...HEALTH MAINTANENCE ORGANIZATION IVAN D. HALOL HCS/212 - HEALTH CARE VOCABULARY APRIL 15, 2013 INSTRUCTOR DEBORAH DOHERTY In 1990 Kaiser Permanente became the largest Health Maintenance Organization in the country. This was the result of a great man. His name was Dr. Sydney R. Garfield MD. Dr. Garfield is one of the pioneers in voluntary prepaid healthcare plans which was a direct precedent to the federal government enacting the Health Maintenance Organization Act of 1973. Dr. Sydney Garfield opened up a fee for service hospital in 1933. However, insurance companies were slow to compensate his practice and delinquent or non-payment from patients had negative impacts on his practice. This led Dr. Garfield to initiate an agreement with insurance companies to charge a prepaid fee of five cents a day to workers. Under a Health Maintenance Organization (HMO) plan patients and/or employers paid a fixed monthly payment. This provided patients with healthcare that included preventive medicine checkups, immunizations, office visits, and hospitalization. Professionally and personally, Kaiser Permanente has been my employer and healthcare provider for the past several years. The HMO system is cost effective to our patients compared to a pay as you go healthcare plan. Dr. Sidney Garfield opened up his first hospital in 1933 called Contractor’s General Hospital. Its purpose was to provide healthcare for over 5,000 workers that were constructing the Metropolitan Water District of Southern...
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...(Hospitals, 2013). After the New York almshouse was successful, new hospitals started to appear all over the United States. The US now has around 5,000 community hospitals that facilitate to people in need of medical attention (American Hospital Association, 2014). The 5,000 hospitals are broken down into for-profit, not-for-profit, and governmental organizations. All of the hospitals have the common goal of quality care for patients but have a different financial structure. For-profit, nor-for-profit, and governmental agencies are the types of organizations that make up the health care system. For-profit hospitals make up a little over a 1,000 of the community hospitals around the United States (American Hospital Association, 2014). For-Profit hospitals are usually owned by a private or public investor. The profits that the hospitals make go to pay expenses, salaries, and also the shareholders. For-profit organizations have to give some of the profits to the shareholders in order for the company to remain viable within the market. For-profit hospitals have higher cost of health care services than other hospitals or organizations (Horwitz, 2013). For-profits have to raise the cost of services in order for a profit to be made and to bring additional income into the facility. The financial structure of a for-profit hospital starts with medical costs for each patient that is serviced. Then the billing and coding department will charge the patient and the insurance company...
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...Health service organization m | Assignment 1 | By Nikunjkumar G Patel | | Instructor Dr. David Tataw | 7/17/2011 | | Question: Explain how health is affected by behaviors, economics, and social structure. Behaviors, economics and social structure have great impact on human health. Health behavior specially consist of those behavior that people engaged in well order to maintain health and prevent disease. When people notice the symptoms of illness in themselves and other is called as illness behavior. When people consulted to a physician and receive a diagnosis and begun course treatment this time some sick roll behavior occurs to the patient. When acute disease convert to chronic illness this time the behavior of the patient change. These are the behavior related to the health condition now these behaviors go beyond to social and cultural level. Patient behavior significantly impact to the other family members, friends and other employees related to him. Sometimes behavior of health care provider also impact sometimes organization where patient treatment occur like hospitals and clinic, professional societies, regulatory agencies and insurance carriers all playing active role. Economic also plying great roll because of load of work and other factors person become ill and now when a person get ill they have to think about do they have insurance to pay the bill? Doctors fee, and all these tighten the belt of their budget of their illness. And...
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...Health Care Organization Management Plan Learning Team D HCS/413 January 31, 2011 Rhoda Banks Health Care Organization Management Plan Introduction According to Lombardi and Schermerhorn (2007), a successful work environment “promotes participation, empowerment, involvement, teamwork, flexibility, self-management, and more. Along with these ideals, there are continuing calls for higher performance, greater efficiency, and lower costs” (p. 2). Health care organizations are faced with the daunting task of balancing organizational and patient expectations to deliver comprehensive and quality health care to patients while increasing productivity and efficiency within an organization. Increased productivity and efficiency within an organization depends on a strong organizational structure paired with the following key elements; effective communication, stable management, intrinsic and extrinsic motivation, successful conflict resolution practices, positive organizational culture, and an emphasis on the development of employees. Communication Management Style There are many various management styles for both organizations. An effective manager should know when the right management style needs to be used in an organization. Understanding how managers collaborate with individuals or groups in an organization in everyday situation can be the main key for assisting managers in becoming more efficient and effective in directing both their activities and working well...
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...Indiana Health Information Exchange Health Information Exchange Organization Mallory L. Origliosso HSM 330: Health Services Information Systems Professor Coleman-Card Devry University May 16, 2013 Indiana Health Information Exchange Health information exchange organizations are places that provide safe, timely, efficient, effective and equitable patient-centered care. These organizations provide the ability to move clinical information electronically. This information is shared between healthcare organizations and providers. By exchanging this information electronically, it is in efforts to improve healthcare safety and quality. Most health information organizations are known as regional health information organizations (RHIOs), for example, Indiana is a regional RHIO. The Indiana Health Information Exchange (IHIE) is a non-profit organization that was formed by the Regenstrief Institute, private hospitals, local and state health departments, BioCrossroads, and other organizations in Indiana (Indiana Health Information Exchange, 2013). This organization connects over 90 hospitals, rehabilitation centers, healthcare providers, community health clinics and long-term care facilities. It serves about six million people and over 25,000 physicians throughout the country. According to the Indiana Health Information Exchange website, it’s vision is to establish a model of health information exchange for the rest of the country, create unparalleled research capabilities...
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...Accountable Care Organizations May 5, 2012 Accountable Care Organizations represent a strategy outlined within the Affordable Health Care Act to control costs and improve quality. They require partnerships between providers, hospitals, and communities. There are challenges in health systems where private practice is the predominant practice structure. Key issues and challenges to an effective ACO are cost reduction and utilization management, business model shifts, risk sharing and population management, consolidation, a changing role of IT and value of data, physician integration, clinical process improvement, and consumerism and the patient. How to reduce cost is a question that has been pursued, and it needs to be looked at, as well as utilization of management. Does this mean that homes for critically ill children or a hospital that cares only for transplant patients is becoming the future of health care in the USA? Why Accountable Care Organizations? No one will dispute the high cost of health care in the United States. Critics often say that it is the result of how health care providers are paid. They claim that—with a fee for each service— this results in increased and wasteful spending. Critics say that this system rewards providers just for doing more procedures, rather than for providing efficient and high-quality care (Matthews, 2012). In an effort to handle this problem, the United States Government has passed legislation: The Affordable...
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...Ownership Forms of Health Care Organizations Class: MHA612: Financial & Managerial Accounting There are many common ownership forms that are available to form a health care organization. So when asked to advise fifty doctors on what common ownerships forms there are you must first think of what organization of health care you plan to open. Working on the capacity as an external consultant in the field is common to give guidance and provide feedback to any ideas that can help improve the way to do things. To have a better outlook on how things can be done 50 doctors have gathered together to come up with ideas on developing ownership form for their organization. The job is to oversee the ideas and ensure them that the ideas they are coming up with are practical ideas that shows a good understanding of the various common ownership forms that they can use as well as give them a detail briefing of the common ones they shouldn’t use. There are four main types of organizations they are Not for profit business oriented organizations, for profit health entities which include Investors owned, professional corporations/ professional associations, sole proprietorships, limited partnerships and limited liability partnerships and limited liability companies. Governmental HCOs and Non-governmental nonprofit HCOs. These four main types of firms differ in terms of ownership structures. They are different HCOs that require slightly different sets of financial statements. Health care organizations...
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...Organization and Management of a Health Care Policy HSA 515 – Health Care Policy, Law, and Ethics August 13, 2015 With lives in their hands, hospitals have to function very precisely, executing high-quality services every hour of every day. Organizations that have this sort of requirement usually take on a vertical organizational structure that is having many layers of management, with most of the organization’s staff working in very specific, narrow, low authority roles. The numerous layers of management are designed to make sure that no one person can throw the system off too much. This structure also ensures that tasks are being done exactly and correctly. Organizational structure of a hospital refers to the levels of management within a hospital. Levels allow efficient management of hospital departments. The structure also helps one to understand the hospital’s chain of command. Organizational structure varies from hospital to hospital. Large hospitals have complex organizational structures while smaller hospitals tend to have much simpler organizational structure. A typical organizational structure of a hospital would usually be a combination of a hierarchical and divisional structure, since there is a chain of command where some levels are under another level, but employees are organized in departments or divisions that have their own roles. At the top of the structure would be the administrators, followed by the information services and therapeutic services. Both...
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...Introduction The World Health Organization - in short the WHO - was born on April 7, 1948. The idea of establishing a global health organization started in 1945, when diplomats met each other to form the United Nations (WHO, 2015). On July 22, 1946, representatives from the countries consisting of the nascent United Nations met to confirm the establishment of the World Health Organization. The formal launch of the World Health Organization took place on July 24, 1948, in Geneva, Switzerland (Markel, 2013). Thomas Parran, a primary architect in the constitution of the World Health Organization stated: “The World Health Organization is a collective instrument which will promote physical and mental vigour, prevent and control disease, expand scientific...
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...In each health care organization, the information system is responsible for strategically managing the cost related from inefficiencies. Managing and reducing the amount of unnecessary care given by providing all information systems with a common database to monitor and document these occurrences. Then develop and implement a strategic solution to further improve the patient quality of care which reflects as a cost saving initiative. Information management systems are responsible for managing costs and striving to provide quality of care by achieving the mission of the healthcare organization. Strategic management can be seen through the coordination of care and patient tracking received by a patient who visits their primary care provider in an ambulatory care setting for health related problem. Next the primary care provider sends a referral as it is determined that the patient needs surgery and hospitalization. The coordination of care continues, because the patient will require a surgical consultation and assessment which will involve providing the electronic health record to multiple individuals for inputting results upon and managing. The laboratory tests, prescription information, medication administration, treatments, and post-surgical instructions will need to be available to coordinate a plan of care action on this particular individual. Depending on if the individual is to follow-up with the primary care provider or is to be transferred to a long-term care facility...
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...Positioning And Differentiation With Health Care Organizations In: Business and Management Positioning And Differentiation With Health Care Organizations Positioning and Differentiation with Health Care Organizations Two health care organizations located in the same area are Cedars-Sinai Medical Center and City of Hope Research Hospital, both in Los Angeles. Both facilities cater to and are championed by Hollywood celebrities, so in many respects they are similar. Their positioning and differentiation is distinctive in other respects, however. This paper will examine the positioning and differentiation of both organizations, noting their similarities and differences. Cedars-Sinai can boast that “Many a star has been born, literally” there (“Cedars-Sinai Medical Center,” 2008). Its location, “where Los Angeles meets Beverly Hills and West Hollywood,” ensures that it serves movie stars and other Hollywood celebrities, and this visibility prompts exceptional care (“Cedars-Sinai Medical Center,” 2008). In addition to its star-studded patient list, the hospital is also known for being a teaching and research hospital that has approximately 600 different research programs (“Cedars-Sinai Medical Center,” 2008). Even its Board of Directors boasts such notables as Steven Spielberg and Sherry Lansing, and it enjoys celebrity supporters such as Barbra Streisand, Denzel Washington, Mel Gibson, and others (“Cedars-Sinai Medical Center,” 2008; “Cedars-Sinai Medical Center,” n.d.)...
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...Health Care Organization and Delivery System Health Care Organization and Delivery System HCS/531 November 09, 2011 In the current era of technology, health care system continues to research on improvising the various ways on delivering outstanding health services to its people. In health care industry, majority of the developed countries are run by national insurance generated by enforced general taxes. Unlike in United States healthcare insurances are run by partly private and government institution ensuring individuals based on certain eligibility. Although the distinct system in the United States protrudes as one of the best health care providers around the globe, some individuals considered it as unmanageable catastrophic scheme. Additional information regarding United States health care system, the implications of its belief and values, and some models of health care delivery used in America are presented below. The health care delivery system of United States is a complicated organization involving education and research, medical suppliers, private, and government insurers, health care providers, payers, and the government. It composed an approximate number of 10 million in employment from doctors, nurses, dentists, pharmacists, administrators, caregivers, and more. The system also involves several institutions such as hospitals, nursing homes, mental health facilities, and clinical sites serving millions of people yearly...
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...Quality Oversight in Health Care Organizations HCA 497 Ms. Gloria Wilson September 17, 2012 Introduction A considerable amount of emphasis has been placed on the quality that is provided by the US health care system and substantial investments have been made for research to address the concerns that relate to health care quality. Promoting quality of care is essential for every person within healthcare organizations, from top-level management to non-clinical personal. The quality of care that is provided by every health organizations is not only the core of the whole health care industry, but the reputation of each health care organization (Baily, M., Bottrell, M., Lynn, J. & Jennings, B., 2006). According to the Institute of Medicine quality can be defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Jost, 2003). The oversight of quality in healthcare is acknowledged as a main obligation to healthcare organizations. The purpose of this paper is to discuss organizations and or agencies that provide quality oversight; in addition to, other stakeholders and the role they play in health care. Joint Commission for Accreditation of Healthcare Organizations The Joint Commission for Accreditation of Healthcare Organizations is a, not for profit organization that was established in 1951and evaluates and accredits more...
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...Health Organization Case Study: United Healthcare Many selections of healthcare plans are available for consumers to choose from to match their own personal needs, preferences and budget. The health care system is most often complex, inconsistent and costly. To maintain and improve the business, healthcare organizations are continuously innovative and evolving to meet the demands of consumers. The purpose of this paper is to discuss a case study of UnitedHealthcare Group, what they are about, their network and resource management, their view on nursing and how they satisfy their patients. About United Healthcare The largest for profit healthcare carrier in the United States (US) is UnitedHealth Group, the parent of UnitedHealthcare. Headquartered in Minnetonka, Minnesota, UnitedHealth Group is a diversified managed health care company founded in 1977 and ranking #17 in the top 500 companies in the US, according to Fortune magazine. UnitedHealth Group has a total workforce of approximately 150,000 in the 50 US states and 20 other countries and serves more than 85 million individuals worldwide (UnitedHealth Group, 2013). They offer a wide spectrum of health care services and products through two operating businesses: UnitedHealthcare, which provides benefits services to individual consumers and employers of all sizes and health care coverage: and Optum, which provides technology health services and information in care delivery and improving the operating and clinical elements...
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...For this task I have chosen World Health Organization or WHO. It is the directing and coordinating authority for health within the United Nations. WHO’s constitution came into force on 7 April 1948 and it has established itself as an important and trustworthy international actor. The main target of the organization is to provide leadership on global health matters, shape the health research agenda, set norms and standards, provide evidence-based policy options, provide technical support and also monitor and assess global health trends. Its objective is to ensure that everyone has the highest attainable state of health. (Ministry for Foreign Affairs of Finland 2008, WHO 2014.) FINLAND AND WORLD HEALTH ORGANIZATION According to Finland’s the...
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