...Health Care Utilization Paper Option B Svetlana Leyzerov HCS/235 May 25, 2015 Hanna Matatyaho Health Care Utilization Paper Option B The Behavioral Model of Health Services utilization was developed by Ron Andersen in 1968, and subsequently refined with his colleagues over the years. It is the most widely adopted conceptual framework for studying the use of health services, especially with regard to determining whether or not access to and consumption of health services is fair. The model underwent three revisions, or phases, the first of which was the initial Behavioral Model. Developed in the 1960s, this phase was focused on individual use of the health care services. Phase two was in 1970s, where Anderson collaborated with other colleagues in order to recognize the importance of national health policy, the resources in the health care system, and changes in those over time. A third phase, in 1990s, acknowledged changes in the environment as part of understanding the use of health care services. Although the Behavioral Model of Health Services Use was revised, the core factors that it was built on stayed the same. It is based on a function of predisposing, enabling, and need for health care. The predisposing factors are stronger in tendency for some individuals than in others. It is further subdivided into demographic factors including age, gender, and ethnicity; social factors- education, occupation, and residence mobility; health beliefs-attitude toward the...
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...Abstract Health care utilization has fluctuated over the past few years. Some things that have been effected are health care spending, health care cost, and the use of name brand and generic drugs. Since the Affordable Care Act has come into play, it has caused some changes for the better. Although name brand drugs are being declined, more generic brands are being produced to be cost effective for both the insurer and the consumer. Many different types of Americans are effected by the health care reform, and the first step starts with making sure everyone is educated on the benefits. After everyone is educated an action is taken, Americans will be healthier as a whole. I will go over many facts that support the healthcare reform, the pros and cons, and much more. Keywords: Health Care utilization, Affordable Care Act Health Care Utilization Paper Recent health care reform measures have expanded access to care by allowing more Americans access to affordable health care. When President Barack Obama introduced the Affordable Care Act to us and signed it into law on March 23, 2010, he meant for it to provide affordable, quality health care for all Americans and reduce the growth in health care spending. Although Obama Care has caused tremendous growth in the healthcare reform, this plan has been in the works for decades now. One way the health care reform has expanded access to care is by making it affordable for seniors to pay for their medication. The Medicaid part d prescription...
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...Health Utilization Paper Jana Byers May, 4, 2015 Mr. John health care utilization may be affected in several ways. The first factor is that he lives in rural area in which the primary care physician is forty minutes away. The passage also mentioned that Mr. John does not have personal transportation. The fact that the primary care physician is not within walking distance increases the likelihood of Mr. John missing a scheduled appointment. If he cannot find reliable transportation to get him to the physician’s office, he may have to re-schedule for a later date. As a result of the uncontrolled hypertension, Mr. John chances of having a heart attack are now increased; especially since he has a family history of heart attacks. But, the upside to this scenario is Mr. John has encouragement to keep his scheduled appointment. He will be more likely to arrive to the appointment because he has to depend on someone else to get him there. Since the appointment has to be scheduled at least two weeks away, Mr. John will have enough time to schedule transportation with the Medicaid driver. Something else to consider is how far will Mr. John have to travel to have any labs or diagnostic test done if the primary care physician does not do the procedures in his facility? With that being said, he may have to miss a whole day of work in order for the Medicaid provided transportation to get him to the necessary location. What if Mr. John is not satisfied with that particular...
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...Health Care Utilization Paper Lawonna Moon HCS 235 March 24, 2014 Cyndie Miculan Health Care Utilization Paper The Healthcare Reform is a very complex issue and it has a government, health care facilities and providers, insurance companies talking about it with how the advantages and disadvantage affect the delivery of health care. According to university of Phoenix Read Me First HCS/235 (n.d.), “How health care is financed influences access to health care, how health care is delivered, the quality of health care provided, and its cost.” “For almost forty years policymakers have relied on two primary strategies to increase access to care for uninsured people: (1) increasing the number of people who have health insurance coverage and (2) increasing the availability of “free” or lower-cost services for those who remain uninsured. More recently, the Bush Administration has proposed tax credits to make private health insurance more affordable to individuals and is now in the third year of a five year program to create or expand 1,200 community health centers. (CHCs)” With most of the growing in health care some are helping the people by helping them with the cost of their insurance and also helping the people that don’t have insurance be able to qualify for it. It is trying to cut the cost of high insurance in the low-income community that can’t afford the high premium for these insurance companies. With expanding the access to health care, it has helped the low-income community...
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...Health Care Utilization Mary-Ann F. HCS/235 December-10-2013 Health Care Utilization Health care physicians and their patients in rural areas are confronted with barriers that are so much more diverse than those in the cities. Rural residents are challenged to deal with distinctive mixture of factors that lead to disparities in health care not found in cities. Financial constraints, type of health care coverage, lack of health care providers and quality of care, transportation difficulties, existing health problems, and complete isolation of living in remote rural areas all act together to hinder rural residents in their struggle to live healthier lifestyles. The purpose of this essay is to present the categories of health care barriers that may affect John Q.’s health care utilization, identify factors that are mutable or immutable, and some of the ways the mutable factors can be change. There are many factors that affect John’s health care utilization; one example is the disparity in incomes for rural residents that cause financial constraints. According to the National Rural Health Association, the average per capita income is $7,417 lower than in urban areas and the rural residents are more likely to live below the poverty level (2013). John Q. has a full-time job but his income is still not enough to allow him to shop around for a better health care coverage that meet his needs. John’s employers are less likely to provide health care coverage which is why he...
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...235 Health Care Utilization In the United States, Health care reform is designed to help make health care insurance affordable for Americans. Due to recent presidential elections, no one can seem to agree on a resolution to help promote platforms. In this paper it will discus ways health care reforms have expanded access to health care. The Patient Care and Affordable Care Act was created and signed to ensure that Americans will have access to health care at an affordable cost as to control the constant rise of cost in health care. With this act it allows people to obtain insurance with pre-existing conditions as well as dependent coverage for people up to the age of 26. Meaning a child who is on their parents insurance is allowed to be on it until they reach the age of 26 then they must go on their own insurance. There are many factors that can influence someone’s ability to be able to obtain health care. Such as Age, because there are certain physicians who only treat children or treat elderly. Income can have an impact as well because if someone is need to see a specialist for any specific reason there may be out-of-pocket expenses due to the fact that there insurance doesn’t cover the visit or may not cover much of it. Transportation can be an influence as well, depending on the type of insurance someone has they may have to travel farther to see a physician because they are the only ones who take there insurance. If patients are unable to receive the care they...
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...Health Care Utilization The Patient Protection and Affordable Care Act otherwise known as “Obamacare”, was signed into law in 2010. It was implemented to make health insurance more affordable to people and to increase access to a more affordable health care insurance. Although it works through the existing health care industry, it is still a political target from both ends of the political spectrum. The conservatives prefer to remain silent and not have any involvement into the health care system. The liberals that do agree with the health care reform do not like the “Obamacare” because the for-profit insurance company model stays the same instead of a single payer system administered through the government. Implementation of Obamacare “Obamacare” was rolled out to be spread over several stages rather than being rolled out at once. After the signing of the law, certain parts of the law was implemented. A couple of those changes implemented as part of the law are children remaining on their parents insurance until age 26 and people not being denied insurance coverage due to pre-existing health conditions. The expansion of access to health care was also written into the law. This mainly referred to the younger adults whose income was too low to be able to afford health insurance and for those people with chronic health issues in which pre-existing caused them to be denied new insurance plans. The individual and business mandates and the state insurance...
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...Health Care Utilization Kerisha Graham University of Phoenix Ms. Delores Usea HCS 235 August 3, 2013 Health care reform in the United States is a sizzling topic and the source of legislation meant to make health care available to Americans. The recent presidential elections have been platforms used to promote health care reform yet no one can agree on what the resolution will be. In this paper I will discuss ways in which recent health care reform measures have expanded or inhibited access to health care. This paper will also discuss how changes to access may lead to influences in utilization. Concepts of what universal health care may be and how current care reflects or contrasts with this will be discussed. Everyone including the government at all levels, insurance companies, the business community, and the general public agrees that the US system of health care is in trouble. Reason being is that both the delivery of health care and the financing systems are unproductive, tremendously complicated and unjust. There are thousands, better yet millions of Americans estimating range from 39 million to 45 million that have no health insurance at all; and the millions that do have insurance have inadequate coverage. Health care costs are simply spiraling out of control; whereas benefits for those with health insurance are becoming more restricted. Different businesses and organizations are finding that their health plan costs are increasing too quickly; the average...
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...Health Care Utilization Danjerell Burks HCS/235 July 16, 2014 Joseph Chiappetta The Affordable Care Act started changing the country’s health-care system almost from the moment it was signed into law in March 2010. It has already expanded coverage of young adults by allowing them to stay on their parents’ plans until they turn 26, outlawed lifetime limits on what insurance will cover, lowered the cost of drugs for seniors on Medicare, caused 13 million consumers to get premium rebates totaling some $1.1 billion, and expanded access to free preventive care for patients of all ages. Last summer it survived a challenge in the U.S. Supreme Court. But all that is prelude to the transformation coming in 2014, when almost all Americans will have access to affordable health insurance that covers essential care. By Oct. 1, 2013, every state will have an insurance exchange—an organized marketplace where individuals and small-business owners can select from among the entire qualified private health plans available in their area. It’s expected that most consumers will shop on their state’s marketplace online, but they can also shop by phone, through brokers, or with the personal assistance of trained helpers called Navigators. There will also be help available for consumers who don't speak English. The health care law was intended to expand the government-run health program for low-income Americans to cover up to 16 million more people with household incomes up to 133 percent...
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...Health Care Utilization Paper Meriecha Gaines HCS/235 Health Care Delivery in the U.S. Prof. Delores Usea Access to care tends to be a large issue across our nation especially in rural towns. It also affects who can get the care they need based on their social standings. The new health care reform has tried to expand the access for these particular groups of patients. The act has allowed for a number of things like access to care for those without insurance, increasing pay to rural providers and more pay for primary care providers. According to the HHS website, each year from 2010 through 2014 allow for new developments in the act to promote access to care. Effective July 1, 2010, “The Pre Existing Condition Insurance Plan provides new coverage options to individuals who have been uninsured for at least six months because of a pre-existing condition. States have the option of running this program in their state. If a state chooses not to do so, a plan will be established by the Department of Health and Human Services in that state (Key Features, 2010). By implementing these new ideas and plans we are allowing more Americans access to not only better quality care but care in general. Many people will say that this hinders us, but in reality it can make us stronger health wise. Allowing rural doctors to have a pay increase generates more enthusiasm to stay and or migrate to those areas. Also paying doctors based on quality not quantity will change the way patients are treated...
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...University of Phoenix Material Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care worker. Fill in the following matrix. Each box must contain responses between 50 and 100 words using complete sentences. Include APA citations for the content you provide. | |Origin: When was the |What kind of payment |Who pays for care? |What is the access |How does the model affect patients? |How does the model affect providers? | | |model first used? |system is used, such | |structure, such as |Include pros and cons. |Include pros and cons. | | | |as prospective, | |gatekeeper, open-access, | | | | | |retrospective, or | |and so forth? | | | ...
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...University of Phoenix Material Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care worker. Fill in the following matrix. Each box must contain responses between 50 and 100 words using complete sentences. Include APA citations for the content you provide. | |Origin: When was the |What kind of payment |Who pays for care? |What is the access |How does the model affect patients? |How does the model affect providers? | | |model first used? |system is used, such | |structure, such as |Include pros and cons. |Include pros and cons. | | | |as prospective, | |gatekeeper, open-access, | | | | | |retrospective, or | |and so forth? | | ...
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...University of Phoenix Material Week 5 Health Care Terms Worksheet Understanding health care terms is a prerequisite for both academic and professional success. This assignment is intended to ensure you understand some of the basic terms used in this course. Complete the worksheet according to the following guidelines: In the space provided, write each term’s definition. You must define the term in your own words. In the space provided after each term’s definition, use the term in a sentence as it applies to the health care industry. You may wish to consider the following: * How has it influenced heath care? What role has the term played as health care developed over the years? * * Save the completed worksheet as a Microsoft® Word document with your name in the file name. * Submit the file to your facilitator. Submitted by: [Akiem Henry Liburd.] Term | Definition | Use the term in a sentence as it applies to the health care industry. | Consumer | Any actual or potential recipient of health care, such as patient in a hospital, a client in a community mental health center, or a member of a prepaid health maintenance organization. | I was a consumer at Florida Medical Hospital for almost a month. | Medicare | A program of the social security administration which provides medical care for the aged. | My aunt Sally is a Medicare recipient enrolled in a nursing home because of her old age and illness. | Professional Association | An association...
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...“Health care reform is a general rubric used for discussing major health policy creation or changes for the most part, governmental policy that affects health care delivery in a given place” (www.wikipedia.org) Affordable Care Act “This started changing the country’s health care system almost from the moment it was signed into law in March 2010. It had already expanded coverage of young adults by letting them stay on their parent’s plan until 26 years of age. It outlawed lifetime limits on what insurance will cover, lowered the costs of drugs for seniors on Medicare, caused 13 million consumers to get premium rebates totaling some $1.1 billion, and expanded access to free preventive care for patients of all ages. Last summer it survived a challenge in the U.S. Supreme Court” (www.consumerreports.org 2013). “ All of that is an introduction to the transformation coming in 2014, when almost all Americans will have access to affordable health insurance that covers essential care” (www.consumerreports.org 2013). “The Six Keys to Organizational Performance – Reformers can use the following six keys to organizational performance to conceptualize different strategies of change. These six factors include incentives to organizations and how they reach managers and workers. They also include the skills and attitudes of workers and managers that enable them to respond to those incentives. This approach allows reformers to address a combination of the reasons to do better (external...
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...Health Care Utilization Paper HCS/235 July 22, 2013 University of Phoenix Health Care Utilization Paper The Patient Protection and Affordable Care Act one of the most controversial pieces legislation of the last 50 years was signed into law by President Obama on March 23, 2010. The Affordable Care Act was designed to put control of health care back into the hands of individuals, families, and small business owners. This paper will discuss the ways health care reform has expanded access to care; how these reforms will influenced the utilization of health care; this paper will explain the difference between these reforms and universal health care: and my personal experience these reforms and what are the positive of my experience with health care expansion. Ways the recent health care reform measures expand access to care. One way the Affordable Care Act will expand coverage is by allowing those with pre-existing health conditions to get health care insurance. Before this law it was almost impossible for people with these pre-existing health conditions to get affordable health care coverage. According to “Aspe.hhs.gov”(2012 “starting in 2012 Americans cannot be denied coverage, be charged significantly higher premiums, be subjected to an extended waiting period, or have their benefits curtailed by insurance companies because of some type of pre-existing heath condition.” Without the protection of the affordable health care act between 50 to129 million non-elderly...
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