...Ornelas Nefitete Phelps HCS/235 September 9, 2015 Health Care Utilization Option 1 {Place Title Here} Health care reform in America is a fiery matter and the source of law meant to make health care obtainable to American people. Another goal of this legislation is to cut down the growth in health care spending. In the past presidential elections have been the stage used to promote health care reform. Over the last few years health care reform has taken great strides under President Barack Obama. This essay will discuss the many different ways recent health care reform measures have expanded or inhibited access to health care to Americans. It will also discuss how changes to access could possibly lead to influences in utilization, Concepts of what universal health care might be, and how current care reflects or contrasts with this. In addition to the thing listed above, this essay will recount a rather personal experience with health care expansion either negative or positive health care reform. The (PPACA) Patient Protection and Affordable Care Act or Affordable Care Act (ACA) for short was created and signed into law in March 23, 2010. This law is to make sure that all Americans have access to health care at an affordable rate and to help take hold of the ever rising health care cost. Disputed from the beginning, this reform measure created multiple opportunities for individual American’s to access insurance for preventative care, immunizations, and even those with pre-existing...
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...Title of Paper Health care is defined as being one of through goods that consumers demand. A study reveals that rational consumers make choices to maximize utility. For example if the Americans chooses to eat more chocolate even though it is bad for his or her health, it means that Americans perceives more utility in the joy of eating chocolate than developing good teeth. However, the market for health care is different from markets for other goods in many ways, which complicates “decision making” in these markets. This simulation paper deals with decision making issues from the perspective of Castor Collins, which is a health maintenance organization. The history Castor Collins health plan continues to provide health insurance and health services to its enrollees throughout the state of Pantone. Since “the year of 1999”, Castor Collins health plans provide its enrollees with statewide network of physician and hospitals by using a capitation model to pay its network providers. Currently the company has 100,000 enrollees and is currently looking to increase this number. However, to increase enrollment numbers it will take the dedication of the chief vice president of strategy and financial planning to interact with new clients as well as formulate a health plan. The chief vice president along with colleagues Helen Feuerman (Chief Financial Officer), Jonathan Wilkes, MD (Chief Medical Officer) ,and Adam Hunter (Executive vice President of planning and development)...
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...implement the changes necessary for the organizations future growth. The determinate of the success of the organization is whether the health care system after redesign will be able to sustain the changes made to the organization long term. To remain a stable organization the culture and leadership need to be stable as well as openness to implementing change to improve processes (Jones & Bartlett, 2009). The current management structures that have been developed in recent years have involved governance, senior management, support staff, and institutions. The largest projected changes to the organizational management structure is predicted to be in the health care industry, due to the implications of health care reform, and meeting the established criteria set forth by the federal government, as dictated in the Health Care Reform Act. The structure that is presented in this reform has not been effect long enough to have predictable data regarding the true out comes or results and has endured some wrinkles and challenges that have required explanation to the senate and clarification from the supreme court as to the constitutionality of the changes made to current processes that have been implemented this far. The new strategic challenge is that the health system needs to redesign and changes will need to be made to the way the health care industry does business. The success of an organization was previously based upon volume of patients in the system or beds occupied...
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...Wayland Baptist University Hawaii Campus School of Business Wayland Baptist University’s mission is: To educate students in an academically challenging, learning focused and distinctively Christian environment for professional success, lifelong learning, and service to God and humankind. HLAD 4337 HEALTH CARE LAW ADMINISTRATION Winter (October 3, 2011 to December 05, 2011) WBU-Tripler |Instructor: |Glenn K. Yoshida, J.D., MPA | |Office: |Mililani Mauka | |Office: Phone: |488-7002 | |Cell Phone No. |741-2237 | |Fax No: |488-7003 | |Email: |gyoshida@hawaiiantel.biz | |Office Hours: |4:30-5:30 p.m. Tripler Mondays :. | |Class Hours: |5:30 p.m. – 9:30 p.m. | |Class Location: ...
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...markets in health care can offer patients greater quality, more options, and lower costs. The Federal Employees Health Benefits Program and Medicare Part D serve as two illustrative examples of competition in health care today. Proper reforms to add further competition to the health care industry would be quite significant and would further America’s position as the world’s leader in health care for years to come. KEY POINTS 1. The body of peer-reviewed academic literature suggests that health care can and should operate like a traditional market. 2. Market-oriented reforms have the potential to improve the quality and cost-effectiveness of care, as demonstrated by the Federal Employees Health Benefits Program (FEHBP) and Medicare Part D. 3. Consumer-driven health plans are viable alternatives to traditional plans, and consumers should have the option of choosing such plans. 4. Proper risk adjustment mechanisms can prevent adverse selection. 5. Migrating toward value-based payment systems will result in greater quality of care at lower costs, in part by incentivizing the health care industry to make great strides in offering integrated care, innovative treatments, and personalized medicine. ABOUT THE AUTHOR Kevin D. Dayaratna, Ph.D.Senior Statistician and Research Programmer Center for Data Analysis Over the course of the past several decades, federal and state lawmakers have proposed a variety of initiatives to reform America’s health care system and...
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...Health care; is it a right, social good or market - based commodity? Name: Institution: Course: Date: Health care; is it a right, social good or market - based commodity? Health care is a service offered by the health professionals to prevent, treat and manage illness that infect humans for their well being and in order to ensure that it is successful, health care must follow the health code of ethics which provides the foundation of shared values for its practice (NCHEC, 2008). Some of these values articulated in the health code of ethics apply to the Bronx Health Reach program. The program comprising a coalition of community based organizations and health care providers are engaged in improving health conditions in the Bronx neighborhood. The essay will therefore argue whether health care is a right and social good or market - based commodity. Health care services should be not be sold and bought like other commodities in the market for it is unethical and immoral to offer such essential services to the people who can only afford them (Daniel, 1985). Life is precious and gives only one chance; therefore, every person is entitled to better and same health care not because of whoever they are or how much they can give. Health is indeed important and just like any other business; they exist to make profit that cannot be maximized by providing health care to whoever needs it. People argue that health insurance companies are not concerned with people getting quality care but according...
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...Health Care Reform By: Tamika Williams August 2, 2014 HCS/235 In the United States, health care reform is a major topic that many people are talking about and how the sources available will help Americans with health care. During the presidential election in 2008, health care reform was a great deal for them to promote the ideas to helping health care but no one actually can explain how it was going to become resolved. America was to the final point, where we as people, thought that the biggest controversy would become resolved and a new era of transparency would be developing. In these years that have come many of the changes that has been promised to America, has yet to occur and is still the same as before. The most recent health care reform is The Affordable Care Act which has expanded access to health care which was created and signed to make sure that all Americans in the United States have affordable health care available to them and to monitor the rising of the health care costs. The Affordable Care Act (ACA) is the most comprehensive reform of the United States medical system in at least 45 years. The ACA transforms the non-group insurance market in the United States and mandates that most residents have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Projecting the impacts...
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...REFLECTION Organizational Leadership For Building Effective Health Care Teams Stephen H. Taplin, MD, MPH1 Mary K. Foster, PhD2 Stephen M. Shortell, PhD3 1 ABSTRACT The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they all need support from leadership to succeed. Teams have been invoked as a necessary tool to address the needs of patients with multiple chronic conditions and to address medical workforce shortages. Invoking teams, however, is much easier than making them function effectively, so we need to consider the implications of the growing emphasis on teams. Although the ACA will spur team development, organizational leadership must use what we know now to train, support, and incentivize team function. Meanwhile, we must also advance research regarding teams in health care to give those leaders more evidence to guide their work. Ann Fam Med 2013;11:279-281. doi:10.1370/afm.1506. Process of Care Research Branch, Behavioral Research Program, Division of Cancer Control and Population Science, National Cancer Institute, Rockville...
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...HCA/240 It is amazing how much the health care delivery services have changed and improved over the years. Today, the health care systems have advanced by prolonging life expectancy and quality of life. Though, providing health care is not cheap and easy to do. Cost, accessibility, and quality is a challenge that they face in order to provide the people with healthcare. Learning and being aware of disease trends has definitely impacted our society in a good form. For example, there are organizations such as WHO and CDC that provide the nation with health care information to inform about diseases that can affect the population and how to prevent them. Instead of worrying about curing the diseases, now there are ways to prevent them before they even spread. Though, will these disease trends as well as demographics have an influence in health care delivery services in the future? If it is now being a challenge, what can be expected of health care delivery for the next-generation? Although some disease trends are preventable, it is impossible to not get any form of disease or illness throughout a life time; also there are many factors that can affect the health care delivery systems in many forms. Demographics and disease trends will influence health care delivery services in the future in many different ways. Not only will the current aging population affect the delivery of heath care services because of its rapid growth , but also obesity. Obesity is one of the...
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...Health Care Utilization August 19, 2013 John Q is a fulltime employee with a few health issues, because of his low income John qualifies for the Medicaid program in his city. With the health issues that John has he recently called around his city to see if he could locate a provider that accepted his insurance. John found a provider, he has also discovered that the closest primary care physician that accepts Medicaid is a 40 minute drive and appointments must be made 2 weeks in advance due to the number of patients at the practice. The provider that John located does not offer weekend appointment, and John relies on public transportation and he occasionally gets a ride from a friend. Looking over John’s circumstance with his health care needs and his transportation needs looks like he will need to go ahead and make the appointment for the next month that way John will have enough time to get his transportation needs in the correct order. When we think about the word utilization and what factors this may play in john’s health care needs. First the word utilization which means the primary method by which asset performance is measured and business success determined. In basic terms it is a measure of the actual revenue earned by assets against the potential revenue they could have earned. So looking into John’s healthcare issue and his family history of health issue John might need to call the physician office and see if he and talk with them about utilization management...
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...How to reduce utilization costs and to improve patient health outcomes? The following report will outline a strategy that can be used to improve patient health outcomes and reduce utilization costs. Increasing pressure to control health care a cost necessitates that limited healthcare resources be used equitably and judiciously. Healthcare expenditures must be correlated with high quality and efficiency in the delivery of services to improve health outcomes. This requires understanding the benefits and effectiveness of clinical procedures, recognizing the major drivers of health care costs, and identifying potential means for achieving savings. (American College of Physicians, 2009) To improve health outcomes, physician and staff members will encourage patient to utilize “my chart.” My chart is a portal that can be used when utilizing an Electronic Health Records. One electronic health records would be Epic/Apex. When patients are able to look at their lab results at will and clinical results this gives them an opportunity to be involved in their own health care. An electronic database allows patients to have access in asking provider questions, and finding out the answers in a timely manner. When patients are able to communicate with their provider by directly sending him/her a message, this gives them easy access involving health outcomes. Patients have an online access that allows them to communicate with a provider in a timely manner, which makes it easier to communicate...
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...Instructor: Roy Redman HCM307-1304A-03: The Health Care Industry Phase 4 Individual Project November 4, 2013 A See PowerPoint Presentation Well Done Joann: Future Healthcare Trends: - provided and discussed the major areas of technology in healthcare and how the innovations will apply to the field in 4-6 slides with speaker notes. Points - 43 /45 Critical Thinking Skills: student advances the discussion by synthesizing some information and drawing most of the required conclusions; additional details could be provided, but basic content is covered. Points - 33 /35 Application of Material to Real Life/Professional Experiences: answers are mostly complete and encourage understanding of the subject matter. Points: - 29 / 30 Organization of Material – thoughtful, thorough, well developed responses to the object of this assignment. Points - 25 / 25 APA Format, Grammar, and Sentence Structure: - Grammar and sentence structure are correct; APA format is followed. Points 15 / 15 Total Points 145 / 150 Be curious, Roy Redman Shi and Singh; Chapters 5, 12 & 14 Task Type: Individual Project Deliverable Length: PowerPoint Presentation 4–6 slides with speaker notes (not including title/referencce slides) with s Points Possible: 150 Due Date: 11/4/2013 11:59:59 PM CT One of the high points of the campaign will be a look to the future of Healing Hands Hospital. Mr. Wood asks you to help the public relations committee come up with some ideas that can be used in...
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...one health care facility (Heritage Valley Medical Center) on how a well-known organization which provide quality services for all citizens in their community is culturally competent. For the past 20 years, this medical center had grown and committed to its mutual ideals and its respect for all patient and their families. Soon after the establishment of the State Health Indigent Care Fund, Medicaid settlement increases which make it comparable to those who managed care organizations. Heritage Valley Medical Center intended to utilize this new market and potential revenues that come with it to target the minorities. After 3 years, minorities’ residents increased from 10% to 40% who were mostly African American and Hispanics. Even with the increase in minority patients, the service providers’ ethnicity remained the same as before. About 85% of the staff members, which include nurses, laboratory technologists, physicians, therapist, and pharmacists were Caucasian. There were only two African American managers and one Hispanic manager. All the employees were like family as most of them had worked there for more than 15 years. They shared similar principles and values for the patients and respect toward them. Ms. Harper, vice president of community relations, shared the outcomes of a recent patient satisfaction with the administrative directors at a management meeting. The results indicated that although 80% of the Caucasian patients were very satisfaction with their care, merely...
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...In recent years financial accounting and reporting in the United States health care organization has revolved. Currently health care organizations that includes public and private, for profits and non for profits adhere to generally accepted accounting principles. The generally accepted accounting principles are a mixture of respected criteria that govern the field of accounting, which consist of rules that accountants must comply by. In this paper first it is going to explain the principles of accounting. Next, give an aspect to the value and important of corporate compliance when using generally accepted accounting principles. In addition, address the importance of cooperate compliance and its relationship with ethics, fraud, and abuse The general accepted accounting principles (GAAP) is a set of accounting principles, standards, and procedures that health care organizations uses to compile financial statements. The general accepted accounting principles also steers health care organizations in recording business transaction. However, general accepted accounting principles are not rules, but are six sets of principles for a health care organization to follow for recording. .The first principle is economic entity, which allows accountants to keep the sole proprietors business transaction separate from the owner’s personal transactions. The second principle is accrual basis, which is a method of book keeping that accountant uses to record financial events on the bases of cash...
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...Many health care organizations have implemented the electronic health record (EHR) system. Assess the issues that are being presented by the technology and evaluate the benefits against the issues. Before the computerized era started, patient’s health records were kept on paper or other non-sophisticated methods. Those color tabbed folders are still in place, but all the information contained in those folders now can be stored in electronic files utilizing huge memory banks and backup systems to protect this information. Everything can be saved and preserved for a very long time. Health information management (HIM) has become a main concern of all healthcare organizations, not only to stay with law compliance, but also to run a more efficient operation. The pros of keeping electronic record versus paper out weight the cons. The main con could be the possibility of someone “hacking” those records. However, that someone could also have access to the paper records and use them illegally. The important issue here is that these records must be kept for a number of years depending of the state and federal requirements (five years or more depending on the state). ACA and HITECH (Health Information Technology for Economic and Clinical Health) act have encouraged the widespread use of electronic records versus paper for obvious reasons. Now, HITECH act is designed to enforced HIPAA (Health Information and Accountability Act) standards, and prosecute major PHI (Protected Health Information)...
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