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Health Services Administration
Examples of three value-added support strategies for a safe and caring environment
Managers of any nursing home are expected to promote the existence of safety and harmony within the nursing environment. This is possible through the adoption of various strategies targeting its valued-added care activities like bedsides procedures, teaching, vital signs, communication with patient care, and activities of daily living. Some of the strategies that can be adopted in order to bolster safety in the nursing home include:
Adopting diverse communication strategies between the patients and the nurses. The management must ensure that patients and nurses can voice their issues and possible grievances to the relevant authorities without fear of victimization. All stakeholders must be free to communicate with the nursing; this will enhance safety because individuals will be having a sense of freedom when expressing themselves. The best strategy is to promote the anonymous…
Choucri, N. (2007). Mapping sustainability knowledge e-networking and the value chain. Dordrecht: Springer.
Coddington, D.C., Fischer, E.A., & Moore, K.D. (2001). Strategies for the new health care marketplace: managing the convergence of consumerism and technology. San Francisco: Jossey-Bass.
Ginter, P.M., & Duncan, W.J. (2013). Strategic management of health care organizations (7th ed.). San Francisco, CA: Jossey-Bass.
Internship at NYU
At the NYU Langone Medical Center where I interned for 15 weeks from September 19th, 2016, to December 31st, 2016, I undertook several duties. While these duties varied and introduced me to a number of different activities connected to the internship process, the work environment at the medical center, laws that pertain to volunteering and more, my overall experience provided me with insight not only of the responsibilities of an intern at the Langone center but also of complexities faced by such an institution. This paper will provide an assessment and reflection on my internship at Langone and what I learned.
The NYU Langone Medical Center
The stated mission of the NYU Langone Medical Center is "to serve, teach, and discover" (Our Leadership, 2015). The Langone center is a non-profit organization that provides patient care, education and research pertaining to several aspects of the medical health field.…
These competitors include the two large hospitals in the region, several freestanding physician-owned centers offering urgent care, ambulatory surgical services and imaging as well as the small psychiatric care facility which offers inpatient drug and alcohol detoxification and rehabilitation. The university hospital which is 75 miles distant of MacMillan is also a stakeholder since they receive complex cases which are referred from MacMillan Hospital. They hospital-based physicians who MacMillan has contracts with are also stakeholders in this case. These physicians provide anesthesiology, emergency medicine, cardiology, medical imaging (radiology), and clinical and anatomical laboratory services. The Joint Commission on Accreditation of Health-Care Organizations which has numerously accredited MacMillan Hospital is also a stakeholder. The status provided by this commission helps MacMillan receive reimbursement for Medicare and Medicaid patients who account for a third of admissions at the hospital. The 21-member board of trustees who are trustees of the trust which was…
Veterans experience a variety of mental health problems, including posttraumatic stress disorder (PTSD), depression, anxiety, aggression, bipolar disorder, and schizophrenia (Wooten, 2015). More specifically, statistics indicate that up to 50% of veterans experience PTSD (Institute of Medicine [IOM], 2013). These problems often stem from exposure to combat. Mental health problems among veteran are further compounded by other problems such as financial difficulties, joblessness, marriage problems, social isolation, and homelessness (Smith et al., 2017). These problems are major risk factors for suicide and substance abuse. Indeed, approximately 22 veterans commit suicide every day (American Public Health Association [APHA], 2014). This paper focuses on this social justice problem, specifically highlighting the oppression faced by veterans with regards to access to mental healthcare, the ethical dilemmas associated with the problem, and policies enacted to address the problem.
For Veterans, access to mental healthcare remains a major challenge, with veterans in rural areas as…
Bright Well Mental Health Service Inc.
(Establishing Fictitious Mental health care center)
BrightWell mental health service Inc. is focused on providing health care facility to individuals of all ages. Their mental health service program is comprehensively designed to cater the needs of children, adolescent, adults and people of old age. The mental health services are not just limited to the psychological and emotional well-being of the individuals but BrightWell mental health service Inc. also provides substance abuse and chemical dependency (alcohol and drugs) services to adults.
The company has been in operation since January 1990, based its head quarters in New York, USA. It has aimed to provide mental health service throughout United States and also consultancy and medical care through its medical camps in developing countries of East Africa and Asian countries like Bangladesh, Myanmar, Nepal, Afghanistan, Syria, Turkey and Tajikistan.
Establishing BrightWell Mental Health Service Inc.…
Basically, building and preserving these relationships can be tough, given divergent institutional priorities, ethnicities, and anticipations and absence of a shared perspective. Members of a compact countryside neighborhood tend to be focused on a number of institutions that carry opposing priorities. Countryside institutions could also deal with restricted chances to partnerships, based on their general public health objectives and institutional priorities. Of further significance is the fact that developing relationships amid local health divisions (LHDs), neighborhood health facilities, health agencies, workplaces of countryside health, medical centers, non-profit institutions, as well as the private marketplace is important to meet the requirements of countryside neighborhoods. Efficient local relationships create the place for properly-synchronized tactical preparation that both enhances resources and motivates innovative methods to consistent general public health issues. By combining knowledge, money, and employees time, partners located in rural towns can determine common interests, rise above common problems, and build…
Determinants of Health elated to Chronic Disease Management of Elderly in Canada
It is agreeable that the health of Canada's population is well, particularly in contrast to various developed economies. However, the prevention and management of chronic diseases among the elderly present the greatest challenge to Canada's health care system. Today, the seniors have a tendency to living longer as they are healthier and economically better off compared to the previous generations. However, as they age, studies reveal that the elderly suffer increasingly from chronic diseases that exert extra burdens on the country's healthcare system. Canada's elderly populations are highly prone to poverty and have the greatest demands for community, home and acute care services (Belanger, Gosselin Valois & Abdous, 2014). Lack of government support and the shortage of home care nurses imply that most of the seniors are confronting health challenges of aging. As a result, the only health…
Belanger, D. Gosselin P, Valois P, & Abdous B. et al. (2014). Perceived Adverse Health Effects of Heat and Their Determinants in Deprived Neighborhoods: A Cross-Sectional Survey of Nine Cities in Canada. International Journal of Environmental Research and Public Health, Volume 11, Issue 11, pp. 11028-11053
Bradley-Springer, L. (2012). The social determinants of health. The Journal of the Association of Nurses in Aids Care: Janac, 23, 3.)
Cott, C. A., Gignac, M. A. M & Badley, E. M. (1999). Determinants of Self Rated Health for Canadians with Chronic Disease and Disability. Journal of Epidemiology and Community Health (1979-). Vol. 53, No. 11: 731-736
Kralik, D., Paterson, B. L., & Coates, V. E. (2010). Translating chronic illness research into practice. Chichester, Toronto: Wiley-Blackwell.
Property and buildings are upfront, whereas equipment that will need replacing or upgrading every several years is ongoing, and most departments are likely to have certain ongoing capital expenses. The acquisition of upfront capital resources should be made through an outside agent capable of sourcing and negotiating the best deal in the given market, while the ongoing capital needs of various departments should be reassessed annually and contracts should be reviewed and shopped just as often (Chernichovsky & Hanson 2009; Carrin et al. 2009). This will ensure ongoing efficiency in capital resources.
The recruitment and retention of human resources is very different then the acquisition and allocation of other resources, though operational needs and financial constraints are still highly influential, of course. Proper balances in compensation for human resources will need to be struck such that the organization is able to provide all necessary services and maintain complete…
Chernichovsky, D. & Hanson, K. (2009). Innovations in Health System Finance in Developing and Transitional Economies. New York: Emerald Group.
Carrin, G.; Buse, K.; Heggenhougen, K. & Quah, S. (2009). Health Systems Policy, Finance, and Organization. San Diego, CA: Elsevier.
ising Cost of Medical Malpractice: The Impact of Medical Insurance on Patients and Physicians
The purpose of this study is to examine the extent to which rising medical malpractice premiums have affected the quality care provided by physicians. esearch suggests that a majority of specialty practitioners are pulling out of practice because of rapidly rising medical insurance premiums. A majority of physicians are unable to pay premiums that are rising upwards of 43% on average per year. esearch has suggested that the recent crisis is due to a number of factors, including a recessive economy and excessive jury awards in recent claims. The solution lies not solely in legislative measures that entail caps on punitive damages, but rather more intensive examination of the cause of such premium increases and examination of more alternative solutions. This study aims at examining the causes and consequences of rising premiums, and examination of proposed…
Bloche, Gregg. (2002). "Trust and Betrayal in the Medical marketplace." Stanford Law Review, Vol. 55, 2002.
Boulard, Garry. "The Doctors' Big Squeeze: Huge Increases in Medical Malpractice Insurance Rates Are Driving Doctors out of Business. What's the Answer?" State Legislatures, Vol. 28, December 2002.
Broder, Ivy E. (1986). "Characteristics of Million Dollar Awards: Jury Verdicts and Final Disbursements," 11 Justice System Journal, 349.
Choi, Seungmook; Hardigree, Don. "The Property / Liability Insurance Cycle: A Comparison of Alternative Models." Southern Economic Journal, Vol. 68, 2002.
How the DOE Used the Acquisition Process to Demolish a Contaminated Building
Today, many organizations lack the resources to engage in a formal acquisition process while others rely on acquisitions processes that are specially designed for a specific project. In either case, these organizations may fail to achieve optimal outcomes due to these types of approaches to the acquisition process. One organization that has recognized the importance of using a formal, standardized acquisition process in the U.S. Department of Energy which oversees dozens of major projects each year. The purpose of this paper is to provide a detailed review of a major program that has been managed, via the acquisition process, over the past decade, by the Department of Energy at the Y-12 National Security Complex. A description of the demolition project is followed by a discussion concerning the acquisition process that was used to guide the process. Finally, a…
4% per year for the entire projection period." (Centers for Medicare and Medicaid ervices. 2009).
ources of Funds
The current funding climate on "health spending is fairly evenly split between the private and public sectors, with private health spending accounting for 54% of total health spending in 2007" (Kaiser Family Foundation. March 2009). Taken in totality, health insurance accounts for 71% of all funding sources with a categorical breakdown of: private health insurance at 32% of total spending, Medicare, 20%, Medicaid 15%, and other government programs four percent. Additionally 12% of funds flow from out-of-pocket programs, while other third party and investment programs account for 13%" (Centers for Medicare and Medicaid ervices. 2009).
pecifically, hospital care receives its 759.1 billion of spend from 24.4 billion of out-of-pocket expenses, and 669.3 billion of health insurance payments, of which private plans accounted for 265.9 billion, Medicare 220.4 billion, Medicaid 136.1 billion, and…
Specifically, hospital care receives its 759.1 billion of spend from 24.4 billion of out-of-pocket expenses, and 669.3 billion of health insurance payments, of which private plans accounted for 265.9 billion, Medicare 220.4 billion, Medicaid 136.1 billion, and other insurance programs 47 billion; other third parties accounted for 65.3 billion in spending. Physician and clinical services respectively spent 505.9 billion in 2009 with funding sources of: 47.9 billion out-of-pocket, and 407.3 billion in health insurance, of which 237.7 billion was private insurance, Medicare of 109.4 billion, Medicaid of 39.9 billion, and other insurance programs 20.3 billion; other third parties accounted for 50.6 billion. (Centers for Medicare and Medicaid Services. 2009).
Health Expenditure Trends
The trends in health care spending for hospital care and physician and clinical services have risen in lockstep over the last decades, and are projected to continue their upward trajectory through the coming projected period 2009-2019. Specifically, hospital care has demonstrated a total increase of 27.2 billion dollars spent in 1970 to 759.1
These individuals will then be able to seek some aspects of care and reimbursement through these qualifying federal services, and allow the IHS to bill federal programs to offset its own billing costs and to ensure the elimination of redundancy. These programs supplement the provision of care for American Indians and Alaska Natives and reduce the funding burden on limited funds directed to the IHS. These federal programs, also assist those who qualify in receiving care in areas where IHS services are not traditionally located, off reservation and possibly even in urban and/or rural areas without IHS services and programs.
Stakeholders in the programs are of course the IHS itself, all those American Indians and Native Alaskans who are covered by its services or could be covered for services, and the 557 Indian Nations in the 35 states they are affiliated with. Secondary shareholders are all the supplemental federal agencies…
About IHS (2008) Retrieved December 5, 2008 http://www.ihs.gov/PublicInfo/PublicAffairs/Welcome_Info/IHSintro.asp
Coward, R.T., Davis, L.A., Gold, C.H., Smiciklas-Wright, H., Thorndyke, L.E., & Vondracek, F.W. (Eds.). (2006). Rural Women's Health: Mental, Behavioral, and Physical Issues. New York: Springer.
French, L.A. (2000). Addictions and Native Americans. Westport, CT: Praeger Publishers.
IHS homepage (2008) Retrieved December 5, 2008 http://www.ihs.gov/index.asp
Even then, social services were largely extended to those citizens who were most vulnerable, like the unemployed, elderly, and young. Today, the idea that someone can be working, middle-class, yet still not have adequate access to affordable health insurance is likely to suggest to many Americans that the individual is at fault, not that the system itself is at fault.
Horror stories about people taken advantage of by their insurance companies when the companies refuse to cover treatment deemed medically necessary by the patient's doctors, and the spiraling costs of health care may increase support for a single-payer system. But it may require health care crisis to escalate still further, and to reach catastrophic conditions, for Americans to overcome their innate resistance to the idea that everyone is entitled to basic health care, not simply the poor, elderly, disabled, and…
Mental health services for adults and children in Florida are commonly provided by community health facilities and agencies. The use of community health agencies and facilities is providing these services are fueled by the need for an intensive care level to address the increase and impact of mental disorders. Florida State has embraced a framework of directive principles of care as the foundation for providing mental health services to adults and children. However, this framework has been insufficient to effectively deal with mental disorders for children in Jacksonville, Florida. Based on recent statistics, over 20% of children and young people experience the signs and symptoms of these illnesses during the course of a year (Goldhagen, 2006). A comprehensive, integrated community mental health service program is a suitable community-based approach this problem in Jacksonville, Florida.
Description of the Population
Mental disorders have developed to become a major health problem…
Buchanan, D. (2007). Integrating Behavioral Health into Primary Care. Retrieved from University of Nebraska -- Medical Center website: http://webmedia.unmc.edu/Community/CityMatch/EMCH/062807/DCBHS%202007.ppt
Cohen et. al. (2011). Three Models of Community Mental Health Services in Low-income
Countries. International Journal of Mental Health Systems, 5(3), 1-10. Retrieved from http://www.ijmhs.com/content/pdf/1752-4458-5-3.pdf
Flannery, F., Adams, D. & O'Connor, N. (2011, February). A Community Mental Health Service
Healthcare Financial Management
To quote Jonathan Clark at the beginning of his article, "Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process." Of the suggestions offered by the authors, which concept(s) give you the greatest insight into creating an improved evenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.
In his comprehensive advisory article to improve the medical industry's revenue capturing capabilities, entitled Strengthening the evenue Cycle: A 4-Step Method for Optimizing Payment, Jonathan Clark provides a series of sensible solutions to the ongoing dilemma of payment optimization. David Hammer also provides guidance to healthcare finance professional in his article The Next Generation of evenue Cycle Management, by reminding them that the key performance indicators (KPIs) which dictated policy in previous years…
Clark, J. (2008). Strengthening the revenue cycle: a 4-step method for optimizing payment. Healthcare Financial Management, 62(10), 44.
Hammer, D.C. (2007). The next generation of revenue cycle management. Healthcare Financial Management, 61(7), 49.
Seddon, J. (2008). Think system. Management Services, 52(2), 10.
Wilson, D.B. et al. (2004). 3 steps to profitable managed care contracts. Healthcare Financial Management, 58(5), 34.
Healthcare in Marketing (Lasik)
Lasik's Methods in Other Health Care Organizations
Customer profiling is a vastly unexplored marketing method in the health industry. While it has been used to target very specific markets, such as potential consumers of elective surgery, other markets have been largely neglected (arber 2001). The reasons for this are many, but mostly they include difficulties with medical data gathering, and legal issues regarding potential customer profiling.
Despite the above-mentioned difficulties, there are several organizations that can and do benefit from customer profiling. One such entity is the pharmaceutical industry (Winterhalter 2002). Here the customer being profiled is normally the health care professional, rather than the patient. y gathering geo-demographic data as well as customer loyalty information from a group of health professionals, pharmaceutical companies can significantly enhance the effectiveness of their marketing practices. This will further benefit not only the professionals, but also the healthcare consumer,…
Barber, F.A., R.K. Thomas, M. Huang. "Developing a profile of LASIK surgery customers." Marketing Health Services, Iss. 2, Vol 21. Chicago: Summer 2001.
Business Wire. "New Customer Wins Position Lawson as Dominant Enterprise E-business Solution Provider to Healthcare Industry." New Orleans, 2001.
Winterhalter, K. "Customer profiling in the healthcare industry." Weber Shandwick, 2002. http://www.browna2.fsnet.co.uk/PMLive/doctor_who_frame.htm
Healthcare Case Study Schuylkill County, PA
County Overview - Schuylkill County, Pennsylvania is located in the heart of the anthracite Coal region of Pennsylvania where the Schuylkill iver originates. Pottsville is the county seat, and the county showed a population of just under 150,000 as of 2010 with a density of 190 persons per square mile. The total area of the county is 782 square miles, almost all land, less than 1/2 a per cent water. The county's history, likely due to large coal deposits, focused on the railroad and industrialization (Schuylkill Chamber of Commerce, 2011).
The county experienced the high point of its population during the 1920s and 1930s, and has been losing people ever since, most between 1950 and 1970, with about a 1-2% population loss since the turn of the century. This is likely due to the lack of appropriate jobs and opportunities within the county. Schuylkill…
County Health Statistics - Healthcare 2010. (2009, March). Retrieved from Pennsylvania Department of Health: http://www.portal.state.pa.us/portal/server.pt-in_hi_groupoperator_1=or&in_hi_req_objtype=18&in_hi_req_objtype=17&in_hi_req_objtype=512&in_hi_req_objtype=514&in_hi_req_objtype=43&in_hi_req_objtype=1&in_hi_req_apps=7&in_hi_req_page=10&in_ra_topoperator=or&
Comprehensive Plan. (2010, March). Retrieved from City of Pottsville, PA: http://www.city.pottsville.pa.us/html/cp1.htm
Election Statistics. (2010, June). Retrieved from Pennsylvania Department of State: http://www.dos.state.pa.us/portal/server.pt/community/running_for_office/12704
Schuylkill County. (2010, June). Retrieved from Sperling's Best Places USA: http://www.bestplaces.net/economy/county/pennsylvania/schuylkill
Health Plan Dev
Health Plan and Health Organization Development
Five Key Events
There are a multitude of different historical events that have occurred in the modern era in a manner that has drastically changed the way in which health and the relationships between society and healthcare has been viewed. In Germany in 1883, Chncellor Otto van Bismarck managed to implement a national insurance-like healthcare scheme that ensured certain basic access to healthcare for many working-class Germans that would otherwise go without medical care. A second highly similar event occurred in England in 1911 with the establishment of a national health insurance program, which eventually became the National Health ervice of the United Kingdom that still provides healthcare services to the nation's citizens today.
The ocial ecurity Act of 1935 represents a major shift in the direction of healthcare policy in the United tates, as this legislation laid the groundwork for…
Socioeconomic and Legislative Influences
In the latter part of the nineteenth century and the first half of the twentieth century, industrialization began to create ever more stark and extreme differences in the living standards of individuals and families living at different rungs on the socioeconomic ladder. Medical care had become hugely more effective, but could not be afforded by many of the working class, and thus government increasingly saw a need -- and felt certain pressures -- to intercede and provide at least a minimum of care for its citizens. There are directly pragmatic economic benefits of such intercession; improved healthcare leads to increased productivity and reduced costs in other social spending, even potentially reducing criminality as fewer families would find themselves in destitute situations without reliable wage earners due to illness or injury. All of these socioeconomic factors have led to an increased sense of social and civic responsibility for healthcare, yet the initial and direct expense of such a system on a national level with universal coverage has been a dissuasive factor.
Healthcare organizations in the United States have been hugely impacted by several key pieces of twentieth century legislation, including the Social Security Act of 1935, the adjustments to Medicare and Medicaid made in 1966 and in subsequent years throughout the following decades. Currently, the Affordable Care Act is set to go into full enforcement in 2014, and healthcare organizations and insurance providers are already beginning to make adjustments based on these anticipated changes.
Health Management (Discussion questions)
The Emergency Medical Treatment and Labor Act (EMTALA) is a law governing how and when patients may be denied treatment or moved from one hospital to another in cases of extreme medical conditions. EMTALA was legalized as a component of the 1986 consolidated budget reconciliation (ichards & athbun, 2009). Sometimes, it is known as the CONA law. This generalized name has generated other laws. A common provision under the COBA name is the statute that governs continuation of benefits derived from medical insurance after job termination. The principal provision of this statute is as follows:
Patients visiting the emergency unit seeking treatment or examination for medical conditions must be given the required medical screening diagnosis. This will be helpful in identifying if they are suffering from emergency medical conditions. In case they are, then hospitals are obliged to either furnish them with appropriate treatment…
Davis, N.A., & Cleverley, W.O. (2010). Essentials of health care finance: A workbook for health information managers. Chicago, Ill: American Health Information Management Association.
Ferenc, D.P. (2013). Understanding hospital billing and coding. St. Louis, Mo: Elsevier.
Richards, E.P., & Rathbun, K.C. (2009). Medical care law. Gaithersburg, Md: Aspen Publishers.
Institute of Medicine (2013). Emergency medical services at the crossroads. Washington, D.C: National Academies Press.
Health Structures in Government Levels
Health at different Government Levels
Health Structures at Government Levels
Health at Government Levels
A national government has a task in ensuring quality health assurance standards across its region are up-to-date. Similarly, increased rates of unexpected epidemics have put governments under the surge of dealing accordingly with factors that can affect the nation directly and indirectly. Different governmental levels of health are identified and objectified in various agency websites. In this context, I have identified with a state level website; Illinois Public Health Institute website. Information presented to the website articles prioritizes in reducing and preventive, curative diseases, complementing health policies and championing for environmental changes.
Website Article eview
The Illinois Public Health institute articulates its review and implication to health quality through partnership programs. The website has supported state-oriented health involvement in ameliorating health levels, in Illinois. The institution has show-cased partnering programs with…
Baum, F and Kahssay, H.M. Health development structures: an untapped resource. World Health Organization. Vol 1 Issue 1. Pg 96-114.
Ladeia, M.L., Jacob, P., Borges, M.C., Rogero, M. M and Ferreira, S.R.G. (2011). Studies of Gene variants related to Inflammation, Oxidative, Stress, Dyslipidemia and Obesity: Implications for a nutrigenetic approach. Journal of Obesity. Vol 1, Issue 1. Pg 1-31.
5th March 2012. Illinois Public Health Institute. Retrieved from URL http://www.iphionline.org / Accessed on 27th March, 2012.
(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…
Resources, and Utilization
As a result, the Govt. has been eager to encourage self-medication, where probable, in an endeavor to save money and time as optimizing convenience for the consumer. (the UK OTC Pharmaceuticals Market: UK pharmaceutical market report)
E) Is there any one burning issue related to health care in this country that is undergoing extensive debate? What do you know about it?
Although Britain NHS has been a model for the rest of the world to emulate, however over the years, a persistent concern with cost constraints and market-defined efficiencies since the bygone twenty years has radically battered the core principles of universal healthcare in UK. The discouragement of proceeds of central taxation as the funding base has been coupled with Govt. passing the costs and dangers to patients and their families. The internal market launched by the Thatcher Govt. In 1980s showed the most prominent features of these modifications, however,…
Bad Medicine. New Internationalist. Vol: 355. April 2003.
Retrieved at http://www.newint.org/issue355/bad.htm . Accessed on 21 March, 2005
Bio-Pharmaceutical Study Finds Significant Link between Innovation and Market-based Drug Pricing. May 9, 2002. Retrieved at http://www.tiax.biz/aboutus/pdfs/press_releases/pharma_may.htm. Accessed on 21 March, 2005
Donelan, Karen; Blendon, Robert J; Schoen, Cathy; Davis, Karen; Binns, Katherine.
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
Furthermore, and despite its popularity as a tourist destination because of its natural beauty, the Appalachians are not a sterile environment by any means and the people who live there have higher risks for certain types of conditions than their counterparts elsewhere. According to Bauer and Growick (2003), "Americans who live in Appalachia experience unique and different ways of life than most Americans. Appalachian culture runs from the bottom half of the State of New York through the mountains of West Virginia and Southeast Ohio to the flatlands of Alabama. This area of the country offers different perspectives and challenges to life. Because of the geographical vastness and uniqueness of the Appalachian culture, many people with disabilities who live in Appalachia are unable to access rehabilitative services and agencies" (emphasis added) (p. 18).
Likewise, many rural residents throughout Appalachia may have septic tanks and will lack access to other…
Anguiano, R.P., & Harrison, S.M. (2002). Teaching cultural diversity to college students majoring in helping professions: The use of an eco-strengths perspective. College Student Journal, 36(1), 152.
Barrett, E., Hackler, R., Highfill, K.A., Huang, P., Jiang, X., Monti, M.M., & Peipins, Lucy. (2002). A Norwalk-like virus outbreak on the Appalachian Trail. Journal of Environmental Health, 64(9), 18.
Bauer, W., & Growick, B.M. (2003). Rehabilitation counseling in Appalachian America. The Journal of Rehabilitation, 69(3), 18.
Brown, J.W., & May, B.A. (2005, April). Rural Appalachian women's formal patterns of care. Southern Online Journal of Nursing Research, (2)6, 1-21.
Healthcare in the United States: Where We Have Been, Where We Are Going
The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.
Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain…
Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.
Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.
Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.
(ennie; Fontanarosa, 2006)
Apart from financial reasons, millions are not bale to access healthcare due to a lot of barriers inclusive of geography, racial differences and immigrant status. The people who do not have access to required care, that might comprise incapability to get primary care chronic care, specialist care, or emergency care stand at risk for severe health consequences. As per a recent report, absence of health insurance was linked with considerably lowered application of recommended healthcare services for cancer prevention, cardiovascular disease threat reduction, and diabetes management within the lower-income as also higher-income adults. Apart from the concerns, trouble, and stress directly associated to their illness, patients those who lack insurance or are underinsured also encounter increased levels of debt, threatening calls from collection agencies, anxiety, and possible insolvency. (ennie; Fontanarosa, 2006)
Impact of reform measures on the nursing profession:
The U.S. healthcare system is considered among the…
Granger, David; Young, Audrey. (1999) "Healthcare and the Underserved: America's Poor and Managed Care." Project of the Standing Committee on Health Policy: American Medical Student Association. Retrieved 10 September, 2007 at http://www.amsa.org/pdf/hlthcareunderserved.pdf
N.A. (2002, Jun 1) "Collective bargaining in the nursing profession: salient issues and recent developments in healthcare reform" Hospital Topics. Retrieved 10 September, 2007 at http://goliath.ecnext.com/coms2/summary_0198-95081_ITM
N.A. (n. d.) "Nursing's Agenda for Healthcare Reform." The American Nurses Association
Inc. Retrieved 10 September, 2007 at http://www.needlestick.org/readroom/rnagenda.htm
The Joint Commission on Accreditation of Healthcare Organizations -JCAHO is among the leading health-care benchmarks setting and accrediting bodies in the world today. To provide for continuous improvement to the safety and quality of health care provided to the general public through the provision of health care accreditation and the related services, which enable performance improvement in organizations that provide healthcare is the mission of JCAHO. The Joint Commission assesses and accredits almost 20,000 health care organizations and programs in the United States. It is an independent and non-profit organization. JCAHO has developed modern and professionally-based benchmarks. The Joint Commission assesses the compliance healthcare organizations using these standards. JCAHO services are provided to the full range of organizations involved or assisting in healthcare in any form. An organization accredited by the Joint Commission is acknowledged all around the country as meeting the performance standards of JCAHO, which…
"Health Facility Quality Assurance" Retrieved from http://184.108.40.206/search?q=cache:slYBAH_cu48J:www.doh.wa.gov/HWS/doc/HS/HS_FSL.doc+DOH+regulates+hospitals& hl=hi& ie=UTF-8 Accessed on 18 November, 2004
"HHS: What We Do" Retrieved from http://www.hhs.gov/about/whatwedo.html/
Accessed on 18 November, 2004
"JCAHO: Joint Commission on Accreditation of Healthcare Organizations" Retrieved from http://www.qmsonline.com/jcaho.htm. Accessed on 18 November, 2004
" (Arnold & Reeves, 2009). ith medical services price at the present time, illness or some kind of complicated to medical services may take people deprived of health insurance years to reimburse for bills that are medical. Furthermore, I believe that individuals who lost their jobs also are uninsured for the reason that their employer gave health insurance is no longer paying for them. I understand that based on the statistic; there are "way too many around 1 million workers that have lost their health reporting in the first three months of 2009. I think that helping people buy health insurance coverage with low-cost with offering the health plans options for the uninsured is the healthcare reform that is really needed now. In this way, individuals that are without health insurance will be able to afford paying their medical insurance to uphold their well-being.
In conclusion, with the increasing rapidly…
Arnold, P.J., & Reeves, T.C. (2009). International Trade and Health Policy: Implications of the GATS for U.S. Healthcare Reform. Journal of Business Ethics, 63(4), 34.
Belcon, M.C., Ahmed, N.U., Younis, M.Z., & Bongyu, M. (40-74.). ANALYSIS of NATIONAL HEALTHCARE SYSTEMS: SEARCHING for a MODEL for DEVELOPING COUNTRIES - TRINIDAD and TOBAGO as a TEST CASE. Public Administration and Management, 14(2), 10-14.
Bolduc, C.R. (2008). The impact of healthcare reform on HMO administrators. Hospital & Health Services Administration, 17(9), 23-45.
Reiboldt, M. (2010). The Industry Responds to the Passing of Healthcare Reform. The Journal of Medical Practice Management, 18(6), 327-328.
Health Policies Medicare
hen everyone in our country finally starts to reach the age of 65 years of age or older, then every person will become eligible for Medicare. It is clear that there are some elderly that are having minimum health concerns while others recurrently are dealing with medical issues for which they will have to seek out treatment by the doctor. However, research is starting to display that there are at least five top conditions that are enhancing on medical and drug spending. It is obvious that Heart disease circumstances are the number one medical issue that the those that are considered elderly are facing and that is becoming very costly to them. Most are unaware that the second one is the disease cancer and it could be internal or external for various elderly patients. Other issues such as joint ailments a lot of the times can cost…
Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.
Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.
Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.
Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.
Healthcare Strategic Management
In healthcare programs, I would like to implement a free healthcare service to poor people at least once a week. This is to provide assistance to those who are not blessed enough to fund their health checkups and care. Even if this program will not show profit, I believe that providing the needy with the health service that they need can help in the maintainance of good health to all people.
The poor health of people that I see in many countries, specifically in African nations, as well as those in the different communites in the U.S. particularly in the slam areas, has triggered me with the plan of providing free health services to the needy. I have the idea that if they cannot maintain a good living for themselves, at least helping them monitor and check their health status can lessen their burdens in life. In…
What Benefits Will I Get?
http://www.massresources.org/pages.cfm?contentID=50& pageID=13& subpages=yes& dynamicID=695#benefits
When considering the ever-changing and highly competitive economic landscape of the modern world; governments, businesses and institutions must remain diligent in their care and compassion for their citizens and staff members. With the current exponential growth and advancement of technology and the computerization of business and learning, voters, workers and consumers have become much more connected to the organizations they patronize (Kurzweil). Accordingly, these important groups are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of their followers, while simultaneously securing lucrative business models and job environments. One of the most important needs presented in all demographics is reliable healthcare. Thus, with the inelasticity in the demand for healthcare, countries need to determine an applicable system, whereby citizens can have access to the medical services they will inevitably need. Collective access to healthcare represents the main problem in field of…
Blumenschein, K. And M. Johannesson. "Economic Evaluation in Healthcare. A Brief History and Future Directions." Journal of Pharmacoeconomics 10.2 (1996): 114-122.
Cox, Malcolm, et al. "Health Care Economics, Financing, Organization and Delivery." Family Medicine January 2004: 20-30.
Hamburger, Tom and Kim Geiger. "Healthcare Insurers Get Upper Hand." The Los Angeles Times 24 August 2009.
Jeremiah Hurley. "An Overview of the Normative Economics of the Health Sector." Journal of Health Economics 1.1 (2000): 55-118.
In their move from a completely government-paid and -- operated healthcare system to a fees-based approach, the Chinese have greatly improved the efficiency, availability, and efficacy of their healthcare system (Wan & Wan 2010). This suggests that a combination of perspectives, rather than the market or single-payer perspectives that form so many healthcare systems, is most effective.
There are also, of course, healthcare systems that have developed in the same period as those mentioned above, but with far more negative results. The South African healthcare system, though effective in combating certain specific conditions, has many of the same failings as the United States' system, only on to a far more apparent degree. A lack of organization and responsiveness, exacerbated by an attempt to exert highly politicized and highly centralized control over healthcare provision, has plagued South African efforts to combat AIDS and many other problems the country -- and the…
Offredy, M. (2008). "The health of a nation: perspectives from Cuba's national health system." Quality in primary care 16(4), pp. 269-77
Sewankambo, N. & Katamba, A. (2009). "Health systems in Africa: learning from South Africa." The lancet 374(9694), pp. 957-9.
Squires, A. (2009). "U.S. Healthcare reform: A comparative book review." Nursing ethics 16(5), pp. 673-5.
Wan, Y. & Wan, Y. (2010). "Achievement of equity and universal access in China's health service: A commentary on the historical reform perspective from the UK National Health Service." Global public health 5(1), pp. 15-27.
6% of GDP in 2002; in America, they were 14.6%, or almost double Britain's expenditure" (Klein 2005). However, this frugality means that bypass surgery, dialysis, and medications in general are much more rarely prescribed in the U.S. than in the UK. hile there is frequent criticism that the U.S. is overmedicated as a society, the opposite is likely true in the UK. In other words, is unlikely that people are so much healthier in England vs. The U.S. To justify certain statistical disparities in care: the rate for coronary bypass surgery in the UK is 20% less than it is in the U.S.
To address the problems of under-medication, recently there has been a proposal to allow drug companies in the UK with "innovative" medicines to bypass the current screening process for cost-effectiveness, as a way of expanding care. The companies could sell the drugs to the NHS at a…
Bosely, Sarah. Scheme to let new drugs bypass NHS value watchdog. The Guardian. Retrieved July 13, 2009 at http://www.guardian.co.uk/society/2009/jul/10/pharmaceutical-companies-nhs-nice-ols
Klein, Ezra. The health of nations: Great Britain. The American Prospect. Retrieved July 13,
2009 at http://www.prospect.org/csnc/blogs/ezraklein_archive?month=04&year=2005&base_name=the_health_of_nations_england
Healthcare in Sweden
The healthcare system in Sweden is used as one of the model systems in the world. hen Johan Hjertoqvist from the Timbro Policy Group spoke before the Montreal Economic Institute in 2002, he said, "...you refuse to accept the consumer as an equal partner, you still look upon the client, the patient, as an inferior partner in the relation" and "you deny the need for good working condition when it comes to the staff, etc." (http://www.iedm.org/conference5_en.html).Moreover, he stressed the need to move interests and priorities away from the processes and production organization to "the quality of the outcome for the consumer" (http://www.iedm.org/conference5_en.html).Quality seems to be synonymous with healthcare in Sweden.
Two important characteristics of the Swedish healthcare system are that it is "decentralized and it is run on democratic principles" (http://www.si.se/docs/infosweden/engelska/fs76.pdf).All residents of Sweden are covered by the national health insurance system which covers medical care, pharmaceuticals,…
Fact Sheets on Sweden: The Health Care System in Sweden. Swedish Institute. May 1999. http://www.si.se/docs/infosweden/engelska/fs76.pdf .(accessed 06-27-2003).
Gennser, Margit. "Sweden's Health Care System." http://oldfraser.lexi.net/publications/books/health_reform/sweden.html.
A accessed 06-27-2003).
Hadenius, Stig; Lindgren, Ann. "Sweden: On Sweden Health care." Countries of the World. January 01, 1991.
Healthcare Partnership in the Community
Discuss an example of healthcare partnership in your community and specifically cite examples that show how nurses, both individually and collectively, influenced the care provided. What obstacles were confronted and what strategies were employed in order to effectively overcome them.
One community healthcare partnership that is salient in my mind is Texas Department of State Health Services' program on tuberculosis or TB. This group of projects is specifically handled by the Office of Border Health, specifically because communicable diseases transmitted over the Texas-Mexico border will inadvertently affect the state of community health of both countries (i.e., the U.S. And Mexico). Under the program, two projects have been successful and known for its accomplishment in helping decrease TB prevalence in communities near the Texas-Mexico border: Proyecto Juntos and TBNet.
Proyecto Juntos specifically centers on "bilateral TB control," centering its efforts to curbing TB prevalence by monitoring…
Texas Department of Health Services, Office of Border Health. Available at: http://www.dshs.state.tx.us/borderhealth/
Texas Organization of Nurse Executives. Available at: http://www.texasnurse.org/
Health care reform has the objective of getting more people insured, and leveraging government bargaining power to lower the cost of health care. Our organization needs to be ready for this. We have the baby boomers joining Medicare, and Medicare is seeking to lower health care costs; so are private insurers. As an organization, we need to bring our costs down in order to remain profitable. This need not be hard -- every other country in the world does it. In this context, streamlining operations, eliminating waste, bargaining with suppliers and finding ways to streamline services to increase customer turnover are all measures that I would undertake in order to ready the organization for the full implementation of health care reform. Eliminating waste is a critical component of maintaining profitability within the health care system (Berwick & Hackbarth, 2012).
Something I would do differently with respect to health care planning…
Berwick, D. & Hackbarth, A. (2012). Eliminating waste in U.S. health care. JAMA. Vol. 207 (15) 1513-1516.
Farmer, J. & Nimegeer, A. (2014). Community participation to design rural primary healthcare services. BMC Health Services. Vol. 14 (130) [HIDDEN]
Olsen, E. (2008). SWOT Analysis: How To Perform One For Your Organization (Webcast). Virtual Strategist.
A 2006 study that examined the rates of depression and other mental health disorders following the December 2004 tsunami found that large numbers of people still faced significant health impairment from the event, and that treatment had been negligible when compared to relief and rebuilding efforts in other areas (CDC 2006). These efforts would likely be made far more effective and efficient, however, if mental health issues were dealt with. Addressing the depression and other mental health maladies that the people suffered from following the tsunami would have led to a better adjusted and more productive (as well as healthier) population.
There was an effective degree of trauma care provided immediately after the tsunami struck, but preventative care measures could have been stepped up during this time to forestall and mitigate the spread of infectious diseases that often comes after a major disaster event (WHO 2005). Obviously, trauma care was…
CDC (2006). "204 South Asia tsunamis." Center for disease control. Accessed 14 November 2009. http://www.bt.cdc.gov/disasters/tsunamis/
WHO (2005). "South Asia earthquake and tsunamis: Inter-agency rapid health assessment." World health organization. Accessed 14 November 2009. http://www.who.int/hac/crises/international/asia_tsunami/final_report/en/index.html
" ("Let My Baby Live..." NP) Other messages of the campaign were to stress the need to avoid high risk pregnancy, prior to age 18 or after age 35 and to stagger pregnancies by two years to help the maternal body recover and be strong enough to care for the developing infant and go through labor successfully. The campaign, promoting these ideas states that it has been successful in reaching its goals, and has currently reached 66% of the population in the regions where the campaign was launched. ("Let My Baby Live..." NP) There is not mention as to whether the campaign will end, or be expanded to a broader audience in Turkey.
Turkey's example program could serve as a template for other health issues that need to be expressed to the public in Turkey and in other nations with challenged health care delivery infrastructures and limited public knowledge of…
Brennan, Teresa. Globalization and Its Terrors. London: Routledge, 2003.
Kaul, Chandrika, and Valerie Tomaselli-Moschovitis, eds. Statistical Handbook on Poverty in the Developing World. Phoenix: Oryx Press, 1999.
Weiker, Walter F. The Modernization of Turkey: From Ataturk to the Present Day. New York: Holmes & Meier Publishers, 1981.
E-Health Project in Turkey" International Telecommunications Network Website Retrieved November 15, 2007 at http://www.itu.int/ITU-D/e-strategies/e-applications/Turkey_E-health/index.html
Healthcare Budgetary Decision Making
With resources becoming increasingly limited in the healthcare industry, managers are continually challenged with devising effective strategies for dealing with budgetary concerns. The most prominent challenge comes in the form of decision making that results in striking a balance between cost reduction and the maintenance of high quality care and safety for patients. The following discussion outlines approaches that can be utilized by managers to effectively deal with budgetary concerns in healthcare settings, with an emphasis on the advantages of group decision making strategies.
It is evident that there is often a struggle in the healthcare industry for managers to continually and effectively manage depleting resources, address the ever-changing needs of patients, and all the while provide a high level of patient care (Sibbald et al., 2010). This struggle has at its core a need for improvement in regards to the processes in which priorities are…
Burleson, G. (1984). Management, budgeting and the use of resources -- a private sector review. Hospital and Health Services Review, 80(3), 124-5.
Sibbald, S.L., Gibson, J.L., Singer, P.A., Upshur, R., Martin, D.K. (2010). Evaluating priority setting success in healthcare: a pilot study. BMC Health Services Research, 10, 131.
Xie, H., Chaussalet, T., Toffa, S., Crowther, P. (2005). A software tool to aid budget planning for long-term care at local authority level. Studies in Health Technology and Informatics, 114, 284-90.
Hispanic Community and Healthcare
This paper is an examination of how the Hispanic community experiences healthcare. The data from a number of articles related to the subject form the basis for the conclusions reached in the analysis.
One study looked at whether Hispanic-specific training should be included for healthcare worker training. It was found that there is a serious lack of training that is currently implemented regardless the community examined. Healthcare workers were unaware of social conventions that were normal among their Hispanic clients which limited the effectiveness of the healthcare treatment given. Because women were unable to discuss personal problems with male healthcare workers and males had similar issues with females, it was difficult for the various agencies to be truly effective. The recommendation, of course, was to include a training curriculum that included cultural training.
Another issue that Hispanic individuals faced is that they were underrepresented in…
Each of these was included in the initial Senate bill, but was struck from the final Senate version. Despite the victories, the group isn't ready to pledge support for health reform bills. The AMA will not endorse any legislation unless Congress gets rid of the mandated payment cuts of more than $200 billion over 10 years in the government's Medicare program for the elderly. The cuts are part of Congressional action that was passed in 1997 in order to cut costs in the Medicare program, but have never gone into effect. There are also several hospitals, insurers, pharmaceutical manufacturers and advocacy groups that are withholding final support. Most of these groups have pledged support to health care reform in principle while working privately through lobbyists to protect their industries (Eaton and Pell, 2010).
Healthcare lobbyists range from very large companies and corporations to very small groups who are all looking…
BREAKING: Health care lobby invests in reform summit. (2010). Retrieved March 1, 2010, from Citizens for Responsibility and Ethics in Washington Web site:
Eaton, Joe and Pell, M.B. (2010). Lobbyists Swarm Capitol to Influence Health Reform.
Retrieved March 1, 2010, from the Center for Public Integrity Web site:
Integrity is a major issue for healthcare organizations because there are many avenues for fraud, and for people to demonstrate a lack of ethics. The problem is that the temptation is sometimes too great and despite the fact that there are laws in place to guard against these practices unethical behavior takes place anyway. The government, which supplies a lot of the money which goes for treatments through Medicare and Medicaid, has structured certain laws to make sure that the practices of healthcare organizations are ethical, but billions of dollars in fines are still doled out every year. The big drug companies complain of arcane and hard to decipher legalese, but the fact is that although they realize the issue and the penalty they continue to subvert the law. This paper looks at qui tam statutes and cases, Medicare and Medicaid admissions criteria, installing a corporate integrity program, and…
American Speech-Language-Hearing Association (ASLHA). (2010). Summary of self- referral and anti-kickback regulations. Retrieved from http://www.asha.org/practice/reimbursement/medicare/regulations_sum.htm
Hanford, J.T. (2001). Regulation of the healthcare professions. Ethics & Medicine, 17(3), 188-190.
Louthian Law Firm. (2012). Healthcare fraud qui tam whistleblower protection lawsuits.
Mattie, A. & Ben-Chitrit, R. (2009) The federal False Claims Act and qui tam actions: What every healthcare manager should know. Journal of Legal, Ethical and Regulatory Issues, 12(2), 49-65.
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
The health care industry is heavily regulated and has several special risk areas that need to be looked out for. An effective compliance program is necessary in order to mitigate these risks. In addition to the challenges that are associated with taking care of patients, health care providers are subject to huge and sometimes intricate sets of rules that govern the coverage and reimbursement of medical services. Because federal and state sponsored health care programs play such a big role in paying for health care, compliance with these rules are necessary in order to avoid penalties that can occur. These penalties can include such things as recoupment of improper payments, along with sanctions imposed by Medicare and Medicaid against health care businesses that engage in abuse or fraudulent practices (Corporate esponsibility and Corporate Compliance: A esource for Health Care Boards of Directors, (n.d.).
A good health care administrator will…
Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors. (n.d.) Retrieved April 3, 2009, from Office of the Inspector General Web site:
Health Administration. (n.d.). Retrieved April 3, 2009, from Web site:
" (AAF, nd)
The Health Maintenance Organization further should "…negotiate with both public and private payers for adequate reimbursement or direct payment to cover the expenses of interpreter services so that they can establish services without burdening physicians…" and the private industry should be "…engaged by medical organizations, including the AAF, and patient advocacy groups to consider innovative ways to provide interpreter services to both employees and the medically underserved." (AAF, nd)
One example of the community healthcare organization is the CCO model is reported as a community cancer screening center model and is stated to be an effective mechanism for facilitating the linkage of investigators and their institutions with the clinical trials network. It is reported that the minority-based CCO was approved initially by the NCI, Division of Cancer revention Board of Scientific Counselors in January 1989. The implementation began in the fall of 1990 and the program was…
Principles for Improving Cultural Proficiency and Care to Minority and Medically-Underserved Communities (Position Paper) (2008) AAFP -- American Academy of Family Physicians http://www.aafp.org/online/en/home/policy/policies/p/princcultuproficcare.html
Volpp, Kevin G.M. (2004) The Effect of Increases in HMO Penetration and Changes in Payer Mix on In-Hospital Mortality and Treatment Patterns for Acute Myocardial Infarction" The American Journal of Managed Care. 30 June 2004. Issue 10 Number 7 Part 2. Onlineavaialble at: http://www.ajmc.com/issue/managed-care/2004/2004-07-vol10-n7Pt2/Jul04-1816p505-512
Darby, Roland B. (2008) Managed Care: Sacruificing Your Health Care for Insurance Industry Profits: Questions You must ask before joning an HMO. Online available at: http://www.rolanddarby.com/br_managedhealth.html
In 2004, a Ten-Year Plan to Strengthen Health Care was announced, primarily intended to improve access to medical services, decrease wait times, and update medical equipment and ensure accurate reporting and enhance public health promotion and prevention programs. Shortly thereafter, the Canadian Supreme Court affirmed the nation's health care philosophy and the immediate need to implement further improvements envisioned by the ambitious 2004 plan in striking down a Quebec law that had prohibited private medical insurance for covered services:
The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care...In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."
According to legal experts, the decision could "open the door to a wave of lawsuits challenging the…
Canadian Medical Association Journal.
1939 September; 41(3):
Chaoulli v. Quebec: Judgments of the Supreme Court of Canada Accessed, September 2, 2007, at http://scc.lexum.umontreal.ca/en/index.html
Kraus, C. (2005) Canada's Supreme Court Chips Away at National Health Care.
The issue of grey and black markets often arose as a result of the shortages of experienced health care personnel. The system could not adapt to a flexible environment as it was led by rigid official procedures and the mentality of the people who controlled it was commanding, their vision short-sighted and hardly beneficial in such a situation (Barr and Mark, 1996).
The breaking up of Soviet Union which brought crippling economic and political problems to the countries also aggravated the health care situation making it reach an all-time low. The collapse of the health care system ran by the government led to the belief that turning towards a market economy or more capitalistic notions and perceptions would have been a better idea. The competition in the private sector would have had improved efficiency and averted an inevitable collapse of the health care system in the Soviet Union. This transformation,…
Balabanova, D., Haerpfer, C., McKee, M., Pomerleau, J., Rose, R. (2004). Health service utilization in the former Soviet Union: evidence from eight countries. Health Services Research
Barr, D.A. And Mark G. (1996). The Current State of Health Care in the Former Soviet Union: Implications for Health Care Policy and Reform. American Journal of Public Health. 86, 3.
Lewis, M. (2002). Informal Health Payments in Central and Eastern Europe and the Former Soviet Union: Issues, Trends and Policy Implications. In Funding Health Care, European Observatory on Health Care Systems Series, edited by E. Mossialos, a. Dixon, J. Figueras, and J. Kutzin, pp. 184-205. Buckingham: Open University Press.
Mikesell, J.L. And Mullins, D.R. (2001), Reforming Budget Systems in Countries of the Former Soviet Union. Public Administration Review. 61. 5.
The Tuskegee Syphilis Study still remains as one of the most outrageous examples of disregard of basic ethical principles of conduct not to mention violation of standards for ethical research. The suspicion and fear produced by the Tuskegee Syphilis Study are still evident today. Community workers often report mistrust of public health institutions within the African-American community. ecently Alpha Thomas of the Dallas Urban League testified before the National Commission on AIDS saying that many African-American people do not trust hospitals or any of the other community health care service providers because of that Tuskegee Experiment (esearch Ethics: The Tuskegee Syphilis Study, 2010).
In 1990, the Southern Christian Leadership Conference (SCLC), which is one of the country's major civil rights organizations, conducted a survey among 1056 African-American Church members in five cities. They found that 34% of the respondents believed that AIDS was an artificial virus, 35% believed that AIDS…
Bad Blood: The Tuskegee Syphilis Study. (2009). Retrieved March 9, 2010, from University of Virginia Health System Web site:
Boskey, Elizabeth. (2007). What Is the Tuskegee Syphilis Study? Retrieved March 10, 2010,
from About.com Web site: http://std.about.com/od/stdsinthemedia/f/tuskegeefaq.htm
Healthcare Reform Models
Health Care Reform Models
Shim and colleagues (2012) argue for taking advantage of provisions within the Patient Protection and Affordable Care Act (ACA) of 2010 that emphasizes preventive and integrated care. They propose that the primary care setting is ideal for screening patients for signs of mental illness and associated risk factors. A mental health wellness program could also include coaches and other experts that interface with patients on an individual basis, including at the patient's home.
Long-Term Behavioral Health Care
Bao and colleagues (2012) examined four patient populations defined by disease severity and ability to pay, and then assessed how these four groups will fare under the behavioral health provisions in the ACA. Patients with private insurance and suffering from mild to moderate mental illness will probably receive the best care at a Patient-Centered Medical Home (PCMH). The authors suggest that the presence of…
Health Disparities in Louisville KY
Health inequities have become a major problem in the United States. Hofrichter stresses in Tackling Health Inequities Through Public Health Practice:
A Handbook for Action ( 2006) that, "The awareness of the existence of inequities in health, health status and health outcomes between racial and ethnic groups in America is as old as the nation itself" (Hofrichter, 2006,P. vii). As will be discussed in this paper, these inequalities have a wide range of repercussions, including social and psychological implications. A definition of health disparity is: "... The difference in the incidence, prevalence, morbidity, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups" ( Samuels, 2005).
There is also a consensus in the literature that inequalities in health and healthcare throughout the world are on the increase. This is largely due to the increasing gap between rich…
Eliminating social and economic barriers to good health and safety: Louisville
Center for Health Equity. Retrieved from http://www.preventioninstitute.org/component/jlibrary/article/id-278/127.html?tmpl=component&print=1
Galvin, J.R. (2006) Diabetes. Ebony, 61 p. 157.
GradNation - Making the Connection: Health & Student Achievement. Retrieved from http://www.silentepidemic.net/Our-Work/Dropout-Prevention/~/media/Files/Our%20Work/Dropout%20Prevention/Grad%20Nation%20Action%20Forum/Steve%20Tarver%20working%20sess%20PPT.ashx
The respondents also believed that premiums should be adjusted based on an organizations willingness to introduce and enforce health and safety standards.
5. Safety representatives-these representatives serve the purpose of serving notices or organizations when breaches in safety and health standards take place.
6. Occupational Health and Rehabilitation -- a significant percentage or respondents believe that there needs to be greater access to occupational health services for employees. The respondents also believed that there should be a "new focus on the provision of rehabilitation services for injured and sick workers."
7. Financial Incentives-finally the respondents believed that employees needed financial incentives to encourage cooperation as it pertains to health and safety standards.
The HSE used all of the information gathered to create new strategies for dealing with Health and Safety issues in the workplace. One of the primary trends that developed was that of enforcement. In an effort to have…
"A strategy for workplace health and safety in Great Britain to 2010 and beyond"
"Enforcement Management Model." (2002). Health and Safety Executive
Enforcement Policy Statement. Health and Safety Executive
Environmental Health Policy Improvement Committee (20 April 2004) . Health and Safety Commission
there are three parts. PAT A EQUIES 4 DIFFEENT ANSWES
"ICD-10-PCS is intended to replace ICD-9 volume 3 for facility reporting of inpatient procedures….ICD-10-PCS is a totally new coding system designed to better accommodate the rapidly changing world of procedures. The code system was developed in the 1990s, but use of the continually updated codes will start almost 20 years later." (Dimick 2011). This new standard is supposed to be more accurate and reflective of current healthcare realities than standards of the past, but it is uncertain if in its implementation this promise will be realized.
Current status of implementation
This standard has yet to be fully implemented. "On October 1, 2013, healthcare providers must begin reporting HIPAA claims using the ICD-10 counterparts to the current ICD-9 code sets" and full implementation will be a 20-year process (Dimick 2011).
Three major issues related to implementation status…
About ASC X12. (2013). ASC X12. Retrieved: http://www.x12.org/about/index.cfm
Dimick, Chris. (2011). Learning and using ICD-10-PCS. Journal of AHIMA. Retrieved:
Health Level 7 International. (2013). HL7. Retrieved: http://www.hl7.org/implement/index.cfm
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland…
Potter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf
Unless the physicians can succinctly argue their case for care and services, the managed care entity will, for reasons of medical necessity, deny access to care and services.
What Cost-Added atio Based on Illegal Immigrant Population?
The argument by opponents that loopholes exist that would allow illegal immigrants to access Obama's proposed legislation on healthcare services is rendered moot in lieu of the fact that those illegal immigrants are currently receiving healthcare services Medicaid and through Immigration and Naturalization Services (INS). The Federal eimbursement of Emergency Health Services Furnished to Undocumented Aliens states:
"Section 1011 of the (Medicare Prescription Drug, Improvement, and Modernization Act (MMA) (P.L. 108-173)) MMA appropriated $250 million dollars in FY 2005 through 2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other non-specified citizens who are not eligible for Medicaid (Centers for Medicare and Medicaid Services, 2009, found online, p.…
Birenbaum, A. (1997). Managed Care: Made in America, Praeger Publishers, Westport,
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care, Praeger Publishers, Westport, CT.
Centers for Disease Control and Prevention (2009). Uninsured Americans: Newly
The research thus concludes the essence of having quality and effective legislation addressing the aspects of overall oral health of the people.
Additionally, the Canadian Dental Association also relates several issues of the overall body health to the oral health of the individual. In view of the article on the relation "oral health -- good life," the article gives information on the essence of good oral health, indicating some of the illnesses of ill oral health (Chattopadhyay, 2011). In this article, the relation between the ill oral health and the overall health of the body is that the mouth is the ingress to the body. Therefore, an individual with ill oral health is at the highest risk of having infection that affects the whole body system severely. According to this article, it emphasizes the need for dentists-patient relation as the dentists is the only person with the skill, expertise and…
Chattopadhyay, a. (2011). Oral health epidemiology: Principles and practice. Sudbury, Mass:
Jones and Bartlett Publishers.
Ramseier, C.A., & Suvan, J.E. (2010). Health behavior change in the dental practice. Ames,
Based upon the fact the baby boomers are all approaching retirement age, it would be a good idea for the organization to pursue programs that are geared towards seniors. Programs that are geared towards seniors are a great way to produce quality comprehensive health care for those in the community that need it. The organization might pursue the idea of opening a PACE program. " The Program of All-Inclusive Care for the Elderly (PACE) is a capitated benefit authorized by the Balanced Budget Act of 1997 (BBA) that features a comprehensive service delivery system and integrated Medicare and Medicaid financing" (Program of All Inclusive Care for the Elderly (PACE), 2009). The PACE program features complete medical and social services that rely on an interdisciplinary team approach in an adult day health center that includes in-home and referral services depending on the person's needs (Program of All Inclusive Care for the…
Baker, J. Judith & Baker, R.W. (2006). Healthcare Finance, Basic Tools for Nonfinancial
Managers. Maryland: Aspen Publications, Inc.
Bury, Elizabeth, Carter, Kara S., Feigelman, Masha and Grant, Jennifer M. (n.d.). Retrieved June
2, 2009, from Web site:
Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:
Lack of a common understanding about errors among health care professionals
Physicians generally think of errors as individual that resulted from patient morbidity or mortality.
Physicians report errors in medical records that have in turn been ignored by researchers.
Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of…
Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000
Patient Safety/Medical Errors Online at the Premiere Inc. page located at: http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc
Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.
Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101
But due to the ineffective allocation of resources, while money was spent on his care when his blood sugar was 'out of control,' and when he began to develop blindness and other symptoms of uncontrolled diabetes, he did not receive the consistent but relatively low-care necessary to reduce the causes of his inability to manage his condition. Conclusion Healthcare operates within the market system, and is subject to opportunity costs like any other good or service. However, overall the healthcare system does not operate upon the principles of efficiency, often due to the bureaucracy of the healthcare system and its methods of reimbursement and prioritizing acute over primary care.
Gawande, Atul. (2009, June 1). The cost conundrum: What a Texas town can teach us about health care. The New Yorker. etrieved February 2, 2011 at http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande#ixzz1CpZ4jbV
Gawande, Atul. (2011, January 24). The hot spotters. The New Yorker. etrieved February…
Gawande, Atul. (2009, June 1). The cost conundrum: What a Texas town can teach us about health care. The New Yorker. Retrieved February 2, 2011 at http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande#ixzz1CpZ4jbVR
Gawande, Atul. (2011, January 24). The hot spotters. The New Yorker. Retrieved February 2,
2011 at http://www.newyorker.com/magazine/bios/atul_gawande/search?contributorName=atul%20gawande
Gibson, Jennifer, Douglas K. Martin, & Peter a Singer (2004). Setting priorities in health
The developed worlds are becoming older. America's population is approaching retirement age due in large part to the baby boomer generation. Those individuals born between 1946 and 1964 will be eligible for more social security and retirement benefits as time passes. As such, pharmaceutical companies, health services, and the medical industry at large will benefit from this influx of older individuals. As competition for new patents, facilities, drugs and more becomes more intense, companies will undoubtedly go bankrupt. Those companies that can continually innovate and provide products that are demanded will eventually prosper as our population ages. Cardinal Health, McKesson Corporation and Amerisource Bergen are at the forefront of this innovation. They continually push the existing boundaries of science to provide better products for society. How they accomplish this task however is very distinct to each company. By delving into the annual reports of each company an individual…
1) "Businessweek." MCKESSON CORP (MCK:New York): Financial Ratios -. Web. 05 Apr. 2012. .
2) "Cardinal Health Plans $90 Million in China Acquisitions - ChinaBio® Today." Cardinal Health Plans $90 Million in China Acquisitions. Web. 05 Apr. 2012. .
The infant mortality rate is of 8.97 deaths per 1,000 live births. This rate places Kuwait on the 160th position on the chart of the CIA. The adult prevalence rate of HIV / AIDS is of 0.1 per cent.
In terms of economy, Kuwait is a relatively open, small and wealthy economy. It relies extensively on oil exports -- petroleum exports for instance account for 95 per cent of the total export revenues as well as for 95 per cent of the federal income. The Kuwaiti representatives have recently set the goal of increasing the oil production per day. Currently, Kuwait is facing the pressures of the internationalized economic crisis -- which however, due to recent economic surpluses in Kuwait, affects the economy to a lower extent.
Simultaneously with the increase in oil production, the Kuwaiti authorities are also focusing on diversifying the economic activities in the sense of supporting…
Agency, Kuwait News. "Blair's "Kuwait Vision." 15 March 2010. Zawya.com. .
Al-Ansari, H. And S. AL-Enezi. "Health Sciences Libraries in Kuwait." Bulletin of the Medical Library Association 89.3 (2001): 287-93.
Al-Awadhi, Olusi, Al-Saeid, Moussa, et.al. "Incidence of Musculoskeletal Pain in Adult Kuwaitis." Annals of Saudi Medicine 25.6 (2005): 459=62.
Al-Baho, A. "Resident's Guide to the Curriculum for Training in Family Medicine." December 2008. Kuwait Institute for Medical Specialization. .