...Reducing Rehospitalizations in Skilled Nursing Facilities Increases the Quality of Care Residents Receive and Decreases Unnecessary Health Care Cost Nurses have the power to increase positive patient outcomes by implementing changes in their practice based on the evidence found in the nursing literature. Utilizing evidence-based practice (EBP) increases nurses job satisfaction, increases communication across the interdisciplinary team, enables nurses to provide their patients with high-quality care and decreases health care cost. The purpose of this paper is to describe why readmissions from nursing homes (NHs) is a nurse practice problem, nurse practice changes to reduce hospitalizations in NHs, evidence found in the nursing literature that supports the change in nursing practice and how to evaluate the change in practice after implementation of interventions. The Problem Residents in NHs continue to experience potentially avoidable 30-day readmissions to hospitals. Rahman, Foster, Grabowski, Zinn, & Mor (2013) define 30-day readmissions as when the resident is readmitted to the hospital within 30 days of being discharged from the hospital to NHs and avoidable readmissions as conditions that can be managed safely and efficiently in NHs instead of the resident being transferred to the hospital (p. 1901) There are more than 1.6 million Americans living in NHs in the United States and 23.5% of these Americans experience readmission to the hospital within 30 days of discharges...
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...You are presented with a 52-year-old female patient. She is experiencing acute discomfort from gall stone symptoms for the fourth time in 8 years. The condition has responded to nonsurgical treatment in the past, but each subsequent time is a slower and more painful recovery. She is underinsured, and the cost of a surgery would be beyond her means without some sort of write-off or assistance. However, her family makes too much to qualify for Arizona Health Care Cost Containment System (AHCCCS). Examine this case, using each of the following principles in turn as a possible guide to your actions: 1. The principle of utility: Bring about the greatest good with the least harm. The principle of utility is determined by the rightness of the act on someone’s happiness. Therefore, after examining the case and using the principle of utility, I would make sure that the action I perform should in turn make the patient happy. Furthermore, if the female patient wanted me to perform surgery to fix her gall stone condition, I would try to come up with the best possible solution to get her the surgery she wants. The surgery would improve the well being of the patient and she will be more comfortable after the surgery is over knowing that she will no longer have to deal with her gall stones. 2. The principle of equality: Everything is distributed equally. `The principle of equality means that everyone gets treated equally, and no one person should be favored. Thus if I were dealing...
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...Berenice Delgado Vernon Thacker, Maria Quimba HLT 305- Legal and Ethical Principles in Health Care Ethical Principles As days, hours, and seconds past by, we are growing older. This is an inevitable reality that no one can stop from occurring. No matter what we do or how we go about doing it, the process of aging is set and stone. Throughout this essay I will portray how I personally and carefully will examine a patient’s case that is suffering from gall stone pain. I will examine her case by analyzing six chief principles that include; the principle of utility, equality, need, contribution, effort, and autonomy. To begin with, this patient is fifty-two years old and has been dealing with gall stone issues for eight years. It is her fourth visit to the hospital because she is suffering acute discomfort. Fortunately, she has been treated with medicine in the past and has not had to undergone surgery. Unfortunately, each time she is treated the process takes longer and the pain is intensified. Due to the fact that her family makes sufficient money, she is not eligible for Arizona Health Care Cost Containment System (AHCCCS). For the reason being that she is underinsured, if she partook in surgery it would be extremely expensive without obtaining any type of write-off or assistance. Now that we comprehend her case, it is time to determine how one can decide which treatment option is best. In more detail, it is essential to comprehend the principle...
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...2015 ACO and Bundled Payments Accountable care organizations (ACOs) were proposed in the Affordable Care Act as a measure to slow rising healthcare costs and improve quality in the traditional healthcare organization. ACOs seek to tie provider pay with quality outcomes and reduce total cost of care by increasing integration and reducing fragmentation. Within an ACO, a group of coordinated health care providers deliver and care across the full continuum to a group or population of patients. The ACA introduces and encourages use of ACOs by establishing the Medicare Shared Savings Program (SSP) for Medicare Reimbursement through the Centers for Medicare and Medicaid Services (CMS). Under the SSP, providers that participate in an ACO continue to receive traditional Medicare fee-for-service payments but may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. Therefore, “if an ACO succeeds in both delivering high-quality care and reducing the cost of that care to a level below what would otherwise have been expected, it will share in the Medicare savings it achieves.” ACOs are however, held to high standards and must meet several quality-performance standards to ensure their patients meet preventative and chronic health needs. The Medicare SSP focuses on achieving the Triple-Aim of better care experience for individuals, better health for populations, and lower per capita costs. While the SSP is a voluntary program, the financial...
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...Health Care Spending in America Teresa Foster University of Phoenix May 20, 2012 HCS/440 Instructor: Michele Burke Health care spending in America has been growing by leaps and bounds and has surpassed the national economy. There are many American's that are without proper health care services, because of losing coverage due to the reduction in employment and the recessing economy. With the constant conflict with the current health care reform, legislators are aware that health care spending needs to become a balanced solution. The current health care system in the United States has many holes to fix, the government has made many attempts to bring spending under control. The theory of bring more managed care and competition into health care can potentially aid in bringing spending in health care under control. Because health care expenses are becoming more of a burden on Americans, the choice of going to the doctor and paying living expenses is becoming more evident in most American households (Altman & Wallack, 1996). Current National Health Care Expenditures According to the National Health Expenditure Accounts (NHEA), it is estimated that health care spending in American has grown annually from estimates dating back to the 1960s. Expenditures include, the net cost for health care insurance, public health services, the cost for medical service and other health related goods, investments that are related to healthcare. During 2010, health care showed an increase...
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...com/downloads/hcs-449-week-2-individual-assignment-personal-action-plan/ For More Courses and Exams use this form ( http://hwguiders.com/contact-us/ ) Feel Free to Search your Class through Our Product Categories or From Our Search Bar (http://hwguiders.com/ ) How healthcare has changed in the last 10 years The healthcare industry has made some dramatic changes in the past 10 years, and these changes have impacted patients and healthcare workers. Health care has gone through a major restructuring period. Some of the key changes were moving from hospital based care to care being provided on an outpatient basis and in nursing homes or managed care facilities. Many medical procedures are now being performed in non-hospital settings, like a physician’s office, patient’s homes, or separate outpatient clinics or surgical centers. Most of these changes were implemented to reduce the number of hospital beds needed and the reduce the length of a hospital stay. There changes were considered the first step towards reducing cost in the healthcare field. TO DOWNLOAD COMPLETE TUTORIAL HIT PURCHASE BUTTON HCS 449 Week 2 Individual Assignment Personal Action Plan Get Tutorial by Clicking on the link below or Copy Paste Link in Your Browser https://hwguiders.com/downloads/hcs-449-week-2-individual-assignment-personal-action-plan/ For More Courses and Exams use this form ( http://hwguiders.com/contact-us/ ) Feel Free to Search your Class through Our Product Categories...
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...Health care cost in the United States is expensive, and it has increased each year without fail until recently. There are a few contributing factors to the health care spending growth; one is the number of individuals who are in need of health insurance and medical care, and the other is the technology changes. Technology is a continuous change, and this will always be a factor in health care spending. For the individuals who were uninsured and could not obtain insurance, they have now been given the opportunity because of the health care reform; those individuals can now enroll in affordable coverage through the health insurance exchange. By providing more individuals with access to health care coverage and reducing the cost of preventative care, the spending value should start to decline. The objective of the Affordable Care Act is to bring out the health care system inadequacies while decreasing the overall health care spending, the other was to increase the effectiveness and quality of patient care (the White House, 2013). Health Care Expenditures In 2013 statistics show that there was one more year of reducing growth in health care spending, the other years that were evident of a slow growth were 2011 and 2012. These years according to Furman & Fiedler (2014), "saw the slowest growth in real per capita health care spending on record” (Historically Slow Growth in Health Spending Continued in 2013, and Data Show Underlying Slow Cost Growth Is Continuing, para 1)...
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...Introduction: ACA (Affordable Care Act) was signed by President Obama on March 23rd 2010 to reform the US medical system. ACA changes the non-group insurance markets in the US and each individual should have health insurance which helps significantly to develop the markets of the public insurance and support the private insurance coverages which leads to rise in the revenue from the new taxes and reorganizes the Medicare health insurance plan. According to Gurbers assumption of funding ACA is mainly based on the “Three legged Stool” approach followed to fix the Non employer insurance in the United states and which helps in the increasing the market of the health insurance in the country. The reforms included based on the three legged stool strategy to the non-group insurance market. First to prohibiting exclusions for the pre-existing conditions and charging different prices based on the health status. The second leg of the stool looks in to the individual authority to take the insurance policy. The third leg of the stool deals with the Subsidiary for the low income families to have the insurance plan. ACA finances through following sources for the above are 1) To improve the government Medicare plans for the seniors by reducing befits of the private Medicare Advantage programs which affects the 14% financing share. 2) Decreasing of the Medicare reimbursement through decrease in adjustments provided to the hospitals every year for the Medicare reimbursement due to this 33%...
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...Can We Capture Potential Health Care Savings Without A Federal Takeover? by David V. Axene Most proposals for reforming the U.S. health care system of today focus on reducing the high cost of care. The standard thought process assumes that reducing costs will increase ac- cess to care by improving the affordability of health care and perhaps funding more care for the uninsured. An endless num- ber of proposals focus on this issue. In fact, most of today’s initiatives are based upon lowering costs and/or “bending the trend.” Too few proposals address the core of this essay, “How do we capture those savings?” Most insured and/or government run programs directly capture savings since the programs are directly and indepen- dently funded by premiums and/or taxes and savings result in surplus that can be readily captured. Self-funded, most experi- ence-rated and self-pay programs create much more challenging issues. The reduced cost flows directly back to the entity or individual without being captured for broader public policy uses. Who owns these “saved” funds? Is it the employer, the covered employees, the labor union, the individual? The plan sponsor very much considers these dollars as its own. After all, it reduced its cost of care; therefore, it is the plan sponsor’s money! Plan sponsors cringe during discussions about potential taxes on such programs since they view their right to self-fund the coverage an important freedom. Capturing Savings The challenging public policy...
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...Health care system is multifaceted because the system is characterised by variety of aspects. The system involves monitoring the services for social agencies. This process again involves wide range of services because it allows many social workers to coordinate their efforts. Many argue that the multifaceted nature of health care system takes into account high expenditure or the high cost of providing the health care facilities. Health care is financed in U.S through various programs. Financing in U.S is entirely different than other countries. This difference is due to the fact that U.S does not have its national health insurance plan. Government programs, self insured plans and insurance companies are some of the payers involved in financing. U.S does not have national insurance plan for its citizens like other countries but various public programs for the benefit of poor, disabled and elder people are organised. There are basically two approaches to health care financing namely: - Market based financing and government financing. Multiple payer health care system is funded by privately owned health insurance companies and is therefore called as market oriented. It is dependent upon the paying capacity of the beneficiary and accordingly the insurance plan is purchased by the beneficiary. Various health plans cover various health care services but choice depends upon the purchasing power of the beneficiary to a greater extent. Advantages and disadvantages of this system...
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...Well To make health care coverage more affordable, the country must address the soaring cost of medical care that continues to increase at a dangerous rate. A greater focus is needed on the main drivers of medical cost growth: soaring prices for medical services, new costly prescription drugs and medical technologies, unhealthy lifestyles, and an outdated fee-for-service system. More than one-sixth of the U.S. economy is devoted to health care spending and that percentage continues to rise every year. Regrettably, our system is not delivering value commensurate with, for example an estimated $2.5 trillion in 2009 spend on health care.1 These costs punish us on multiple fronts. For American families, the soaring cost of medical care means less money in their pockets and forces hard choices about balancing food, rent, and needed care. For all businesses, employers alike, it makes it more expensive to add new employees, more difficult to maintain retiree coverage, and harder to compete in the global economy. For federal, state, and local governments, rising health care costs lead to higher Medicare and Medicaid costs, and funding cuts for other priorities, such as infrastructure, education and public safety. Thus, the net results of rising health care costs are far-reaching: higher costs for health insurance, the fraying of the nation’s safety net, an erosion in our global competitiveness, nauseating political positioning and long-term fiscal insolvency. While the health reform law...
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...of improvement. Discussion The United States increased expenditures in the hospital services industry is growing at a concerning rate and isn’t showing any signs of slowing down. According to the National Health Center for Statistics, the national health expenditure as a percent of gross domestic product (GDP) has grown from 12.1 percent in 1990 to 17.4 percent in 2013 (National Health Center for Statistics, 2014). Economic growth can be measured by using the GDP and the United States’ GDP ratio allocated to health care has continued to rise faster than most other developed nation (Hockenberry & Thorpe, 2014). The continuous growth and comparison to other developed nation is the primary concern for economists. In order to obtain a clear picture of the growth it is beneficial to analyze health care data over the course of several decades. In the table below several data components are analyzed including: the total health expenditures, per capita health expenditures, health as a percent of GDP, health sector employment, and average increase in employment percentage are shown to give an idea of the overall increase in this sector from 1970 to 2007. Table 1 Year | Total Health Expenditures ($Billions) | Per Capita Health Expenditures | Health as % of GDP | Health Sector Employment (000) | Avg. Increase in Employment % | 1970 | $74.9 | $356 | 7.2% | 3,052 | | 1980 | 253.4 | 1,100 | 9.1 |...
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...Managed Care Describe the beginning of ACO In 2011, the US Department of Health and Human Resources has proposed the guidelines for Accountable Care Organisation (ACO) under the Medicare shared saving Program. The Patient Protection and Affordable Act authorises CMS to create the MSSP that help doctors, hospitals and other health care provider in coordinating care for Medicare patients through ACO. An ACO is a network of group of provider and suppliers who work together to provide high quality care for the Medicare Fee-for service patients they serve. The ACO model was developed by Fisher, that private hospitals and organisation can be grouped into virtual organisation that is accountable for cost and quality of the range of care services delivered to Medicare patients. ACO work to provide high quality care to Medicare enrolees while simultaneously reducing health care costs. ACO is accountable to beneficiaries of Medicare for cost, quality and care. Till now eight private health insurance plans have entre with provider into ACO agreements that shares a payment risk model. Keeping the cost below a benchmark will make providers eligible for bonuses and incentives (Berenson & Burton, 2012). Objectives of ACO The main goal of ACO is to provide effective, accessible and coordinated care to patients it serves. ACO assures that care is delivers in a cultural component manner. The organisation aims to deliver seamless supreme quality care to beneficiaries of Medicare...
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...University of Phoenix HCS/405 Health care organizations, particularly hospitals face increasing problems managing cash flow due to changes in billing procedures and the economic climate. Research quoted in Fierce Healthcare Finance showed that hospitals are using investment cash flow, normally reserved for capital expenses, to pay for operating expenses. In a study quoted by Fierce Healthcare Finance (Ziegler, 2008) the depth of the problem becomes apparent “Between 2004 and 2007, the 170 hospitals studied by Best allocated a steadily greater portion of their invested assets to cash and short-term investments, climbing from 27 percent in 2005 to 31.1 percent in 2007.”With reduced funds available for capital expenses, it becomes difficult for hospitals to keep up with technology and to thrive. Elijah Heart Center is facing the financial dilemma common in specialized health care organizations, the combination of the need for improved technology, reduced income, and the demand for expansion. Without the needed technology and expansion, there little the hospital can do to improve income. The financial situation requires a combination of strategies to reduce costs and to make the wisest choices regarding acquiring needed technologies and expansion. Phase I: Capital Shortage The goal is to save $900,00 for the first year and to help improve the cash flow problem that Elijah Heart Center is experiencing. The hospital can select two cost cutting options that in an effort...
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...(Langabeer, 2008). This material management proposal document will elaborate on the role materials management plays within a hospital and the role of operations managers in this process. This document will further identify possible constraints a hospital may experience in its supply chain, the potential effects and justification on implementing a new collaborative planning process, and provide suggestions on how to manage a hospital supplied during a disaster. Role of Materials and Operations Management The role of materials and operations management plays within a hospital system is vital to the success of any health care organization. According to Langabeer (2008) material management controls significant resources and have total expenditures, or spending at 50% of a hospital budget. Materials management not only directs and controls the supply chain of a health care organization it is responsible for managing the flow of goods throughout the hospital and carry out supply and resource logistics. Materials management has numerous meanings and some hospitals view material management as an umbrella department with various functions such as central stores, laundry and linen operations, and sterile processing with many other functions to endure. Therefore, the major role that material management plays within the hospital environment is to focus on acquiring, storing, distributing, and replenishing materials, and supplies (Langabeer, 2008). Whereas material management has various...
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