...Health Utilization and Finance Melissa Dorn Organization Systems and Quality Leadership Western Governors University The United States and the United Kingdom have a lot of systems that are operated the same, such as their legislature and government operations, but the one difference is how they offer healthcare. The US healthcare system is an almost fully private system and the UK healthcare system is socialized. One may ask well what does this mean exactly. And the answer is that in the UK everyone has access to healthcare no matter how poor or rich they may be. The insurance is paid through taxation. In the US, the insurance is mostly private, which means that a person will have to pay for insurance premiums out of their pocket. The quality of the insurance will depend on the type of plan that a person is paying for and there could be high out of pocket expenses. In the US healthcare isn’t guaranteed by the government like in other industrialized nations. In the US the government doesn’t control most insurance systems or how they operate. People in the US who do have healthcare coverage are covered either by private insurance or a public health care system. A lot of unemployed individuals don’t have any coverage at all. Medicare, Medicaid, Children’s Health Insurance Program and the Veteran Affairs program are considered public health care systems. For some of these government programs, individuals may still be responsible for a premium depending on income. The...
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...Affordable Care Act Myer Mikan Alden University Abstract The Affordable Care Act (ACA) in North Carolina: Discussion points; 1) The impact of this act on the population. 2) The economics of providing care to patients from the organization point of view.3) The effect of cost of treatment, quality of treatment and access to treatment. 4) Examining the ethical implications of this act for both the organization and the patients. Affordable Care Act Impact As we all know before the Affordable Care Act came into existence in 2010, the federal and state programs that provided health insurance, and social welfare funding are the Medicaid and Medicare. However, a new legislature was enacted into law by President Barack Obama in 2010 to extend health insurances across all demographic ladder as well as all income levels thereby making health insurance flexible and affordable. “Over 45 million Americans who are uninsured speak volumes about the problems with our present Healthcare system” (Rashford, 2007). This new law that is widely referred to as the Obamacare aimed at providing Americans with affordable quality health insurance and to reduce the high cost of healthcare spending in the United States. This new insurance as argued by the government offers a lot of new benefits, rights and protection rules for insurance companies, tax breaks ...
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...Running head: ACCESS TO QUALITY HEALTHCARE PAPER ASSIGNMENT Access to Quality Healthcare Paper Rudolphe Lubin University of Phoenix Lori Lewellen MBAJOGZL57 April 27, 2009 Quality Healthcare Introduction It will be evident to realize that financial, educational, and socio – demographic implications can bring serious impact on access to quality healthcare in the organization. Labor shortage will stay an important component that can affect as well the access to quality care. Socio – demographic changes linked with chronic illnesses can have an effect on the aging population, which may reduce the quality of life, increase costs for healthcare and rise resource allocation. In point of fact, both labor shortage and socio – demographic changes are exactingly dominant in the admittance to quality care in the United States. Besides, the demand for registered nurses and changes in science is already exceeding supply in U.S. nation, including more implications associated with other ethical dilemmas. Healthcare Labor Shortage People have to realize that progresses in medical technology, increasing expenses and market forces provide to the financial decline of many rural healthcare organizations. In reality, small rural healthcare suppliers, particularly hospitals, cannot meet the costs of the equipment and practitioners needed to treat the range of modern syndrome and injury...
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...Implications of Health Economic Concepts for Health Care Melissa James Strayer University Dr. Wanda Allen Health Economics – HSA 510 February 1, 2015 Assignment # 1 Implication of Health Economic Concepts for Health Care Assess the value of healthcare professionals and decision makers understanding the discipline of health economics. Healthcare is getting gradually complex around the world. The need for technological development, economic support, demographics changes and the study of diseases are shifting at a fast speed. There had been numerous labors in describing collective capabilities and values within the healthcare organizations. It is necessary for learning and training programs to be regulated based on the needs of the humanities they support. Therefore, the institutions that are designing and delivering those activities must take responsibility for the products they manufacture for the use of the society. Hence, Academic institutions that are in charge of educating healthcare professionals together with their various stakeholders must interact in collaboration to create actual and proficient strategies that will promote suitable culture in the healthcare systems. Current medical education process has its origins in the European institutions of higher learning that customarily cherished academic freedom, sovereignty and self-regulating exploration...
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...Accountable Care Organizations: Key to Transforming Healthcare? The Talia Goldsmith, MHA Candidate 2011 Suffolk University Sawyer Business School HLTH 890AE: Healthcare Strategic Management Professor Richard H. Gregg, M.A., M.B.A. April 28, 2011 Table of Contents Objective .....................................................................................................................................3 Introduction ..............................................................................................................................3 Overview of ACOs as a Mandate and an Opportunity for Healthcare Organizations............................................................................................................................4 Examples of Missions, Visions, Values and Goals for ACOs........................................6 Mission ................................................................................................................................................. 6 Vision ....................
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...Bisht et al. Globalization and Health 2012, 8:32 http://www.globalizationandhealth.com/content/8/1/32 REVIEW Open Access Understanding India, globalisation and health care systems: a mapping of research in the social sciences Ramila Bisht1*, Emma Pitchforth2 and Susan F Murray3 Abstract National and transnational health care systems are rapidly evolving with current processes of globalisation. What is the contribution of the social sciences to an understanding of this field? A structured scoping exercise was conducted to identify relevant literature using the lens of India – a ‘rising power’ with a rapidly expanding healthcare economy. A five step search and analysis method was employed in order to capture as wide a range of material as possible. Documents published in English that met criteria for a social science contribution were included for review. Via electronic bibliographic databases, websites and hand searches conducted in India, 113 relevant articles, books and reports were identified. These were classified according to topic area, publication date, disciplinary perspective, genre, and theoretical and methodological approaches. Topic areas were identified initially through an inductive approach, then rationalised into seven broad themes. Transnational consumption of health services; the transnational healthcare workforce; the production, consumption and trade in specific health-related commodities, and transnational diffusion of ideas and knowledge...
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...1: Implications of Health Economic Concepts for Healthcare HSA 510 Health Economics Introduction What is health economics? Health economics is one of the many branches in economic. Most of the concepts surrounding this branch are both the micro and macroeconomics placed in the context of efficiently and effectiveness in the production and services delivery in the health sector industries. The concept of health economics can be explained in layman language as the study of economical functioning of the health care system in an economy. It involves matters affecting the health of individuals in a society (Cromwell, 2011) Assess the value of healthcare professionals and decision makers understanding the discipline of health economics. Building on their longtime leadership in identifying standards of care, professional medical organizations already have played a role in shaping the value. It is critical that individual physicians and other health professionals also understand the goals of health care and engage as partners in implementing its principles. Healthcare professionals and decision makers are more disciplines of the health economics. The value of healthcare can be mentioned as the microeconomics. The reason for that being said is the evaluation of their treatment level and providing care in all segments relates to cost and effectiveness. The demand for health care has an impact or influence many different areas such as education, hazards, income and health in...
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...Chapter One 1. A. What are some of the industries in the healthcare sector? The major industries in the healthcare sector includes health services, health insurance, medical equipment and supplies, pharmaceuticals and biotechnology, and other (includes a diverse collection of organization ranging from consulting firms to educational institutions to government and private research agencies. B. What is meant by the term healthcare finance as used in the book? Finance, as the term is used within the health services industry and as it is used in the book, consists of both the accounting and financial management functions. C. What are the two broad areas of Healthcare Finance? Accounting as its name implies, concerns the recording, in financial terms, of economic events that reflect the operations, resources, and financing of an organization. Financial management or corporate finance, provides the theory, concepts, and tools necessary to help managers make better financial decisions. Certain aspects of accounting involve decision making, and much of the application of financial management theory and concepts requires accounting data. D. Why is it necessary to have a book on healthcare finance as opposed a generic finance book? The reason is that while all industries have certain individual characteristics, the health services industry it truly unique. 2. What is the difference between a business and a pure charity? A business such as a hospital or medical...
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...Implications of Economics and Policy for Health Professionals Daveen Wilkin Walden University Health Policy & Economics/MMHA-6135-4/Assignment Week 1 According to the World Health Organization (2015), health policy can be defined as a group of decisions, plans and/or actions that may be undertaken with the objective of obtaining specific health care goals within society. Health economics refers to the study of economics and how it relates specifically to the field of health (Teitelbaum & Wilensky, 2013). Policies made with regard to health are often formulated after extensive analysis of how said policy will impact the nation’s economy on a whole. The Importance of Understanding Health Economics Healthcare can be considered a business (Laureate Education Inc., 2010). It is therefore important that healthcare professionals understand that economics theory provides a fundamental building block when it comes to making policy choices with regards to health care and public health on a whole (Teitelbaum & Wilensky, 2013). By using economic tools to help predict consumers’ response to the implementation of a particular policy, the most effective and efficient policy can be chosen in order to achieve the goals of the policymakers (Teitelbaum & Wilensky, 2013). Economic policies and the level of economic activity of a country greatly influence the health of that country’s population (Zollner, Stoddart & Selby Smith, 2003). Health care providers need...
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...Practice To my colleagues, the health care system has begun a decade of transitions that, for the nursing profession, promise to change the practice of nurses, expand current nursing roles and create new ones, and provide many opportunities for nurses to participate in shaping the future delivery system. With the passage of the Affordable Care Act (ACA) in 2010, care delivery and financing systems are undergoing significant transformations that will accelerate in 2014, when major provisions of the legislation are implemented. The purpose of the this letter is to explain how the practice of nursing is expected to shift and to also discuss the concepts of continuum of care, accountable care organizations (ACO’s) medical homes, nurse-managed health care clinics (NMHCs). Under the Accountable Care Organizations, strategies will be developed to align the goals of health care delivery reorganizations, enhance care coordination, and improve patient transitions across the care delivery continuum. Expansion of medical care homes, NMHC’s, and enhanced coverage for preventative care services will help to shift the delivery system's current focus on acute care to a greater emphasis on prevention and treatment of chronic care conditions using health care teams and information technology. Medical homes, sometimes referred to as NHMC’s, are identified as a concept that began in pediatrics over 40 years ago. Over time, the medical home has now evolved into a health practice that encompasses a models...
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...CHAPTER ONE 1.1 Background to the Study Health is central to the development of any human society, thus an adequate healthy society can improve the social status of the people (Akanbi, 2014). Though healthcare is a vital service, however, it is often treated from symptoms rather than the causes of the poor health. WHO (1948) affirms that, health is a state of complete physical, mental and social well-being and not mere absence of disease and infirmity. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. In recent years, much evidence has been accumulated which shows just how important the planning of physical, social, and economic environment in which we live and work is to our health. Conversely, physical planning systems are the methods used by the public sector to influence the distribution of activities in spaces of various scales (Andreas and Bas, 2002). Also, it is a process intended to promote sustainable development and is defined as goingbeyond traditional land use planning to bring together and integrate policies for the development and use of land with other policies and programmes which influence the nature of places and how they function.In the developing countries, a substantial and growing population lives in or around metropolitan areas and megacities (Adesina,2007). The urban sector of any country is never static. It changes with time, in fact as the days and years go by, the urban landscape is altered...
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...international basis, the development of health care policy is increasingly being influenced by cost considerations. As there are advances in health science and the ability to deliver care continue to expand capabilities of treatments. One major subject of debate has been on the ability of nations and communities to pay for health care with their available resources. One debate has been researched that Americans are paying more for healthcare services than any other nations. It is said that there is a struggle providing health care services and other programs while maintaining economic stability. This could possibly promote frustration for healthcare providers and payers in situations like these. In the efforts to research these concerns of health care policies, it was found that there are significant economic challenges that have direct implications for health care financing and delivery. Concerns about quality could frustrate important changes in health care delivery and financing. Policymakers, payers, managers, and others must confront current and potential quality-of-care problems with the same vigor and sophistication that they are directing to issues of cost. At its best, health care in the United States is superb. Even Americans with insurance, including Medicare and Medicaid, may not always have access to adequate care. At the same time, some Americans may be subjected to inappropriate or unnecessary procedures. American healthcare, with all of its pros and cons, is very...
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...American healthcare system on Indian health services USA is the world’s largest economy. Its dominance in the sphere of arts, science, technology, culture and medicine is unparalleled today. Given its dominant socio-political and economic status, no country on earth can be said to be beyond the sphere of American influence in almost all aspects of life. While the pervasiveness of such American hegemony is a matter of debate today in many sociological discourses today, for the purpose of this paper, we will concentrate on influence of American healthcare on the healthcare system of India. The American way of life is typified by the example of “rugged individualism,” where each individual works to secure their own interest....
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...* Health Care Economic Issues Outline * I. Introduction A. More than 50 million uninsured in the United States (Young, 2012) B. Uninsured population is considered vulnerable population C. Uninsured use emergency department to meet their primary health care needs D. Overcrowded emergency departments require reallocation of resources * II. Effectiveness of the Current Procedures in Place * A. Federal Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals * to treat every patient irrespective of the payer source B. Limited community resources forces uninsured population returning to emergency department for minor ailments C. Shrinking federal and state funding for medical assistance programs D. Current procedures do not address medical needs of the undocumented populations * E. Treating uninsured costs taxpayers more than $175 billion per year (KFF, 2008) F. Hospitals absorb more than $65 billion dollars per year in uncompensated care III. Affects of financial decision-making process A. Express/Urgent Care areas added to emergency B. PA added to Triage to treat minor health issues C. Sponsor Care Funds Created 1. Hospitals have created sponsor care programs designed to help alleviate the amount of debt created by an insured patient. The funding for sponsor care programs comes from direct donations from the community and are meant specifically for patients that are receiving...
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...The healthcare industry, specifically the patients receiving care, have been subjected to a service based industry where they must pay increasing costs for services and customer service has essentially taken a back seat. The implementation of Value-Based Purchasing (VBP), as outlined in the Patient Protection and Affordable Care Act (PPACA), has now addressed this concern. The move from a prospective payment industry to a value based industry is to benefit the patient while holding providers accountable for usage of procedures and tests, and providing increasingly higher quality of care to their patients. Due to the high volume and high expenditures specifically in hospitals, there is a new type of approach being taken when it comes to patient care in acute care settings. The prospective payment system (PPS) was established in the 1980’s in conjunction with Medicare’s Diagnostic Related Groups (DRG) system. This was established due to the rising costs of to the social security administration (Mayes, 2006). During this time hospitals were placed under pressure to accept the new payment system and structure due to an exponential rise in Medicare expenditures. To give perspective on the growth of expenditures to Medicare enrollees, in 1972 Medicare had approximately 21 million enrollees and expenditures approximated $7 billion dollars. In 1982, Medicare enrollees amounted to 30 million and expenditures skyrocketed to $50 billion dollars per year (Mayes, 2006). The DRG system was...
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