...Case Study Comparisons Shelly Collins HCS/490 April 25, 2015 Humana Health Care has different coverage options and plans to choose from. For example there is Coverage First, HMO, High Deductible Health Plan, Humana Classic, and Humana Simplicity. Humana Simplicity is a co-payment only plan, no deductible will need to be paid. Humana also offers a variety of products and services with their coverage plans, including a prescription drug plan (Humana Health Insurance, Medicare, & Dental Insurance, 2015). This female is an 80 year old widow, and takes several medications for chronic health conditions that must be monitored daily. It is important to find an affordable plan that fits her needs. For this individual there are two plans that she could choose from that would fit her needs. Humana has an Individual plan and a Medicare plan. The Individual plan includes medical, prescription drug coverage, and discounted dental and vision plans (Humana Health Insurance, Medicare, & Dental Insurance 2015). The Humana Medicare Advantage Plan probably makes the most since. The Medicare Advantage Plan offers more benefits, both medical and drug coverage are combined into one, and at no cost it includes a wellness program (Humana Health Insurance, Medicare, & Dental Insurance, 2015). Humana also offers extra support from other sources. For example, if there is a need for more care such as in the home, there is At Home Service Care. Humana has a program...
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...received their health care; how they viewed their health care and health care providers; what changes they have seen in the health care system; and any other facts or information. Moreover, this paper will list all questions and answers as posed and stated by both the interviewer and the interviewee. As I have stated I will be interviewing three generation of women my mother an 85 year old, my sister a 60 years old and my niece a 37 years old. When referring to health care in this interview we will be discussing inpatient care, outpatient care and long term care. What is your name and age? What has been the biggest barrier to healthcare for you? Understanding the healthcare system in itself has been a hurdle for me to conquer. Medicare Part A, B, C, and D. (non-financial hindrance to access healthcare) How do you see healthcare in America today? If we had a more nationalized healthcare system, we could do a better job for our patients and physicians would feel more satisfied with their jobs. How has the ACA affected you? situation or obstacle you have overcome What do you think the future holds for aging in Canada? ie) you could refer to Baby Boomers, technological advancements that could prolong life, cure for diseases etc. What steps have you taken to prolong your overall wellbeing? ie) diet, exercise What are your feelings towards living on your own? Can you see yourself eventually moving into a retirement or care facility? Why or why not?...
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...1. Read and study information related to: Integration of technology in health care evaluation and planning. Planning of health care services. Effectiveness of the delivery of health care services. 2. Prepare an outline of the most relevant aspects of the readings to be discussed in class. A. Integration of technology in health care evaluation and planning. a. As part of the strategy for the nation to put information technology to work in health care. This includes a variety of electronic methods used to manage information on health and health care of people 1.- Clinical decision support 2.- Diseases computerized records 3.-Computerized provider order entry 4.-Electronic medical records (EMR, EHR and PHR) 5.-Telehealth b. It makes it possible for health care providers to better manage patient care through secure use and sharing of health information. By developing records and private insurance for most Americans and provide electronic health information electronic health when and where needed, can improve healthcare quality, even as it makes health care be more profitable. B. Planning of health care services. a. Health care plan means a plan that promises to make arrangements for the provision of health care services to enrollees, or to pay or reimburse any of the cost for these services, in exchange for a fee paid in advance or periodic paid by or on behalf of the subscribers or enrollees. Also known as the service plan specialized medical care. C. Effectiveness...
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...benefits of the Medicare system while exploring the many challenges of the program. The United States Medicare program is the closest program to universal health care for one portion of the population. While providing some level of health care to most elderly citizens over 65 years of age, it sometimes is found to be highly confusing to its patients. Additional concerns explored by this paper relate to the costs, quality of care, and availability to all who need this insurance. When all of the pros and cons are explored, one final concern arises. Amid the rising costs of medical care, prescription drugs, and costs of program administration, will the funding of this program continue and will this be a program that the young families of today can depend upon for their retirement years? 1. Introduction: The rules and regulations of Medicare Simply stated, Medicare is the federally financed health insurance program for people aged 65 and over, certain individuals with disabilities, and individuals with end-stage renal disease. Medicare Part A covers hospital and other inpatient stays. Medicare Part B is optional insurance, and covers hospital outpatient, physician, and other services. Medicare Parts A and B are known as original Medicare or Medicare FFS. Medicare beneficiaries have the option of obtaining coverage for Medicare Part A and B services from private health plans that participate in Medicare's MA program, also known as Medicare Part C. All Medicare beneficiaries...
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...Radiation Physics 10/24/14 Intensity-Modulated Radiation Therapy Intensity-modulated radiation therapy is a high-tech precise way to deliver prescribed cancer treatment. It is more effective in killing cancer with far less chance for reoccurrence than conventional radiation therapy. The advantages of intensity modulated radiation therapy out-way the disadvantages. As IMRT technology advances and spreads more cancer patients will have the benefit of the technology. The theory behind IMRT has been around for many years but not until the year two thousand did we have the ability and technology to create a working treatment machine with IMRT capabilities. The theory behind IMRT is largely attributed to Brahme A. in 1982. The image above is an illustration of the IMRT principle from Brahme (1988). A number of intensity modulated beams (5 in this case) with their intensity profiles are shown. The schematic shows an axial cut through the patient’s body where the hatched area symbolizes the target volume. The intensities are typically reduced in those regions where the rays pass through critical structures and increased where the rays ‘see’ primarily the target volume. (Sprmn) The concept behind IMRT is to modulate the intensity of the radiation beam at different angles to lower the dose of critical structures and organs within the patient’s body. With this same concept IMRT technology increases the intensity of the beam when critical structures are not compromised to...
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...Course Project The Baby Boomers Impact on Medicare Abstract This project will address the baby boomers impact on Medicare. Baby boomers have changed the world in which we live and the lens through which we view it. The aging of the baby boomers, which is roughly one third of the population, will continue to usher in dramatic changes across most business sectors and areas of our lives in the years to come. The Issue A. How is Medicare Funded? Medicare provides health coverage for 45.2 million people. In 2008, Medicare spent $468 billion for covered items and services. Medicare is paid through two trust fund accounts held by the US Treasury. These funds can only be used for Medicare. The first trust fund is the Hospital Insurance (HI) Trust Fund. It is funded by payroll taxes paid by most employees, employers, and people who are self-employed. Other sources, such as income taxes paid on Social Security benefits, interest earned on the trust fund investments, and Part A premiums from people who are not eligible for premium free Part A. The second trust fund is the Supplementary Medical Insurance (SIM) Trust Fund. It is funded by funds authorized by Congress, premiums from people enrolled in Part B and Part D, and other sources, such as interest earned on the trust fund investments. B. Medicare Plans People with Medicare may be able to get health care coverage in several ways. Original Medicare is a fee for service plan managed by the Federal...
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...Memo To: Representative Howard Hughes From: Date: Re: Panel discussion on funding Medicare crisis Message: Below please find outline of current Medicare cost concerns as well as some history on the program as well as some plan options to cutting overall costs. Medicare is facing a major financial crisis. The federal government subsidizes medical care for more than 45 million elderly and disabled Americans through Medicare. Medicare is the third-largest federal program after Social Security and defense, and it will cost taxpayers about $430 billion in fiscal year 2010. Medicare is one of the fastest-growing programs in the federal budget, with spending likely to double over the next decade and to surpass Social Security spending by 2028. Numerous studies suggest that about one-third of Medicare spending is wasted. [ (Edwards, 2010) ] Many elderly people may believe that Medicare is an insurance plan as they pay into the cost and are charged for co-pays. Although it’s been known as welfare program, led by the government there is controversy regarding this. AARP Vise President, Joyce Rogers stated AARP is focused on protecting Social Security and Medicare for the millions of beneficiaries who have paid into the systems over their working lives. Rogers’ statement follows: “Medicare is not a welfare program. Seniors pay into Medicare their entire working lives based on the promise that they’ll have secure health coverage when they retire. Applying a means test...
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...Determine whether you would incorporate and state the advantages and disadvantages of doing so. Running a health care organization should involve many people. Incorporating a vast number of multi-disciplinary specialists is required for the organization to be managed appropriately. This is helpful as it ensures that the facility has enough people with different levels of expertise and all medical fields are properly furnished with adequate personnel. This also helps patients know the health care services provided are of high quality. The additional skills and expertise is not only an asset to patients, but to the community and the organization due to being able to offer knowledge that is helpful and important in managing the health care organization. The partnerships of different health care specialist that are created within the facility encourages better use of resources and promotes higher levels of organizational excellence. (Shortel & Kalunzy, 1997) Based on the facility being multi-specialty it cannot be a sole proprietorship. A partnership exists if someone joins the proprietor and sharks in the rewards and risks. The simplest kind of partnership is a general partnership. In this arrangement the partners usually receive equal shares of profits or losses, are entitled to equal voting rights, and are personally liable for the debts of the venture (Showalter, 2012) Deciding to incorporate a medical facility can be tough. The first factor is whether you want limited...
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...information on health care terms and defining these terms in short is not an easy assignment. Researching the term Medicare opened up an immeasurable amount of data on the subject, and I have chosen to write about the different parts of it. Medicare is a federally funded program, which has 4 different parts that include Part A, which is coverage for inpatient care in hospitals and skilled nursing facilities, hospice, and some home health care. Part B, which is coverage for medical insurance to include doctor’s visits, some home care services, and preventive care. Part D, which is coverage for prescription drugs, and Part C which is called Medicare Advantage Plan is available for an extra fee and would include Parts A, B, and D. Medicare is the nation’s top insurer of the elderly 65 years and older and is eligible for social security as well as permanently disabled but younger than age 65. Medicare also covers those with permanent kidney damage or failure and need to do dialysis on a daily basis until a transplant can be done. Although there are many kinds of conditions to be eligible for Medicare, it is also available to be purchased as with any other insurance carrier but can hardly be afforded by the aging population. Healthcare reform could seriously affect the premiums of coverage to the elderly population, but it is important for lawmakers to keep Medicare intact so that the senior population can receive the healthcare service they require without spending all of their...
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...Ethics and Social Responsibility MGT/498 September 2, 2015 Ethics and Social Responsibility Ethical behaviors offer significant advantages, society as hold benefits. Executives who behave ethically are better off and live more fulfilled lives, and unethical behavior can destroy an organization and the individuals who take part in it. Conducting business in the appropriate manner may not always generate the greatest profits however in the end it will lead to greatest personal satisfaction, fulfillment, and a successful outcome. What is Ethics? Ethics is the study of what constitute right and wrong behavior, it focus on morality and application of moral principals in the everyday life, also what is conform to our personal beliefs Business ethics focus on what constitute ethical behavior in the world of business, however it is not a separate behavior. Understanding business ethics is important to long viability to the business and the well-being of the officers and directors as well as the welfare of the employees (Merriam-Webster Dictionary). Ethical Standards and Behaviors The minimal acceptable standards for ethical business behavior are the compliance of the law. Ethical standards such as those in the company's policy and code of ethics must also guide decisions. Nevertheless, simply complying with the laws does not always does not necessarily make the business practice ethical. When can sometimes be ethical and still constitutes as being illegal? During the...
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...This literature review of academic research suggests that competitive 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...
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...Positioning and Differentiation Paper Theresa Williams University of Phoenix Marketing for Health Care HCS/539 Marcia Thompson August 30, 2010 General Information The two health care organizations that will be identified in this paper are Central Texas Medical Center (CTMC) and Guadalupe Regional Medical Center (GRMC). These two organizations are within 25 miles of each other and are in Central Texas. CTMC’s major county it serves is Hays for GRMC’s county is Guadalupe. Both organizations will overlap on counties it serves with health care services. A non-for-profit hospital based organization; each hospital has plenty of similarities and differences among them both. This paper will include the similarities and difference as well as some of the marketing and Public Relations each organization is doing. The difference in the two non-for -profit organizations will allow patients in Hays County and the surrounding counties to decide which health care facility is best for him or her. With similarities involved it will just add extra bonus to the patients for if they could not receive results from CTMC they can got to GRMC and vice versa. One of the major marketing tactics that will cause a patient to be faithful to one organization more will be the customer service and how he or she is treated. Similarities First thing first, let’s start with the similarities on the two organizations. We already know that CTMC and GRMC are considered a non-for-profit organization...
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...Although about half of current medical expenses in the United States are currently paid for through government programs such as Medicare (for the elderly), Medicaid (for the very poor and disabled), and the Children’s Health Insurance Program (CHIP)for children, the American health care system can best be described as a patchwork of public and private programs (such as employer-based coverage). A mixture of public programs and private programs is common among nations that essentially cover all residents, but the American system is unique — and often uniquely inefficient in economic terms. Keywords Accessibility; Adverse Selection; HMO (Health Maintenance Organization); Medicaid; Medicare; Medicare Modernization Act of 2003 (Part D); Managed Care; "Play or Pay" State Health Care Tax Policies; Rationing Health Care; Single-Payer Health Care System; CHIP (Children’s Health Insurance Program); Socialized Medicine; Two-Tiered Health Care System; VA (United States Department of Veterans Affairs) The US Health Care System Social Issues Overview Health Care Systems The medical business defies the normal laws of economics in at least three important ways: * Government-run programs are often cheaper, more administratively efficient, and even of superior quality than privately-run programs at the national level. * Medical insurance functions poorly by market principles unless potential policy holders most in need of health insurance are either denied coverage or are denied...
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...1 Running Head: THE FUTURE OF HOME HEALTH The Future of Home Health Mary C. Reed The University of Texas at Arlington College of Nursing In partial fulfillment of the requirements of N5311 Nursing Management in Health Care Stephanee Thurman, MSN, RN August 1, 2012 2 THE FUTURE OF HOME HEALTH The Future of Home Health Home health has been the topic of several news discussions lately. Doctors and nurses are afraid that since Medicare fraud has taken place in so many home health agencies, that Medicare is going to start shutting down a lot of home health agencies so that they have less fraud to watch out for. The studies I have chosen discuss positive outcomes that are related to providing care in the patient’s home. I have worked in home health for four years. In those four years, home health services have been through many changes. After obtaining my Masters of Science in Nursing I plan on continuing to work in home health. I would like to move up to a management position after graduation. Home health is interesting to me and I enjoy working with patients in their home environment. Patients seem to be more motivated in their home setting instead of being in a rehabilitation center or hospital. “In home nursing care, patient care activities focus on enabling patients to assume responsibility for self-monitoring and self-management through teaching, supporting, goal setting, and modeling decision-making” (Or, Valdez, Casper...
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...lessen the disagreements among politicians regarding how Medicare should be governed, protect it, and come up with a feasible solution for cost containment? Here in Alabama, there has been close to 98,000 people sign up for the Affordable Care Act (ACA) (arisecitizens.org). This shows that there is a need for healthcare coverage within this state. However, with this increase in people inundating the system, there could be a possible rise in cost. Specifically, there could be a rise in Medicare. This program was signed into law on July 30, 1965 (SSA.gov). It is designed to take care of the elderly at 65 years and older, certain individuals who are disabled, and people who have kidney disease (CMS.gov). Even though this program is not income specific, it does help more low income people and individuals who have bad health issues and it is also a target for political battles (Tietelbaum & Wilensky, 2014).There are Republicans who are opposed to Obamacare and want to run Medicare their way. Then there are Democrats who want the program ran another way. They are in favor of Obamacare and see a positive outcome now and in the future. As for the public, the divide among politicians is equally the same amongst Americans. There are individuals who are in favor of Obamacare and there are others who are opposed to it. There are the hospitals and its doctors and staff who will be affected through the number of patients seen and Medicare payments, to name a couple. Overall, Obamacare gives...
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