United States with more medical bills they are unable to pay. But, even though they have insurance many...
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...Health Care Utilization HCS 235 October 30, 2012 Health Care Utilization The Affordable Care Act was signed into law March 23, 2010 by President Barack Obama; however, the constitutionality of the law remained in question. In a controversial 5-to-4 ruling, The U.S. Supreme Court upheld the law on June 28, 2012. The ACA is thought by some as the United States health care rescue, and as its downfall by others. It is estimated that the ACA will provide new services to 64 million Americans, providing health care coverage to 32 million previously uninsured. In addition to providing new health insurance coverage, the ACA implemented several components that can expand access to health care. One policy change will allow single adults, who are in school to remain on their parents’ insurance until they are 26. Another policy prevents denying children health insurance due to pre-existing conditions, this same protection will be provided to adults beginning in 2014. Rural communities are now expected to have greater access to health care as a result of increased payments for physicians willing to relocate. Additionally, the National Health Service Corps expanded to provide more health care providers to underserved areas. Community health centers are also expanding to provide care to those with little or no income. As an incentive the government is also offering tax credits to small business owners in order to make health coverage more affordable for their employees. One aspect...
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...Within this paper we will be discussing many aspects of managed health care. That being said, before going ahead and getting into all discussed such as pros and cons, I would like to start this off by discussing what exactly managed health care is. Now let’s ask ourselves this question, what is managed health care? Managed health care is basically a system in which incorporates financial and delivery. This is basically a way for health care businesses to have somewhat of a control on such services. That being said there are many options that fall under such type of organization. In the United States, we have a private and competitive health insurance system which will cause managed care to continue to evolve. Competition and rising costs of health care have even led indemnity plans to incorporate elements of managed care, resulting in fewer "traditional" indemnity plans. There are several key elements common to all managed care arrangements: explicit standards for selecting providers; formal programs for ongoing quality improvement and utilization review; emphasis on keeping enrollees healthy to reduce use of services; financial incentives for enrollees to use providers and procedures associated with the plan. Managed care is a system that integrates the financing and delivery of appropriate health care using a comprehensive set of services. Managed care is a broad term which encompasses many types of organizations and insurance options including: health maintenance organizations...
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...EXECUTIVE SUMMARY Trends come and go, and this is especially true in the healthcare industry where everything is currently constantly changing. It is always important to analyze pros and cons of business trends when deciding whether to implement them in an organization. While there are countless trends to consider, six in particular will be the topic of this discussion: Mergers and acquisitions, consumerism and the role of the patient, outsourcing, Lean Six Sigma, Medicaid Expansion, and Bring Your Own Device. In the ever-changing health care world, different business and finance trends come and go. In the midst of all the uncertainty, there is only one thing for certain and that is the goal of improving the bottom line. There are countless trends on the horizon for healthcare but there are six in particular that will be discussed: Mergers and acquisitions, consumerism and the role of the patient, outsourcing, Lean Six Sigma, Medicaid Expansion, and Bring Your Own Device. Careful consideration of the pros and cons of each trend can help determine whether implementing one or more of them is right for an organization. Mergers and acquisitions are expected to grow within the healthcare industry in the coming months and even years due to the Affordable Care Act. According to KPMG, 60 percent of the healthcare executives it recently polled said they plan to make more deals in 2013 than in 2012. Many of the deals are expected to be mid-market sized or smaller...
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...University of Phoenix Material Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care worker. Fill in the following matrix. Each box must contain responses between 50 and 100 words using complete sentences. Include APA citations for the content you provide. | |Origin: When was the |What kind of payment |Who pays for care? |What is the access |How does the model affect patients? |How does the model affect providers? | | |model first used? |system is used, such | |structure, such as |Include pros and cons. |Include pros and cons. | | | |as prospective, | |gatekeeper, open-access, | | | | | |retrospective, or | |and so forth? | | | ...
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...MEMORANDUM ON MANAGED CARE TO: Dr. Forney Fleming and the Class of Fall’14 for American Healthcare System FROM: Iyappan Somasundaram DATE: September 10, 2014 RE: Managed Care, Markets and Rationing Briefing Paper MANAGED CARE: An organized way to deliver healthcare services by efficiently utilizing healthcare resources to provide quality patient care. Managed care principles have been used for over 100 years in the U.S. The major goals of managed care include improving quality and accessibility of health care, improving outcomes and overall quality of life for patients and containing costs. The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973. The organizations that use the above techniques or provide them are called “MCO” or “Managed Care Organizations”. Managed Care organizations are broadly classified into two categories viz. HMO, PPO & POS. During the last quarter of the 20th century, HMOs emerged as an important alternative to traditional medical indemnity insurance plans, and largely supplanted them. This was largely known as the “managed care revolution”. HMOs have had a profound effect on every aspect of the practice of medicine-professional, scientific, social, economic, and legal. HMO (Healthcare Maintenance Organizations): HMOs are comprehensive health care delivery systems that offers a wide range of healthcare services through a network of providers who agree to supply services...
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...Medicare and Medicaid Reimbursement for Primary Care Introduction The Social Security Act of 1965 created Medicare and Medicaid, which provides health care coverage for the elderly, poor, and disabled. Medicare has become the largest single payer health entity spending $57.9 billion in 1980, $271 billion in 2003, and $513 billion in 2010 (Social Security Administration, 2012). Whereas, Medicaid being state funded, its governance is state-specific for spending. There have been very few changes to The United States health care payment system since Medicare’s and Medicaid’s inception, until March 23, 2010, when President Barac Obama signed into law the Patient Protection and Affordable Care Act (ACA). The three main goals of the ACA are to: increase the access to health care for all Americans, increase their quality of care, and make this care affordable. Unfortunately, despite the ACA’s good intent, its scope was far reaching, glossed over current problems within health care, and created more issues. It is filled with contradictory verbiage that required multiple teams of lawyers to decipher (with many different interpretations), and changed health care reimbursement with unknown consequences. Description of Policy and the Legislation The ACA attempts to solve the reimbursement problems in several ways. The act established the Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services, which is responsible for overseeing voluntary...
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...three assignment. Saint Joseph’s Hospital will focus on improving patient discharge instructions. This paper will have a description of each methodology researched as well as the pros and cons of each for the chosen performance improvement area. One of the mentioned methodologies will be chosen for the organizational plan as well as an explanation of that methodology was chosen. There will be a description of information technology applications researched as well as an explanation of they could be used to improve the performance area chosen for the organization. An explanation of the involvement of benchmarks and milestones in managing how quality indicators will be provided as well as three potential benchmarks and milestones from the quality indicators that could be used as part of the plan being developed. The last information to be provided is a description of an organizations performance and quality measures are aligned with the organization’s mission, vision, and strategic plan in general. After providing how performance and quality measures are aligned a description of how they align with the organization I have chosen will be provided. Quality Improvement Methodologies It is important for health care managers to improve quality services in health care facilities. This means the health care managers must use methods which are proven to be helpful in the QI process so they can improve quality services. One example is Six Sigma is used to display and measure quality improvement...
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