Healthcare Delivery System
Health care delivery system
This essay is based on the health care delivery system and in a bid to elaborate more on this topic; the essay will begin with a description of the current health care delivery structure in an organization, then a comparison of two different health care delivery systems will be done. Thirdly the effects of licensing and regulatory factors on health care delivery requirements will also be highlighted and the changes occurring in the economy or with regards to licensing and regulatory factors that must be considered in the future will also be mentioned. Lastly the essay will look at the national trends that are affecting competition and pricing initiatives in the healthcare sector before concluding by noting the quality indicators that affect pricing at the local level in health care sector.
The health care delivery system
According to Starr (1982, 99-106) he described…… [Read More]
Healthcare Delivery System
ithin the United States there is a dynamic between for-profit and not-for-profit health delivery systems. Health, in this instance, can be defined primarily as the facility's ability to restore ill patients to optimal physical standards. Both hospitals claim to provide similar care, with in-patient and out-patient services being offered to those in need. However, the real question becomes which provides better care for patients and what types of patients seek out each type of hospital. This paper will discuss primarily for-profit healthcare delivery systems and the advantages that these hospitals bring when compared with non-profit hospitals. Specific issues that will be considered are the types of patients common to each hospital, these individuals' access to healthcare, and the impact of insurance.
For-profit hospitals are simply that, a for-profit entity seeking to bring in revenue through providing high-quality medical services to patients. This is accomplished through higher overall…… [Read More]
Health Care Delivery System
The American healthcare system is a very complex system that utilizes the private sector to grow and impact medical research and technology in the attempt at making healthcare more beneficial for patients. There are three main categories of players in the American healthcare system, each with a distinct role. The first category is administrators. Included in this category are physicians and hospital administrators. The next category is insurance companies. Companies such as Aetna provide healthcare coverage for citizens and pay percentages to the administrators. The final player is research. This includes the medical drug and technology companies that continue to expand and improve modern medicine.
Hard providers are those that utilize strict healthcare management systems and refuse to grant coverage to anyone seeking to go outside of that coverage. For instance, if a person wishes to see a doctor that is not within the hard provider's…… [Read More]
Healthcare eform: ecommendations and Analysis
Wells Fargo Small Business oundup vs. The Physicians Working Group (PWG)
According to the privately-run bank Wells Fargo's website that supports small business interests, universal single-payer health insurance is not feasible in the United States. Unsurprisingly, the bank wants as little government intervention as possible. "To the greatest extent possible, Americans should receive their health insurance and health care through the private sector. One-size-fits-all insurance and care are not wise options in a nation of 300 million people. We need better health care delivery models, financial management systems and risk-sharing arrangements" (Wells Fargo Small Business oundup, 2008, eforming health care reform). However, the Physicians Working Group (PWG) counters that the simplicity of the universal payer system and its effectiveness of achieving universal coverage has its advantages. "Administrative costs would undoubtedly be much lower than they are now, although it is a mistake to think that…… [Read More]
structure of the American Healthcare System has long been a topic of much debate. The purpose of this discussion is to trace the evolution of the structure of the American system delivery service. e will begin with a timeline of the healthcare system. e will then examine the evolution of the structure of the healthcare delivery system.
According to a timeline created by PBS the evolution of healthcare delivery services has been dramatic. At the start of the 20th century the American medical Association becomes a very important organization for doctors. In the ten years between 1900 and 1910 the membership of the American Medical Association goes from 8,000 to 70,000. It is during this time frame that the AMA gained a tremendous amount of respect and physicians focused on ways to deliver organized medicine to Americans. ("Healthcare Crisis: Healthcare crisis")
During the ten-year span between 1900 and 1910,…… [Read More]
Reflection on Healthcare Delivery Models and Nurse’s Role in Public Health
Since commencing this RN-BSN program at West Coast University, my perception of healthcare delivery models and the role of nurses in public health programs has evolved. Prior to undertaking the course, I did not know that there are different healthcare delivery models since I believed that healthcare delivery is basically about providing care services to patients. I also believed that public health programs are simply policies enacted by the government to promote health. However, the course has changed my perception about healthcare delivery through enabling to understand that there are different healthcare delivery models with different roles for members of the clinical team. Through lessons learned from this course, the healthcare delivery models I support are acute care models, transitional care models, and the collaborative payer model because they are innovative care models through which nurses become care coordinators…… [Read More]
Healthcare -- Immune Suppression Syndrome Clinic
ho were the stakeholders? ho were OpenMRS's champions?
Answered in table below.
hat were the expected benefits or improvements (potentials) from the EMR system (OpenMRS)?
Answered in table below
Looking at the list of stakeholders you came up with in question 1 and the list of potentials in question 2, discuss OpenMRS's achievements in each of these arena for various stakeholders.
Answered in table below
A feasible and potentially scalable method to strengthen the evidence available for implementation of ART delivery in Africa
Through development and implementation of OpenMRS, practitioners and healthcare facilities are better able to coordinate ART delivery in Africa.
UCSF Team Members
Generating ample high-quality data
The systemic use of OpenMRS has assembled a wealth of well-organized, relevant data.
Uniformity of data collection, categorization and transmittal.
The once-decentralized, haphazard method of healthcare resulted in equally haphazard…… [Read More]
Because consumers are administering their bank accounts, investments, and purchases online, and many turn to the web for gathering information about medical conditions and will expect the same level of control to be extended to online medical information.
6. What can we learn from other countries in formulating recommendations to improve the U.S. health care system?
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. When comparing the United States to nations such as Australia, Canada, Germany, New Zealand and the United Kingdom, our health care system ranks last or next-to-last in five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country that does not have universal health insurance coverage, partially accounting for its poor performance on access, equity, and health outcomes. The inclusion…… [Read More]
(Gigante, S. February 22, 2010).
These numbers suggest a population which will demand a high level of services over their retirement lives, and as such place enormous pressure on premiums and fees. The result of this excess demand will be a rejoinder by physicians, hospitals, and other service providers to increase prices. The issue will be how Medicare and Medicaid policy makers will treat these price increases. If history serves as a guide, Medicare cuts will not occur to control these price increases. Recently in November 2010, Congress again failed to act to control Medicare reimbursement costs. "Repeating what has become an ominous political ritual, U.S. lawmakers voted at the last minute Monday to delay a scheduled average 25% cut in physicians' Medicare reimbursements" (Gerencher, K. November 29, 2010). The continued inaction to control prices on a payer system which will cover an additional 78 million individuals will result in…… [Read More]
Imagine what would go through a person's mind if he or she had wrong site surgery. What emotions would arise? Can he or she take legal action? Are ethics involved? One will study in depth the legal and ethical aspects of healthcare delivery of a 62-year-old woman. The legal aspects of the 62-year-old woman are worth noting. They failed to offer her a full disclosure along with an apology from the physician. The hospital did not fully train the doctor on how to do this through proper training. Furthermore, the patient was not allowed to see her face with a mirror to see if the correct spot was marked before the operation, which would have reduced the medical error. This physician neglected her during Ms W's time of distress. In regards to the laws that were broken, she can take him to court for "de facto admission of…… [Read More]
quality and safety issues on healthcare delivery absolutely cannot be underestimated. When quality and safety issues are addressed head on, healthcare delivery improves for the better and patients receive a higher quality of care. The fundamental issues are thus: people are living with an increased life expectancy and a higher rate of survival. This means that the increase range of treatment options put an additional burden on professional healthcare and in lieu of that, a great deal of literature conducted has identified significant shortfalls in the way that healthcare is currently delivered. Main issues that have emerged from this literature are that the way that healthcare is that healthcare is often delivered in a risky fashion, and that failings like these contribute to avoidable morbidity and mortality, and healthcare expenditure. "There have been substantial developments in information technology hardware and software capabilities over recent decades and there is now considerable…… [Read More]
For many people who have a pressing health issue or concern that does not occur when their doctor is in office, the emergency room is their only alternative. An emergency room doctor can’t turn them away, and for the uninsured the ER is often the place where the bulk of their health problems are addressed—including things that are non-emergencies. Now the advent of the urgent care center has changed all that. Research suggests that patients should use utilize urgent care clinics versus an emergency room for non-life threatening medical issues because they are often treated faster, utilize fewer resources, and have less out-of-pocket expenses.
Finding patient accessible care has long been a problem. For example, some workers who have to be at work at 8am, before most doctor’s offices are open, might go to the emergency room to get an ear infection treated. Of course, this is how many people…… [Read More]
Comparative Analysis of Global Healthcare
Various governments across the globe are tasked with the responsibility of providing healthcare to the citizens. Their economic status and models influence the quality of care provided. This has resulted in the disparities in quality from country to another with some countries acting as case studies to be emulated. The following study is a comparative analysis of three healthcare systems around the world with a focus on Australia, Saudi Arabia, and Switzerland. The study compares the residents’ overall level of access to preventive and tertiary care. This is followed by the comparison of the health expenditures and healthcare funding mechanisms in the three countries. The discussion will then delve on the life expectancy for each gender, overall leading cause of death, and infant mortality rates in each selected country. The final section provides an overview of deaths caused by diabetes, obesity, cardiovascular diseases and oncological…… [Read More]
Financing Health Care in the United States
How do the rapid and dynamic changes in financing impact health outcomes within your practice?
Health is a very important part of human existence. We also live in very interesting times when there are new lifestyle diseases that emerge which require enormous medical resources in terms of finances to treat. Medical providers are thus faced with quite a number of challenges in their endeavor to provide efficient and adequate healthcare to their patients. The changes have gone as far as healthcare delivery, technological advances, and increased patient expectation. This trend of events thus requires nurses to increase financing and acquire the latest information.
Healthcare finance refers to the number of resources in terms of money that are used to ensure that the population of a country gets efficient and adequate healthcare. Allocation of these resources is necessary for creating a strong primary care…… [Read More]
A Model Healthcare Delivery System
The healthcare delivery system also referred to in short as the HCDS is the most effective system that works for most healthcare organizations in all countries with fair, effective and efficient distribution of resources. It is a fast growing service that demands attention from various quarters and domains. At the optimal level, the service program presents relief and hope to the individual, and the general population. The system offers a balanced quality care service through efficiency and fairness. HCDS varies across the world but its focus is constantly on enhancing healthcare access, quality of service and coverage. The success of the program is dependent on the availability of certain basic resources (Kumar & Bano, 2017, p. 1).
HCDS is how the society has responded to the health determinants. The idea of a healthcare system contemplates involving the people that are likely to be served…… [Read More]
U.S. Healthcare Delivery
What is your evaluation of the effectiveness of the U.S. health care system in the context of delivery, finance, management, and/or sustainability? What are the issues that prompted a need for health care reform?
healthcare system is effective at delivering state of the art services and cutting edge solutions for patients. This helps to make it one of the best in providing various services and treatment options. The result is that more people will come and utilize the American healthcare system because of these benefits. This is why institutions such as the Mayo and Cleveland Clinics are so popular. They are known for delivering the best treatment options in the world to patients. (Anderson, 2011) (Shi, 2009)
However, the financing and management are two major issues which impact the needs of different stakeholders. In the case of financing, many people cannot afford to pay the high premiums…… [Read More]
Social, Cultural, And Political Influence in Healthcare Delivery
Social, cultural, and political inequalities are detrimental to the health and healthcare system of the U.S. This is because the U.S. is one of the most multicultural, overpopulated, diverse and undergoing rapid economic growth. The federal government has embarked on efforts geared at addressing unsustainable costs of health care in the U.S. With the leadership of the current president, Barrack Obama, initiatives of containing health care costs will evaluate and explore strategies to contain the growing costs of health care based on a system-wide while enhancing the value and quality of health care (Ubokudom, 2012). The apparent system of health care is rife with opportunities of minimizing waste, delivering coordinated, effective care, and improving well-being and health of all Americans. The government in collaboration with care providers must prioritize cost effective containment strategies with the greatest possibility for political success and non-partisan…… [Read More]
One of the major theoretical models for healthcare delivery is the Parse theory of human becoming, created by Rosemarie Rizzo Parse—originally titled the man-living-health theory (2011). This theory focuses on healthcare and the human through the lens of quality of life. This theoretical premise for delivering and receiving healthcare was able to gain steam as a result of its alternative to the more standard bio-medical method and the biological-psychological-social and spiritual method contained in the bulk of other theories of nursing. This theory has enjoyed much attention and use when delivering healthcare as a result of the fact that it views quality of life as all relative to a person’s viewpoint.
Main assumptions of Human Becoming Theory
Human becoming allows one to select specific meaning in situations within the realm of human experience. Reality is the culmination of lived experiences. A sometimes nebulous process of co-creation occurs via…… [Read More]
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…… [Read More]
Healthcare Delivery Systems Annotated… [Read More]
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…… [Read More]
During times of labor scarcity, workers have less of an incentive to take low-paying jobs, and employers have more of an incentive to provide benefits, to attract a higher-quality workforce. During times of high unemployment, workers are more desperate for jobs and will accept work at lower wages and lower benefits. But over a long duration of time, poor health status can actually result in higher rates of unemployment and lower wages, as conditions become more chronic and impede a worker's ability to labor: for example, 64% of males with diabetes and 40% of women with diabetes between the ages of 50 and 60 were employed; versus 82% of males and 60% of female without diabetes (Jacobs & apoport 2002: 259). Diabetes is a condition often associated with the working poor and very poor, and if the disease goes unmanaged it can become more chronic and impede the ability of…… [Read More]
Healthcare Legal Issues
Discuss the impact Federalism has on the regulation of health care delivery; how do the different sources of law as they related to the federal and state governments matter, if at all?
In general, federal regulation of health care delivery would be much more appropriate and efficient than state or local law, at least in so far as major aspects of health care delivery are concerned. That is because state laws vary considerably; that makes it impossible to establish a consistent or uniform standard of health care delivery across state lines. Certainly, there are aspects of health care that are appropriate to regulate at the state or even the local level, but there are others that would be much better to regulate on a national or federal level.
One of the best examples of an aspect of health care delivery that should be regulated federally are elements…… [Read More]
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…… [Read More]
" (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…… [Read More]
Evolving Practice of Nurses
Dear Fellow Nurses,
The nursing profession is currently experiencing revolutionary changes that are expected to transform nursing practice today and in the future. These revolutionary changes in nursing profession and practice are largely influenced by the fact the changing role of nurses in the modern healthcare environment. The nursing role in the modern health care sector is changing because patient care delivery or caring for the sick is becoming more complicated, which force nurses to assume a wider range of health care responsibilities (Tiffin, 2012). Moreover, nursing profession and nursing practice is experiencing significant changes because of the ongoing restructuring of the United States health care delivery system. Actually, as the country continues to transform is health care delivery system, the nursing profession is expected to continue playing an important role in this process. The growth and change in nursing practice will generate new models of…… [Read More]
"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.,…… [Read More]
The idea with this part of the strategy is to be able to form some kind of a partnership with these individuals. This will help to push for a transformation inside the organization. As, these people will help to provide everyone with: a reason for adapting and pushing others to do so (indirectly). (Turner, 1999, pp. 162 -- 163)
Once this occurs, you could then have these individuals become a part of a committee. They will have the responsibility for making specific recommendations about how this can be implemented. This is important, because this will help everyone to realize that some kind of change is occurring inside the facility. Over the course of time, this will lead to shifts in the operating environment by giving people reason for embracing these changes. (Turner, 1999, pp. 162 -- 163)
The Effectiveness of the Plan
To determine the effectiveness of the plan the…… [Read More]
(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…… [Read More]
The experiences of seniors within the healthcare delivery system will alter how all Americans view healthcare. The healthcare delivery systems and overall organizational structure in the United States has been slow to adjust but that rest of the world is currently in flux that will migrate into our system. Technological advances in communication have made telehealth and telemedicine vialbel solutions to our outdated healthcare industry orgainzational structre. While these types of advances are only in their infancy, "...there seemed to be broad acceptance that telehealth and telemedicine had provided positive benefits to the worlds healthcare delivery system." (Telehealth Applications) Our technoloically challenged seniors have actually discovered the trend within the healthcare system and telehealth and telemedicine seems to be an advance that will find worldwide support so we as a nation will be reqquired to jump on the bandwagon.
In conclusion, this article review focused on new Healthcare Delivery Systems…… [Read More]
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…… [Read More]
A patchwork of laws provided narrow privacy protections for selected health data and certain keepers of that data." (Administrative Simplification in the Health Care Industry) Therefore, new technologies such as relational databases have simplified the data gathering and maintenance processes of all types of healthcare related data like the physician information process. It is not unheard of today for healthcare and insurance providers matching or 'sinking data' on a monthly or quarterly basis because of the availability of better communication capabilities as well as compatible database comparison processes.
Even the doctors themselves have access to providers' systems and databases today. Through automatic telephone systems, business to business Internet portals, and tape or disk delivery processes, all of a physician's personal, office and patient information can be updated easily. In many cases, the entire process including security and confirmation is a completely hands free operation. In other words, without human intervention,…… [Read More]
Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.
Past Health Care Services -- Early America
Health care in colonial…… [Read More]
Health Care: The Next Twelve Months
Over the next twelve months, there will be many changes to health care in the United States. The largest and most ambitious goal is to provide the majority of Americans with health insurance (Blendon & Benson, 2010). However, there will be a presidential election and a Supreme Court ruling, which means that 2012 could be the year that determines whether the health care law moves forward or whether it is shut down. It could also go forward in part, after having large pieces of it removed, and it could go forward with some fundamental changes. How the elections go will greatly affect the law - unless, of course, the Supreme Court strikes the law down before the elections arrive. It seems like that the Supreme Court will rule on the individual mandate from a constitutional standpoint, and that could lead to some of the…… [Read More]
Universal healthcare is the only saving formula for this nation, which is doomed in a health care crisis of unprecedented proportions. There is a urgent need to transform healthcare from its present state of commercialism towards the humanitarian approach which guarantees 'healthcare for all' independent of their social or financial circumstances. A shared and collective responsibility of healthcare management is the only viable formula for America. It is high time we learn from Canada, UK and other European nations and restructure the current broken state of our healthcare. The successful passing of the USNHC act (H.R. 676) is the only way for America to wake up from its healthcare nightmare. Will the powerful insurance industry hold its ground yet again and resist this awakening leaving all the citizens doomed? This is an important question for all the citizens of our country.
1) Science Daily, 'American Values lamed for U.S.…… [Read More]
In the current era of managed care in medicine, physicians and other healthcare providers and institutions have been under tremendous pressure to reduce costs. In that regard, avoiding unnecessary hospitalization is one of the most important goals of lowering the costs of healthcare delivery (Stanhope & Lancaster, 2004). Toward that end, diverse strategies have evolved to provide as many healthcare services as possible on an ambulatory basis.
Hospitals and insurance companies now encourage patients to participate in preventative medicine and routine testing intended to lower the costs associated with hospitalization over the long-term. The strategy is simply to reduce the incidence of serious illnesses, particularly those that typically develop over many years and which are capable of prevention through behavior modification and early detection through diagnostic testing (Stanhope & Lancaster, 2004).
Because state and federal governments must absorb much of the costs of uncompensated medical services, the many administrative agencies…… [Read More]
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…… [Read More]
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…… [Read More]
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…… [Read More]
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.…… [Read More]
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…… [Read More]
In addition, Senator Collins led the fight to restore critical f funding to Medicare for home health care so that elderly citizens and disabled can receive needed care in their own homes ("Biography")."
Obviously the senator encourages the funding of both Medicaid and Medicare as she has fought to ensure that both are funded correctly. Collins was also a supporter of the stimulus package that improves healthcare information technology.
As it pertains to abortions Susan Collins is also pro-choice and believes in stem cell research. She is adamant about the right of a woman to choose just as Senator Kennedy. She also voted no on prohibiting HHS grants to organization who perform abortions. She has also been a proponent of expanding stem cell research.
In both the present and the past Collins has worked to ensure that healthcare coverage is affordable. From the bill that she coauthored with Senator Kennedy…… [Read More]
Healthcare Financing and Nursing
Healthcare is one of the most contentious subjects in the United States today, with the financing of the healthcare system the specific issue of concern in legal, ethical, and pragmatic spheres. The debate surrounding this industry has impacted all areas of the healthcare industry, including the nursing profession, in a variety of complex ways that are both direct and indirect. ising healthcare costs without a rising ability to pay has created a strain on many medical institutions, and a rising demand for are with the rapidly aging population of the United States (that is, with a much larger older generation(s) in the country, the overall demographic of the nation is shifting quickly towards more elderly and care-intensive individuals) has not been adequately met with a rising provision of services (Kovner et al. 2011). The following paragraphs will explore several implications of this situation on…… [Read More]
Many of the alternative health care delivery systems predate the allopathic mode of treatment, but remained popular only in the pockets of their early existence. The popularity of allopathic mode of treatment stem from the quick pace of relief it is able to give in most cases if not curing the cause giving symptomatic relief. As mans pace of technological growth increase so did his desire for quick health care delivery systems to which allopathic mode of treatment was well suited. The fast increasing rate at which the cost of the allopathic mode of treatment has climbed and continues to climb coupled with the increasingly established fact that in chronic diseases like arthritis and asthma the allopathic mode of treatment seldom goes to the root of the problem and only provides symptomatic relief are just two of the main reasons that have caused an increased re-look at the…… [Read More]
Leadership and Management in Healthcare
Effective Leadership and Management
Leadership is much like communications in regards to the complexity inherent in these concepts. There are many different perspectives that are used to examine these issues and researchers study leadership and management from such disciplines includes Industrial and Organizational Psychology, Social Psychology, Business, and Sociology. There have been somewhere in the neighborhood of six to eight major approaches, depending on the vantage point, to leadership theory produced in the scientific literature over the last sixty years and even more have emerged from outside academia (Kilburg & Donohue, 2011). Competing theories include such perspectives as trait theory, situational theory, behavioral theory, competencies theory, network theory of leadership and many more.
Much of the work that a nurse-leader engages in on a daily basis rests in their ability to communicate with others; including clients, colleagues, superiors, and subordinates. Therefore, since this…… [Read More]
According to a research focused on examining elderly persons' health status for individual states, an aging population with better life expectancy, but increasing prevalence of chronic ailments like obesity and diabetes indicates an emergent healthcare crisis. According to Dr. honda andall, non-profit organization United Health Foundation's senior adviser, it has only been some years since Baby Boomers first began turning 65, triggering a huge population demographics shift (Healy, 2013). The American Geriatrics Society's chief executive, Jennie Chin Hansen, who has authored one commentary within the Foundation's U.S. Health anking Senior eport states that the report provides a vital collection of messages focused at individuals, families and communities, together with warnings to both lawmakers and healthcare practitioners. She further claims a few trends are highly cautionary and health sector workers must sincerely be prudent, purposive and considerable to ensure improvements in citizens' wellbeing and health. Although healthcare workers possess…… [Read More]
Healthcare Organization Case Study
Health Care Organization Case Study
Health Care Organization Case Study
Banner Healthcare represents a set of diverse healthcare related facilities that provide healthcare services to societies in USA and beyond. Banner seeks to establish a healthier life for communities through developing a healthy environment. Banner Healthcare is arguably the largest healthcare provider in the country. The organization spans seven states, including Arizona, California, Colorado, Nevada, Alaska, Nebraska and Wyoming. The organization operates 20 hospitals, including healthcare facilities. The organization offers such services as hospice care, home care and physician services. Banner Healthcare also provided $130 million as their contribution to charity. The organization is a healthcare leader in all the communities it offers its services. The agency has shown tremendous growth in the past years. They admit over 190 000 patients every year and have a workforce in excess of 29-000. The emergency departments…… [Read More]
In principle, there is a very good reason for the standardization of medical terminology: it reduces one of the most common and preventable potential causes of serious error: miscommunication.
Non-Standard Medical Terminology in the Insurance eview Process
From the perspective of the medical insurance claims professional, non-standard medical terminology is equally problematic. The insurance claims process is highly codified (literally) into numerical designations for specific procedures and expenses. In combination with the degree to which the process relies on computer functions and databases encoded with those specific designations, that process is even more susceptible to error from non-standard communication than healthcare delivery, although rarely with comparable harm to patients. However, in some cases, the miscommunication caused by unnecessary non-standard language can indeed result in serious harm or even death, such as where crucial services are denied for coverage improperly as the result of issues of terminology that are not discovered…… [Read More]
Healthcare Delivery System Challenges
The American healthcare system has been criticized as favoring the middle and upper classes while ignoring the lower classes. Based on these speculations, the federal government has constantly tried to institute reforms in the healthcare sector though some of the proposals have failed to overhaul the industry. With rising insurance costs, the number of citizens barred from accessing quality healthcare has increased to more than 45 million uninsured Americans. On the same note, it is hypothesized that with time, the problems currently witnessed in the industry are likely to increase and finding solutions to them will be a tall order for the government (Stolberg & Pear, 2010). Despite the advent of new technology in the sector, which is likely to improve service delivery over the years, it is speculated that the cost of new tests and treatments will outweigh the savings. With the better technology, physicians…… [Read More]
future of health care delivery in anada, the country that you intend to practice medicine.
The anadian health care's most significant issue is it's disconnect of communication between medical practitioners and patients, on the one hand, and the different hierarchies and departments of medical care on the other.
The Primary are Advisory ommittee, for instance, reported last year that primary care services are becoming more fragmented with fewer doctors being sufficiently motivated enough to involve themselves in the full range of services such as hospital-based services, emergency services, or obstetrical services. Meanwhile, the health care team, including nurses, nurse practitioners, pharmacists, Physiotherapists, family doctors, and others are not structured or trained to fill in the gaps and collaborate in order to meet the needs of patients -- or even to attempt to meet these needs. The Government of Newfoundland and Labrador has taken steps to improve in this area and…… [Read More]
Strategic human resource management:
Applications in a healthcare organization
It has been said that one of the great ironies of healthcare is that despite the fact it is an industry where the 'human' dimension is so important, the H department is often one of the most-overlooked aspects of healthcare organizations. "There is arguably no other labor-intensive industry that is so reliant upon a highly skilled, highly educated, high-cost, and high-in-demand workforce that literally makes life-or-death decisions every day. And yet, in many hospitals and health systems H remains an afterthought in the C-suite" (Commins 2013:1). However, the need for change is constant, and many organizations are finding they must 'adapt or die,' given the new realities they are facing. "by the federal healthcare law, the inevitable and growing shortages of skilled healthcare professionals, and the newfound and measurable importance of patient satisfaction scores for reimbursements will prompt…… [Read More]
Education in Healthcare:
The health care system has been characterized with several issues in the recent past including increased costs, poor patient outcomes, shortage in the number of health workers across every category, and under-utilization of health workers. While lack of access to care and increased demand for health care choices are also major issues in this sector, workforce issues will continue to have tremendous impacts on health care delivery. According to the findings of a recent report, dysfunction in private and public health workforce policy and infrastructure contributes to vulnerabilities for health workers and puts the health of the nation at risk (Kreitzer, Kligler & Meeker, 2009). In addition, the current health care system consist inequities and misrepresentations that have continued to affect health workforce.
Health workforce is mainly influenced by the current system of healthcare education, which is characterized with certain challenges. The modern education in healthcare deters…… [Read More]
Americans healthcare delivery in the United States has been via a market driven system, 1 usually through purchase of health insurance, participation in HOs or other types of collective agencies. For those who qualify enrollment in edicare and edicaid programs will cover or defray costs of healthcare.2 For a growing number of people in the U.S. medical care costs are not covered by insurance or government programs, for them out of pocket and indigent services are their only options.3 This paper will look at the how financing healthcare affects both costs and use of healthcare services.
Private Health insurance.
Private health insurance in the United States developed around the 1930's during the Depression4 and grew during the economic expansion of the post-WWII years. "Under most private insurance and Blue Cross -- Blue Shield plans, fee-for-service, with physicians determining the economic value of their own services, became the established method of…… [Read More]
Health Care and Nursing
As the medical profession gains a greater understanding of the various approaches to healthcare delivery, the concept of segmenting the services proscribed to a patient into primary, secondary, and tertiary care has emerged as one of the most useful advancements in the field. The preventative measures advocated by proponents of primary health care (PHC) are designed to improve a patient's quality of life in such a way as to reduce or eliminate their prospects of becoming ill or injured. Among the fundamental precepts of PHC are the administration of immunizations to guard against viruses and other contagious infections, the development of a nutritious daily diet to improve the body's natural immune defenses, and advisements to refrain from smoking tobacco or drinking alcohol to excess. As it pertains to the nursing profession, PHC involves "the delivery of comprehensive coordinated, continuous and individualized total patient care through the…… [Read More]
What direction is the quality of health care and delivery of health care moving in; it is not moving in a direction at all. Like the pendulum, the direction of health care remains suspended to the far side - right or left, depending upon which side of the political isle one is on. The pendulum remains frozen in time, and it reflects chaos in the delivery of health care and the quality of patient care. Health care remains the captive audience to managed care company stockholders and executives whose business focused decision making on what benefits can access, when, and where remain guided by an archaic DG system that was implemented more than twenty-five years ago.
If there is a direction for American health care access and quality of care, it is that direction of circling the drain before it falls into the black abyss of the unknown, and…… [Read More]
overwhelming connections between healthcare costs and the macroeconomic performance of the U.S. economy. The impact of healthcare industry on the macroeconomic performance is evident from the fact that in 2009 healthcare expenditure of the U.S. was 18% of the gross domestic product (GDP) of the country. It was also estimated that should the healthcare costs continue to grow at historical rates, 34% of the U.S. GDP will compose of healthcare spending by 2040 (Whitehouse, 2009). The major sources of funding the healthcare costs are the Federal, State, and local governments of the U.S. Medicare is a healthcare program that subsidizes healthcare for citizens above 65 years of age. Medicaid subsidizes healthcare delivery for people below a certain income level. Approximately 50% of the healthcare expenditure is bore by governments at the federal, state and local level. It is also estimated that Medicare and Medicaid spending of Federal and State governments…… [Read More]
2.) Based upon your personal, non-professional experiences, briefly discuss 2 or 3 applications of it which have enhanced or hindered your financial or medical well being. It and cyber-commerce/e-commerce do not exist devoid of context; thus please help define and shape this context.
The advent of computerized billing and medical coding has undoubtedly streamlined the process of managing a hospital's income and expenditures, but this aspect of healthcare it has been known to create unanticipated disadvantages as well. Although it is true that "the management of healthcare organizations can be improved through the intelligent use of information ... (and) this requires systematic planning and management of information resources to develop information systems that support patient care, administrative operations, and strategic management" (Citation pg. 21), there are a number of caveats that still apply. In my own non-professional experience, I have encountered confusion, frustration, and ineptitude on the part of healthcare…… [Read More]
health care system has focused on the prevention and cure of disease and illness. When people got sick, every bit of energy and finances went into trying to figure out how to stop it. This was true even when the patient had a disorder or a disease that was deemed incurable. For many years when someone got a disease in which there was no cure, it did not change the method of treatment. The medical community, the family and the patient continued to try every possible avenue to stop the progress. Often times the patient would submit to painful and disorienting treatments, because they didn't want to disappoint their family members or their doctors. At the same time the medical community was expanding the length of life so that many people were living longer than ever before. These two things began to clash. At what point do people stop trying…… [Read More]
1970s, streamlining American healthcare is a subject that appears significantly in the news. If this revitalized political concern mirrors a rising consent that the present structure has touched its ceiling of difficulty and expenditure, simultaneously that it eliminates so many citizens in order to create the circumstances politically hazardous, something essentially might change. This might be the conclusion of the political, as well as, ideological efforts to identify our general health care principles and objectives that has been uncontrolled for more than two decades. Otherwise, if all the hoopla is merely the "sound and anger" that usually escorts a political disappointment such as our previous presidential election, it might indicate nothing (Patricia, 1993).
Simply one thing is clear. Even though some corporate managers now support a single financier, socialized structure such as the Canadians maintain, they are nonetheless in the underground. Robert Evans, a Canadian health commentator, has plainly associated…… [Read More]
Quality of Care: Healthcare eform
Health care reform legislation is expected to reduce health care spending by $590 billion over 10 years and lower premiums by nearly $2,000 per family by slowing the annual growth rate in national health expenditures. Discuss how this savings will be accomplished and what potential sacrifices in health care delivery may be experienced. Is the figure of $590 billion when calculated over a ten-year period really a significant savings?
The Affordable Care Act (ACA) was designed to make healthcare more accessible to a wider array of Americans and also more equitable in its method of delivery. Some of its provisions included requiring all adults (with some hardship exemptions) to have healthcare or pay a penalty. The hope was that expanding the risk pool of young, healthy insured who might otherwise forgo coverage would support the costs of some of the other provisions of the bill,…… [Read More]