Questions On The Environment And The Healthcare Industry

Questions On The Environment And The Healthcare Industry
Analyze the Environment
Five Forces (Top three):
1. Threat of New Entrants: Threat of entry is low in healthcare industry for several reasons; most significantly government
regulations. Federal and state governments have strict regulations in place that each company in the industry must follow in order
to operate. High capital requirements may also deter small firms from entering into the market. New firms will require enough
resources to compete against the large existing firms to be able to negotiate contracts with service providers.
2. Bargaining Power of Suppliers: Private practice physicians, healthcare professionals and hospitals are the key suppliers of
healthcare industry. The power of suppliers is high because firms must come into ... Show more content on Helpwriting.net ...
Even though Careington International is in a niche market, the healthcare industry significantly impacts the social aspect of dental
health insurance. Recently a Pew Research Center Study identified that 51% of adult patients would feel more valued through
online health communication (Trader). Another 41% of surveyed citizens said that social media would help determine their choice
of health insurance (Trader). As the population is able to gain access to information more easily, social media is influencing and
informing more people on dental healthcare. According to Paw Research, only 26% of hospitals in the United States use social
media (Trader). The PEST Social aspect has easily become the most relevant to the dental healthcare industry.
The economical impact is directly related to the through laws and policies in politics. Health insurance is steadily changing as a
result of a federal statute called the Patient Protection and Affordable Care Act (ACA). This is requiring approximately 30 million
new Americans to obtain health insurance in 2014. More individual health care plans are being bought instead of the usual
employer group plans. The well–known Blue Cross Blue Shield plan had 59% of the healthcare market before ACA, while it
currently is claiming only 24% (Wayne). The American Student Dental Association is expecting approximately 3 million children
to obtain dental benefits by 2018 (ASDA).
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Analysis : Data Immersion, Data And Data
1.1 Procedures
To analysis the collected qualitative data, the five steps for qualitative data analysis was applied: data immersion, data coding, data
reduction, data display, and interpretation (Lui 2014).
In the data immersion step, besides reading and rereading the transcription of recording, the observation note and report also been
reviewed to familiar with the research topic and context; meanwhile, other general information before the research also been
reviewed, such as memos and relative reports. To identify the different issues which are associated within the two interviews, the
next step is coding. At the first cycle of data coding, there were 18 codes which are identified by loose coding method. Next, I
aggregated these codes into 6 categories. At the end of the data reduction step, I got three themes. After that, to assemble the
information and patterns the data would be displayed by matrix method which also easily illustrated the conclusion of this
research. Finally, in the interpretation part, the general deep and meaningful understanding would be shown through the data
display and analysis.
1.2 Categories
Before coding the qualitative data, I have picked up the important and topic relevant context and integrated them into matrix for
the further data coding and reduction. For Li's interview, I took 67 items from the whole content; and for Qi's interview, I took 37
items because Qi haven't worked in an Australian hospital, and she only can provide the general

Walgreens Co. Swot Analysis Essay
Walgreens Company SWOT Analysis
Melanie Garces
MGT/521
July 16, 2012
Kirk Davis
Abstract
This paper will provide insight into the strengths, weaknesses, opportunities, and threats of the Walgreens Company, the nation's
leading drugstore chain. The company's key stakeholders – customers, employees and the community are also identified and an
explanation provided as to how the company is satisfying the needs and wants of each stakeholder type. This paper analyzes the
strengths of the company as the industry leader with its wide portfolio of products and services, as well as establishing the
benchmark for growth through acquisitions. The company's weaknesses include prescription errors resulting in death and being
unable to keep ... Show more content on Helpwriting.net ...
The acquisition also includes corporate offices, a distribution center located in Pine Bluff, Ark., and a wholesale and private brand
business. In fiscal 2011, the company completed its acquisition of drugstore.com, extending its multichannel reach to an additional
three million online customers, forgoing relationships with new vendors and partners and adding approximately 60,000 health,
personal care and beauty products to its online offerings. (Wasson, 2011) In 2010, Walgreens completed its acquisition of Duane
Reade Holdings, Inc., a large drugstore chain in New York. With one big purchase, Walgreens has become New York's biggest
player on many blocks, adding 258 metro–area stores to its portfolio. (Ritter, 2010)
Wide Portfolio of Pharmacy and Health–Related Services. Walgreens offers an extensive range of pharmacy and health care related
services that complement each other. The company offers pharmacy benefit, home medical equipment, specialty pharmacy,
infusion and respiratory, mail service pharmacy, on–site pharmacy, and community pharmacy services. It serves businesses and
organizations, managed care organizations, hospitals and care facilities, healthcare professionals, employers, unions, brokers, and
educational facilities, as well as the public sector.
Weaknesses
Pharmaceutical Errors Resulting in Death. Since 2006, Walgreens has faced multiple lawsuits

Gm588
Table of Contents
Executive Summary 2
Introduction 5
Company Background 7
Quality Intitiatives 9
Key Observation Points 11
Comparative Analysis 12
Concluding Remarks 13
Future Recommendations 15
Appendix 17
References 21
Executive Summary
Coventry's roots can be traced back to November 21, 1986, the date the company's predecessor company, Coventry Corporation,
was incorporated. Coventry Health Care, Inc. became a public company in 1991, and is currently listed on the NYSE with ticker
symbol "CVH".
Since the company's inception, the building blocks of "The Coventry Model" have remained financial discipline and service
excellence. The company's senior management team has long understood those two ... Show more content on Helpwriting.net ...
The company's Health Plan and Medical Services division provides health plan commercial risk, commercial management
services, Medicare advantage coordinated care plans, and Medicaid products. It also offers commercial risk products, including
health maintenance organization, preferred provider organization, and point of service products to individuals and employer
groups. In addition, this segment provides health insurance benefits under the federal employees health benefits program;
administrative services only products, such as medical claims administration, pharmacy benefits management, and utilization
management and quality assurance programs; consumer–directed benefit options comprising health reimbursement accounts and
health savings accounts to commercial customers; and comprehensive health benefits on a risk basis to members participating in
the Medicare Advantage Coordinated Care Plans and Medicaid programs. Its Specialized Managed Care includes Medicare Part D
program that provides access to prescription drug coverage for eligible beneficiaries; network rental business that offers network
rental services through a national PPO network to national, regional, and local third–party administrators, as well as insurance
carriers; and behavioral health benefits business provides coordination of comprehensive mental health and substance abuse
treatment services. The company's Workers' Compensation division offers managed care services, such as

Discuss The Advantages And Disadvantages Of Healthcare...
Though there are advantages of the healthcare insurance due to its cost effectiveness, there are also challenges. One among the
drawbacks that insurance brings into the medical care system is the lack of profitability for hospitals. Many hospitals have been
reporting that their profit margins are shrinking due to the intervention of many players that seek to have cheaper care. As
competition among healthcare providers intensifying, more hospitals are closing mostly attributed to the managed healthcare
insurance systems. Physicians are also feeling the effect of insurance in their profession. Over the years, physicians from the
United States have always been the envy world over. This is changing due to the stagnation of their earnings and increasing
premiums. Hence, more healthcare providers are seeking to retire earlier this is affecting the physician–patient relationship.
Concerns on the spending on the healthcare system are also real. A large portion of the Gross Domestic Product (GDP) goes to
financing healthcare. According to studies, the major worry is that with the inflation of cost in medical services provision, its
spending will have a negative effect on all the other indicators of growth. That is, currently the healthcare depends on insurance for
funding. Accordingly, it will depend on government taxes and the funding coming from employers. Increasing medical care cost
will prompt the government to increase taxes influencing negatively on the economy. Employers on

State Health Policy Analysis
State Health Policy Analysis William Bythwood MHA620 Health Policy Analyses Professor Saran Tucker March 7, 2011
State Health Policy Analysis Abstract: The rises of health cost have put strains on State, Federal and employers budgets and have
severely hurt US families' income in recent years. An analysis of State health policy by the federal government projects that
premiums for insurance for employer based programs will increase from 12,298 in 2008 to 23,842 by 2020. This would be a 94%
increase in insurance cost. It is projected that health reforms by the federal government will help states reign in health cost and
slow the growth by 1% in all states by 2020. This would save $2571 per year per ... Show more content on Helpwriting.net ...
Enrollment growth may be attributed to the recession and the decision to expand Medicaid eligibility in some states because of the
American Recovery and Reinvestment Act. (Kaiser Commission February 2011) Unfortunately the ARRA Medicaid matching
funds are due to expire on June 30, 2011 and States are being crippled by immediate budgetary crises and many cuts are expected
in the Medicaid programs despite their success in controlling per capita cost growth. If the ARRA is allowed to expire despite
many states fiscal situation are still bad, it could be castrophic for those on Medicaid because states will be forced to cut services
and spending and this could have an adverse effect on access to the poorest and most ill patients because access and health quality
will be affected. If States decide to reduce enrollment it will affect the already growing uninsured population. (Kaiser Foundation
February 2011) State Governors according to the Kaiser Family foundation commission on Medicaid were able to maintain all
Medicaid expansions and improvements to their Medicaid programs and State Children Health Insurance plans despite budget
constraints. This allowed States to cover millions of low income families who would be part of the uninsured. State Medicaid
programs could not cover adults without children before the health reform law provided the money and the waiver. The New Law
allows for

Health Care in Great Britain Essay examples
Running Head: Global Healthcare
Healthcare in the United States Vs. Great Britain Tyra Baruti Kaplan University
The healthcare system in the United States and Britain are different and many in ways. The purpose of the healthcare system
should be to satisfy the needs and preferences of the individual patient who are ill but many countries have a different approach.
One of the biggest differences in the two healthcare systems is that in the U.S healthcare is considered private; on the other hand
Great Britain has a universal healthcare system. Healthcare is funded and provided for individuals in many ... Show more content
on Helpwriting.net ...
In Great Britain even though they have a choice to private insurance majority of use of the universal healthcare system which is
more affordable. Many Britons take advantage of private insurers in order to get better quality care and for reduce waiting times.
Another difference in the two healthcare systems is that in Great Britain there are no deductibles and close to no copayments
except for small co payment associated with prescription drugs.
The similarities of the two healthcare systems are that both countries have an organized healthcare system although they are
organized in a differently. All citizens in each country are treated by physicians in an attempt to heal and treat the sick. Also both
healthcare systems use preventive medicine as a way to improve the overall health of all citizens. Another similarity amongst the
two is that there are many citizens in each country that share the same opinion on the quality of the care that is provided.
According to a study it shows that the views of Americans on the quality of medical care in their country are not overly different
from those in Great Britain – 48% of Americans, 52% of Canadians, and 42% of Britons say they are satisfied. (Blizzard, 2003)
Before researching Great Britain Health care system I have always thought that universal healthcare was the best choice. After the
reading my opinion about both systems gradually changed. The United States healthcare system is not

Financing The Failing U.s. Healthcare System
Financing the Failing U.S. Healthcare System
The three principle parties involved in the U.S. Healthcare system are the consumer, provider and insurer. The provider includes
the hospitals, clinics, doctors, nurses and pharmacies that provides a service; the consumer is the individual who receives the
medical service and supplies the money; and the insurer is a third party intermediary between the provider and the consumer which
accept money from a pool of consumers and reimburse the providers. Like any transaction, there is a certain degree of risk
associated for members of the different parties. This risk is based upon variables within the U.S. healthcare model including the
method of, and who is reimbursing the providers.
The method of reimbursement determines which party will bear the greater financial risk and can lead to an excess supply of
medical services that drive up prices and provide no additional benefit to individual consumers because of producer and consumer
moral hazard. To maintain a sound healthcare market government regulation is required in the current U.S. healthcare system
because it would otherwise fail.
The following paragraphs will discuss the methods and effects of reimbursement in the U.S. healthcare system, which party bears
the financial burden, issues of moral hazard and cost control mechanisms, and the role of government regulation in the healthcare
market.
Fixed payments are pre–determined amounts that providers receive regardless of the

The Shift Of The Affordable Care Act ( Aca )
2014).
Results
Economics As the shift for HCOs is made to a PCMH model, the financial aspect also has to make a transition to accommodate to
the changes. In recent years, there have been implementations of different payment and reimbursement options, health insurance
programs, and the establishment of the Affordable Care Act (ACA). Between May 2009 and April 2012, one of the initial PCMH
pilot programs was conducted in Colorado, appropriately named The Colorado Multipayer Patient–Centered Medical Home Pilot.
More than 100,000 patients within sixteen internal medicine practices participated in the experimental PCMH model, using six
different health plans (Harbrecht & Latts, 2012). When the pilot was conducted, Harbrecht and Latt (2012) state that the monthly
care management fee, that was used to pay physician fees, was calculated by "multiplying the number of [...] patients in each
practice by the per member per month (PMPM) case management fee (pg. 2011)." To avoid discrepancy and to remain consistent
throughout the financial process, each plan supported the same payment models, payment schedules, and administrative
procedures adhering to the standards set forth by the National Committee for Quality Assurance (NCQA). To be able to arrive to a
PMPM fee, other pilot programs' PMPM fees were compared, the cost estimates for enhanced care were analyzed, and the ability
of each plan to recoup their initial investments, explain Harbrecht and Latt (2012). Each health

Mathematical Modeling and Pharmaceutical Pricing: Analyses...
Abstract. In the face of significant real healthcare cost inflation, pressured budgets, and ongoing launches of myriad technology of
uncertain value, payers have formalized new valuation techniques that represent a barrier to entry for drugs. Cost–effectiveness
analysis predominates among these methods, which involves differencing a new technological intervention's marginal costs and
benefits with a comparator's, and comparing the resulting ratio to a payer's willingness–to–pay threshold. In this paper we describe
how firms are able to model the feasible range of future product prices when making in–licensing and developmental Go/No–Go
decisions by considering payers' use of the costeffectiveness method. We illustrate this analytic ... Show more content on
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Coverage and reimbursement decision making for new technology entering European markets occurs at the country–level.
168 J.A. VERNON, W.K. HUGHEN AND S.J. JOHNSON
Figure 1. Medline citations of cost–effectiveness studies, 1979–2002. also consider these values as prices. Under the assumption
that a payer has perfectly inelastic demand for products that have gained coverage, there is great value to the firm in understanding
the processes payers use to determine their own willingness to pay, especially for early stage products where the level of price
uncertainty is high. The optimization problem for the manufacturer primarily becomes one of maximizing price given the
constraint of a payer's willingness to pay for an improvement in health.
The paper will proceed as follows. Section 2 will describe the field of cost–effectiveness analysis, and how it is used by payers,
including governments and managed care organizations
(MCOs), to set new drug reimbursement policies. This section will also describe how firms, fully cognizant of these policies,
model future product prices when making in–licensing and developmental Go/No–Go decisions. Section 3 will illustrate this
analytic method with a simple deterministic example, and then incorporate stochastic assumptions using both analytic and
simulation methods. Section 4 will conclude.
2. Demonstrating value for money: Cost–effectiveness analysis To determine the social

Factors Of Favor Of The Argument Essay
Module 2 Assignment 2: Factors in Favor of and Against
Name: Kellie Runyon
Topic: Universal health care: Governmental provision of free health care for all citizens.
Part 1: Matrix
Strength of the Argument
(1– strongest,
6 – weakest)
Reasons for
Reasons Against
1
Universal health care would be affordable for everyone
Millions of people would save money with universal healthcare due to everyone paying an equal amount; whether it be through tax
increase or some other form. However, it will amount to less money than those who are paying for healthcare now due to the fact
that every citizen pays for it and not only the people who can afford the raising prices.
Tax Increases to cover the healthcare change.
2
Public health would improve with universal health care
All citizens will have unlimited access to the medical professionals. Many people that cannot afford insurance will now have
unlimited opportunities to get annual exams and help to prevent major health issues from going unseen.
With an increase in the amount of people needing/wanting medical treatment, there will be a shortage of medical staff. This will
cause longer wait times, limited resources, as well as not having enough doctors and specialists to meet the demand.
3
The cost of healthcare would be lower for the US when expenses are prioritized.
Other countries that provided universal health care spend half as much as the US does with the amount of people who currently
have health insurance. The US is

Bachelors Capstone In Healthcare Administration: A Case Study
Martin Pointer 16 Mar 2017 HA499 Bachelors Capstone in Healthcare Administration Unit #7 Franciscan St. James Hospital is a
source of health services to the south suburban communities in Chicago, IL. The hospital has expanded its commitment to improve
health by developing this more specific Community Health Needs Assessment and by adopting a Strategic Implementation Plan
which describes specific programs that have been developed for the benefit of improving community health. After turning around
its finances, Franciscan St. James Health in Chicago's south suburbs has made a significant investment in order to combine
medical services and enhance the abilities between its two hospitals. For most of its history, Franciscan ... Show more content on
Helpwriting.net ...
It has received an Excellence Award for Cardiac Surgery in 2014–2015 for having one or more of the country's top 100 cardiac
surgeons. Additional awards were received for Treatment of Sepsis, Colo–Rectal Surgery, Coronary Intervention, and Treatment of
Respiratory Failure. Suffice it to say, the hospital has achieved remarkable accomplishments. Franciscan St James Hospital is
accredited by the Health Facilities Accreditation Program. The Commision on Accreditation of Rehabilitation Facilities and the
American Osteopathic Association have also given accreditation to the hospital for its superb quality and commitment in
healthcare. The physicians, clinical staff, and employees of the hospital have made a commitment to, and made it a career
obligation to live the hospital's mission. In following this mission, they live and work by a set of common values that include the
"respect for life, compassionate concern, and Christian stewardship, and fidelity to the mission" (Association of Psychology Post–
Doctoral and Internship Center). Our new management model is intended to ensure consistency, promote the implementation of
best practices, and achieve the goal of providing better care, better health, and lower costs for patients that are in need of
healthcare services. The refinement of the Franciscan Alliance hospitals reflects and reinforces an

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
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 model first used?
What kind of ... Show more content on Helpwriting.net ...
Indemnity health plans run on a retrospective payment system. A member has a monthly premium. Co–pays and a deductible.
Upon visits the provider submits claims for services rendered to the insurance company, upon which the insurance company pays
their part and the member is billed for the remaining balance to be paid out–of–pocket.
With indemnity plans employers deduct the monthly premium from payroll of each employee on the plan. Both the member and
the insurance company pay for services rendered. Upon receipt of the services the insurer pays the provider their portion if the
deductible has been met. The member is then responsible for the remaining balance and the co–pay at the time of service.
The structure of an indemnity plan is completely "open access". The member may choose any provider or specialist they would
like. In an indemnity plan there are no restrictions on providers or provider type. It is the member's responsibility to seek and sign
on with their preferred provider or specialist.
Positive aspects of indemnity plans include the liberty of the member to choose their preferred provider or specialist and their
preference of type of care they wish to receive. A negative aspect of indemnity plans from a members stand point is the cost of
these plans. Premiums and deductibles then to be higher with indemnity plans over other insurance plans due to the freedom

Medical Malpractice and Tort Systems Essay
Health care organizations, particularly hospitals, currently face numerous legal issues, several of which will be examined in this
paper. The first issue to be examined is medical malpractice and the tort system. The medical malpractice and tort system makes up
one of the major legal issues encountered by hospitals and health systems. Showalter (2012) states that with the decline of
charitable immunity in the 1970s, healthcare was one of the areas impacted by personal injury law and was held liable for
negligent acts. Today, malpractice continues to be a significant problem. Malpractice lawsuits are considered when negligence in
medical treatment provided by a physician, surgeon, other health professional, or hospital results in injury. ... Show more content
In addition, according to Showalter (2012), physicians consider malpractice suits a substantial contributing factor to increasing
health costs and defensive medicine. Furthermore, Nelson, Morrisey, and Morrisey (2011) report that physicians emphasize the
negative impact of malpractice lawsuits on their reputations, since judgments and settlements must be reported to the National
Practitioner Data Bank.
Like the malpractice and tort system, HIPAA and data breaches are an important legal issue that health organizations face. HIPAA
was enacted in 1996 to ensure medical insurance portability and later, to improve standards for health information privacy and
security (Showalter, 2012). As a result, it is currently extremely important that health organizations are in compliance with HIPAA
regulations and ensure that patient records are protected; health organizations that fail to comply can face significant legal costs
and penalties. In November 2010, Page and Fields (2011) report that six hospitals and a nursing home in California that failed to
prevent unauthorized access to confidential patient information were levied a fine totaling $792,000 in November 2010. More
recently, the General Hospital Corporation and Massachusetts General Physicians Organization, which represent Massachusetts
General Hospital in Boston, had to pay the

United Health Group Business Analysis
An own account with the organization's transfer agent, as Well Fargo Shareowner Service, or else you are the owner on an
athematic stock certificate, you will be considered a "registered shareholder. If you have United Health Group stock account,
known within your name with a brokerage firm, such as other agent like trustee then you are a beneficial shareholder." Even if you
have shares in the organization's such as an Employee Stock Purchase Plan or 401 (K) you are a "plan partaker" as opposed to a
shareholder. It is vital for workers to memorandum that some United Health Group shareholders may be both "beneficial and
"registered" (Shareholder Supplies," n.d.), Board of Directors: The Board member are scrutinized and ... Show more content on
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The organization commitment should be conducting a public survey yearly. This is a small, nameless survey that is arranged for all
is hired to all workers by a group company. Profits are up–to–date to leaders to analysis, for opportunities for upgrading as well as
execution of change. All questions should be directed to the organizations pros and cons as there are evident of broken processes
and leadership problems, which must be talked about. Research proposes that respectable leadership is important to satisfying
employees, growing efficiency, and reassuring as well as supporting employee

Essay on Health Care System in Turmoil
Health Care System in Turmoil
Quality healthcare in the more rural areas of the United States is not only getting more difficult to obtain, but difficult to afford.
American citizens living in rural areas have the highest rates of chronic disease, higher poverty populations, less health insurance,
and there is less access to primary care physicians. When the economy is at its lowest point it causes an increase in a number of
access and health issues that have already had prior problems in communities and in rural areas, therefore the main goal of the
national health care tax of 2010 was to allow coverage to all residents of the United States, and also by transferring necessary
health care to places that were farther away, such as the ... Show more content on Helpwriting.net ...
This national health care tax is supposed to be an answer to most of our health care insurance issues. Although most people agree
that our health care system is in turmoil and needs to be reformed, some people do not agree that the solution is a national health
care tax. Americans seem to be even more upset over the cost and access to care even more than the quality of care that is given. It
is amazing to note that most Americans when asked what they think the most important health care issue facing the United States,
the cost and access to care remains the most common response. (Newport, Jones, & Saad, 2012). Some benefits of having a
national insurance system, such as the Affordable Care Act (ACA) include: Ending the long–time discrimination by most insurance
companies based upon a pre–existing condition and your current health status. Under the Affordable Care Act (ACA), persons
seeking health insurance, while they already have a pre– existing condition, and could not get health insurance previously will
have access. The ACA will give choices of health insurance that are affordable. Under this national insurance system, a large
number of Americans will be able to obtain affordable insurance because of the creation of health insurance exchanges, which will
allow families to compare health plans and then be able to choose a plan that fit their needs. These exchanges will guarantee
families or persons that quality

Health Insurance Matrix Essay
What kind of payment system is used, such as prospective, retrospective, or concurrent?
Who pays for care?
What is the access structure, such as gatekeeper, open–access, and so forth?
How does the model affect patients? Include pros and cons.
How does the model affect providers? Include pros and cons.
Indemnity
In 1932 the American Medical Association (AMA) adopted a strong position against prepaid group practices, favoring instead
indemnity–type insurance that protects the policyholder from expenses by reimbursement (Jones & Bartlett, 2007). As one of the
first health policies in the U.S., indemnity plans are considered ... Show more content on Helpwriting.net ...
Potential for higher payment amounts at time of service. Alternatively, there is a potential for greater debt amounts. Larger debts
will make it necessary for health care providers to be more aggressive for collections. Providers will also encounter increased staff
costs in order to follow–up with patients in advance of treatment, as well as in subsequent collection efforts (Fifth Third Bank,
2008).
Point–of–service
HealthPartners of Minneapolis pioneered point–of–service (POS) plans in 1961, but the concept took 25 years to get off the
starting blocks (Dimmit, B., 1996). In 1986 CIGNA Healthcare launched Flexcare, the first POS plan. By 1995 forty percent of
employers with at least 200 employees offered POS plans.
Providers within a point–of–service network are usually paid a capitated fee. The fee is fixed and does not alter regardless of
services rendered. POS plans operate using a prospective payment system. Insurance companies reimburse providers an agreed
amount that is decided before a patient receives services.
Patients are responsible for paying a co–payment when visiting a doctor. After the patient is seen, the provider submits claim forms
to the insurer for the services rendered. Once the claims are processed the insurer will reimburse the provider (Austin & Wetle,
2012). If a patient goes out–of–network, they are required to pay the provider in full. Afterwards the patient can submit a claim for
reimbursement.
Point–of–service insurance plans

HCS/212 Health Services and Systems Matrix Essay
Health Services and Systems Matrix
Choose at least seven services or systems from the following list:
Hospice care
World Health Organization (WHO)
Public health
Rehabilitation center
Department of Health and Human Services (DHHS)
Medicare
Centers for Medicare and Medicaid Services (CMS
Center for Disease Control (CDC)
Health Maintenance Organization (HMO)
Occupational Safety and Health Administration (OSHA)
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
In the following table, describe each of your choices and explain their functions and roles within the health care field. Your
responses should total at least 50–75 words for each choice.
Service or System ... Show more content on Helpwriting.net ...
Department of Health & Human Services , 2013).
The mission of the Department of Health and Human Services is to help provide the structure that Americans need to live
prosperous and healthy lives. This service gives families, children, and seniors a way to receive quality health care. This achieved
by helping parents find affordable childcare and legitimate jobs. This organization is dedicated to keeping American's food safe,
preventing infectious diseases, and by pushing the boundaries of how to treat and diagnose disease (U.S. Department of Health &
Human Services , 2013).
Medicare
Medicare provide health care to those who cannot afford it;
Government insurance programs designed to pay for the treatment of disease and medically diagnosed conditions (Peggy S.
Stanfield, 2012).
Medicare reimbursement repayment cover most out–of–pocket medical expenses. .
The Medicare offers three types of insurance coverage. Medicare part A hospital insurance covers inpatient care in hospitals, and
skilled nursing facilities. It also helps cover hospice care and some home health care. This coverage does not cover custodial or
long–term care (Center for Medicare and Medicaid Services, 2013). Medicare also offers part B Medical insurance that covers
preventative care and outpatient care. Prescription drug

Health Care And Hospital Systems
Running head: HEALTH CARE AND HOSPITAL SYSTEMS 1
Health Care and Hospital Systems
Between Two Countries: Italy and the U.S.
Jacqueline S. Valladares
Western Kentucky University
HEALTH CARE AND HOSPITAL SYSTEMS 2
Health Care and Hospital Systems
Between Two Countries: Italy and the U.S.
The healthcare system of a country is an important unit that plays a key role in ensuring that a country is able to cater for the
healthcare needs of its population. It can be referred to as a network of organizations, trained personnel and facilities within a
country; which are used to provide medical services to the population. Medical services are geared towards preventing disease,
diagnosing ... Show more content on Helpwriting.net ...
Its necessary do develop an effective healthcare system and this can be aided by investing significant amounts of resources needed
to develop quality healthcare services (Garson, 2000). This paper aims to make comparisons between the healthcare systems of the
U.S. and Italy.
Healthcare and Hospital System (The U.S. and Italy)
Developing countries are characterized by ageing populations and advancements in technology have impacted on the way
healthcare services are delivered in such countries. The
HEALTH CARE AND HOSPITAL SYSTEMS 3
United States is located in North America whereas Italy is located in Europe and has one of the oldest populations in the continent.
The two countries vary in terms of the size of their populations, standards of living, size of their economies, quality of healthcare
personnel, nursing education and cultural practices. U.S. comprises of a population of over 316 million people whereas Italy has a
population of over 59 million people. The US has a life expectancy rate of 79 years whereas Italy has a life expectancy rate of
81.5years. Annual spending on healthcare in the U.S. during 2014 was over $2trillion whereas in Italy, healthcare spending costs
accounted for 9% of GDP (Carollynn, 2014).
Funding healthcare in the U.S. is aided by a variety of arrangements ranging from insurance, (Employed individuals and their
families are at times funded by their employers, self–employed individuals on the

Emanuel Medical Case Analysis
STATE UNIVERSITY OF NEW YORK AT ALBANY
Emanuel Medical Center
Situational & Decision Analysis
James T. Onisk 4/29/2012
Table of Contents Situational Analysis Appendices External Analysis Appendix A: S.W.O.T. Analysis Appendix B: External
Trend/Issue Analysis Appendix C: Environmental Trends/Issues Plot Appendix D: Stakeholder Map Appendix E: Service Area
Profile Appendix F: Service Area Structural Analysis Appendix G: Service Area Competitor Analysis Appendix H: Critical Success
Factor Analysis Appendix I: Mapping Competitors Appendix J: Synthesizing the Analysis Internal Analysis Appendix K: Financial
Analysis Appendix L: Value Chain Strengths and Weaknesses Appendix M: Value Chain Competitive Advantages Relative to
Strengths ... Show more content on Helpwriting.net ...
Since most specialty procedures are inpatient services, EMC's inpatient occupancy rate suffers. The occupancy rate for Emanuel
Medical Center – fifty percent – is far below that of its competitors and industry benchmarks. To accompany this, EMC (on
average) receives a lower reimbursement for in–patient Medicare services per patient seen in comparison to its competitors. A
result such as this is correlated with directly to the fewer amount of specialty services that EMC offers. In order for Emanuel
Medical Center to be able to compete with other hospitals in its service area, it is imperative that EMC evaluates what services
they currently offer and are capable to offer in the future to add value to the hospital, increase its revenue stream, and expand its
patient mix. Currently, Emanuel Medical Center has not succumbed to its increasing financial pressurealthough EMC has had a
negative operating income for five straight years. A negative operating income places EMC at a disadvantage because it limits the
hospitals ability to renovate its aging building or hire new specialists to offer revenue enhancing procedures. EMC's competitors,
on the other hand, have large sources of revenue due to their mergers with large healthcare networks such as Catholic Healthcare
West. Another competitor, Kaiser Permanente Modesto Medical Center, has extremely large financial resources due to the fact

Readiness for Future Health Needs at Banner Health
Readiness for Future Health Needs at Banner Health Name Grand Canyon University Michael Jones NRS– 451V Date Readiness
for Future Health Needs at Banner Health Banner Health celebrates its fifteen year anniversary this year (2014). Samaritan Health
System merged with Lutheran Health System September 1st, 1999. Lutheran Health System began in 1938 across Western and
Mid–Western states. Samaritan Health System dates back to 1911 that covered California and Arizona, primarily in the metro
Phoenix area. At the time of the merger, Banner Health occupied 14 states, with 32 hospitals with 2,882 beds, and employed
22,500 workers. Today, Banner Health is one of the largest health care systems in the country, occupies seven ... Show more
content on Helpwriting.net ...
This allows more access to doctors without having to have many doctors on site 24–7 (Banner Health, 2012). Strategic plan for
resource management In the area of resources for healthcare needs, Banner Health has expanded their services to the point of being
self–sufficient. The services that are offered are endless. A few of the listed services are; comprehensive, hospice, home care,
rehabilitation (from physical therapy, psychiatric to drug addiction) services, specialized Alzheimer's units, trauma centers, stroke
and cardiac centers, and tertiary care centers. Within the Banner system, there are specialist for all areas of medical needs from
prevention to rehabilitation. The plan of Banner Health is being carried out today by the building and opening of additional
medical facility locations (Banner Health, 2012). Resources for the community can be reviewed on the home page of the Banner
web site www.bannerhealth.com. On this site an individual can look at all of the possible resources available by searching the
individual hospitals. There is also a list of consumer resources available. On this site, you may view direct pay pricing, a quality
report in order for the consumer to view the quality reports of the system, and a list of community resources (Banner Health,
2012). Strategic plan for addressing issues related to patient satisfaction Patient satisfaction is an increasingly important area of
concern. Especially with reimbursements from

Health Systems And The Health System
From my point of view, I believe that the health system is facing a hindrance in providing value to the patient. The inability to
provide high quality, low cost health care is now a double edged sword in our industry. In a time where reimbursements are made
on the patients perceived quality of their treatment, the organization can no longer afford to run the business off of the volume of
patients seen. Moving forward, I believe that there are many changes that can be made, both internally and externally, throughout
the health system to successfully implement patient centered care, which would enhance our value chain. Based on the following
recommendations, I believe that the cost savings, or revenue generated, would impact the health system substantially. Currently we
are receiving a 1% penalty on a section of outpatient physician practices. This proposal would allow for us to cease paying a 1%
penalty, and also allow for us to receive possible incentive payments for striving to create a high quality at a low cost. To fulfill my
proposal, the entire health system would need to be educated, and willing, to make changes in their daily routines. In a small
community hospital where culture and politics often predict outcomes, this would have to be a task that bypassed these factors.
The clinical staff will have will impact the most change, but all of the support staff will need to take action for the plan to be
successful. Although initially the proposed action to increase

Benefits Of Being A Part Of Sutter Health
The Benefits of being a part of Sutter Health
Sutter Health a non–profit organization providing health care for the people in the Northern California region. Sutter Health has
been recognized one of the top 100 hospitals in the nation, with its quality and innovation (Sutterhealth.org, 2016). Obtaining a
position for Sutter Health Sierra Region Administration will provide a great career opportunity. The interested position in the
organization is for the Vice President position of Strategy and Business Development. To apply for a job posting with Sutter
Health, applications are located on their website. The career path I am interested in is for the Vice President of Strategy and
Business Development; in accordance with the job description ... Show more content on Helpwriting.net ...
Extensive experience in strategic business planning, business development and marketing strategy, acquired during 5–6 years of
experience. Expertise in developing and implementing physician strategy, analyzing and consolidating service product lines; and
driving business growth while managing costs in a matrix organization. One should also have knowledge in understanding of
strategy development and business planning processes, particularly as they relate to health care. Applicant should be able to
translate current knowledge of healthcare trends, regulatory laws and standards into actionable strategies. And one should bring
significant knowledge of health plan economics, marketing strategies and research concepts, risk financing, forecasting and
scenario building techniques.
Sutter Health believes a culturally diverse and inclusive workforce enhances our ability to provide high quality care to patients and
their families. Sutter Health believes in diversity recruitment and retention by seeking and welcoming employees who bring
diverse backgrounds and perspectives that reflect all the communities that they serve. I myself being a volunteer at the Sutter
Health Valley Area administration office, I got a chance to ask questions to my supervisor Laughlin–Guerra M. who is the senior
executive assistant to James Conforti president/CEO of Sutter Health valley area and Grant Davies CEO of valley area Hospitals. I

health insurance matrix HCS/235 Essay
As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to
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.
What ... Show more content on Helpwriting.net ...
According to Austin and Wetle (2012), employers covered 83% of premium costs for single coverage and 73% for family coverage
in 2009. The employee, or beneficiary, paid the difference. Then, the health insurance company pays the provider directly.
Example:
HMOs have the strictest access structure, called a gatekeeper model, where patients must have a primary care physician (PCP)
through whom all care is routed. PCPs decide which diagnostic tests are needed and control access to specialists through referrals,
deciding when it is necessary for a patient to seek more expensive specialty care (Barsukiewicz, Raffel, & Raffel, 2010).
Example:
HMOs are usually the least expensive health plans, offer predictable costs for health care, the least administrative paperwork, and
cover preventive care (Barsukiewicz, Raffel, & Raffel, 2010). However, HMOs also restrict direct access to specialists by
requiring referrals by a PCP, requiring patients to see a provider in the HMO network, and often not covering more costly
procedures or care options, because care is managed to control excessive or unnecessary care. Providers gain if they provide less
care (Austin & Wetle, 2012). This incentive could affect patient–provider trust.
Example:
Advantages of HMOs are that a known amount of revenue is guaranteed and the patient population number is fixed (Austin &
Wetle, 2012). In addition, if providers use less in services than the capitated fee,

Community Health Center for the Uninsured and Undocumented...
Although the number of illegal immigrants is substantially growing on a daily basis, the national health care policies seem to fail in
addressing their medical needs. This, however, is becoming a growing challenge because of the conflicts between medical ethics
and immigration laws. Despite the alluded hope for this patients group within the immigration reform, the Patient Protection and
Affordable Care Act (PPACA) fails to alleviate the burden of their unmet health care needs. Advocates of their rights for health
coverage argue that medical ethics and the United States moral obligations necessitate expanding coverage to all population
residing within the borders of the country. Conversely, opponents deny their health coverage because their illegal status disqualify
them from all public benefits. This paper goes beyond these opposing assumptions and instead, proposes a strategic plan to raise
and combine resources necessary to establish a health care center for the uninsured, underinsured, and illegal immigrants in
Northern California. The paper covers the establishment of this center with special focus on strategic funding, funding constraints,
related state and national regulations, health policy, resources allocation, and managerial and leadership. Funding Like any
business idea, the first step to establish a community health center is to figure out all necessary funds and funding resources for the
anticipated expenses. In general, according to McLaughlin and

2006 Arroyo Case Study
2006
National Institute of Sta nda rds a nd Technolog y
Technolog y Administration De pa rtment of Commerce
Baldrige National Quality Prog ra m
Arroyo Fresco
Community
Health Center
Case Study
2006
National Institute of Standards and Technology
Technology Administration Department of Commerce
Baldrige National Quality Program
Arroyo Fresco
Community
Health Center
Case Study
The Arroyo Fresco Community Health Center Case Study was prepared for use in the 2006
Malcolm Baldrige National Quality Award Examiner Preparation Course. The Arroyo Fresco
Community Health Center Case Study describes a fictitious nonprofit organization in the health care sector. There is no connection
between the fictitious Arroyo ... Show more content on Helpwriting.net ...
Year(s)
__________________________________________________________________________________________________________
Name(s) of Applicant
__________________________________________________________________________________________________________
2. Highest–Ranking Official
X
J Mr. J Mrs. J Ms. J Dr.
Name Ramon Gonzalez
_______________________________________________
Address 1345 Desert Bloom Ave.
_________________________________________________
Title CEO
_______________________________________________
Yuma, AZ 85364
_________________________________________________
Telephone No. (555) ARROYOF (277–6963), ext. 12
_______________________________________________
_________________________________________________

r_gonzalez@af.net
E–Mail
_______________________________________________
Fax No. (555) 277–6967
_________________________________________________
3. Eligibility Contact Point
X
J Mr. J Mrs. J Ms. J Dr.
Name Roger Sinclair
_______________________________________________
Address 2219 Lakeview Blvd.
_________________________________________________
Title Director of Performance Excellence
_______________________________________________
San Luis, AZ 85349
_________________________________________________
Telephone No. (555) 487–6235
_______________________________________________
Overnight Mailing Address (Do not use a P.O. Box number.)
(555) 487–6277

Akron Children's Case
With changes due to Healthcare Reform, healthcare organization's are becoming more competitive in its market as they move
towards finding the right effective fit through process improvements for their organization based on quality measurements,
operational effectiveness, and financial performance in an effort to maximize their reimbursements in order to protect their margin
and stay afloat in the healthcare industry to deliver the most profound care to the patient's (Amerinet, n.d). Through new
organizational architect and design, training, dashboards that helps to make matrix decisions, and big data analytics gathered from
the electronic health record system, healthcare organization's are driven to use the best fit resources and tools to improve their
performance and be sustainable and successful in the healthcare market (Amerinet, n.d) (Stichler, 2017).
With addressing the Board of Directors, Akron Children's Hospital can better compete in the pediatric market as a goal ... Show
more content on Helpwriting.net ...
For example, the MRI scheduling was an area addressed by COE. There was a bottleneck in scheduling MRI's, and of the two
available MRI's, only one was in use. Because children often moved while receiving MRI's, many times the MRI had to be redone
which prolong time, and created long wait time for other patients needing a MRI. In many cases the child was sometimes sedated
to prevent them from moving. Working COE, ACH had a two day Kaizen meeting that produced multi–solutions, to the bottleneck
scheduling of MRI's, such as adjusting the master schedule, streamlining the insurance process, and providing work standardized
instructions. As a result, the level–loading solution by adjusting the master schedule worked and eliminated the bottleneck of long
wait times and allowed more patients to seen within an effective throughput time, therefore increasing the MRI's from 86 to 112
per week with more revenue

Kevin
Homework4 2013年3月16日上午 10:42 (二選一) 4.2.Perform a financial analysis for a project using the format provided in
Figure4–5. Assume the projected costs and benefits for this project are spread over four years as follows: Estimated costs are
$200,000 in Year 1 and $30,000 each year in years 2, 3, and 4. Estimated benefits are $0 in Year 1 and $100,000 each year in years
2, 3, and 4. Use a 9 percent discount rate, and round the discount factors to two decimal places. Create a spreadsheet (or use the
business case financials template provided on the companion Web site) to calculate and clearly display the NPV, ROI, and year in
which payback occurs. In addition, write a paragraph explaining whether you would recommend investing in this ... Show more
The new application must also import data from the current systems that track employee expenses submitted to the company and
the company 's costs to the insurance provider. You believe that having this data will help you revise policies concerning employee
contributions to health care premiums and help you negotiate for lower premiums with insurance companies. You estimate that this
application would save your company about $20/employee/year for fulltime employees over the next four years and cost about
$100,000 to develop 3. Cross–Selling System: Develop an application to improve cross–selling to current customers. The current
sales management system has separate sections for major product/service categories and different sales reps based on those
products and services. You see great opportunities to increase sales to current customers by providing them discounts when they
purchase multiple products/services. You estimate that this system would increase profits by $1 million each year for the next three
years and cost about $800,000 each year for development and maintenance. 4. Web–Enhanced Communications System: Develop
a Web–based application to improve development and delivery of products and services. There are currently several incompatible
systems related to the development and delivery of products and services to customers. This application would allow customers

Health Care Reform: The New Definition of Socialism Essay
Health Care Reform: The New Definition of Socialism. "In 2007 nearly fifty–million Americans did not have health insurance,
while another twenty–five million were underinsured". (Health CS). The United States one of the most powerful countries in the
world where a national health care system is nonexistent because there is no financial accountability. Politics, money and
bureaucracy have left Americans with doubt, confusion and the worries on how to pay for health coverage. United States should
have a national healthcare plan because it will cut down on cost be more efficient and make doctors more financially responsible
when it comes to spending money. Of the people I questioned thirty percent said that the health care premiums are ... Show more
Michael Morre.2007. Really was an eye opener for me about Untied States health care and why is it so far behind. Countries' like
Canada, France and Cuba have had national health care plans for years and faced the same economic woes as United States or
even worse. Cost and money play a big part in health care if they cannot make a profit why change the process even though it is
the right thing to do. Also government ran health care system can be just as efficient as private paying system. The health care
system in the United States has submerged in bureaucratic red tape where money has taken place over humanity (Moore, Sicko).
The healthcare system in United States is tied up with politics and propaganda that puts a choke hold on the whole process. It was
sickening to see the 911 responders after the twin towers incident were going to another country to receive medical treatment.
They actually traveled to Cuba to seek medical treatment because the insurance companies wouldn't cover their claims and drop
their coverage. Cuba has one of the most respected health care systems in the world the ratio is one doctor per Two Hundred
citizens. The United States ratio is one doctor per Four Hundred citizens. Annually Cuba graduates about four thousand doctors a
year out of its twenty one medical schools (Health Cuba). How could a country so rich in resources turn its back on American
people who make this country strong?

Social Security Benefits Of The United States
The messed up status of the existing healthcare system is so much wanting. Medicaid killed the market forces and Medicare
initiated by the government where the insurance given is of poor quality and over taxed on the workers who are the contributors
(Mitchell, 2013). This also brought about over insurance, which is not proportional to the service rendered to the contributors when
they fall ill. This is all problematic and uneconomical to them (Mitchell, 2013). The various invented forms of mediation led to
many problems, such as increasing prices and incomprehensible complexity, and many people blamed that the "private" and "free
market" healthcare (Mitchell, 2013). Social Security benefits enactment will be a big boost to the workers welfare and saving on
the taxes they pay with the elimination of the other existing inefficient schemes (Smith & Couch, 2014). Obama care, endorsed in
2010, perceived to course paradigm–shifting revolution in healthcare structure. This has not solved the problems and there for
there is a need to revisit our policies and come up with a workable program that will solve the existing problems (Mitchell, 2013).
In conclusion, Obama care scheme cannot eliminate the existing problems. We need an elaborate scheme to solve this problem
completely. Social Security benefits program bears the solution. Limitation of the program study Having to implement this new
scheme, there are few shortcomings encountered but bearable. Amongst them, is the competition

The Affordable Care Act : A Critical Analysis Essay
The Affordable Care Act: A Critical Analysis Bryan Erik Nelson Swartz Webster University – – – Executive Summary An abstract
is a single paragraph, without indentation, that summarizes the key points of the manuscript in 150 to 250 words. For simpler
papers in Paul Rose's classes, a somewhat shorter abstract is fine. The purpose of the abstract is to provide the reader with a brief
overview of the paper. When in doubt about a rule, check the sixth edition APA manual rather than relying on this template. (I
prefer only one space after a period, but two spaces are suggested by the sixth–edition APA manual at the top of page 88.) This
document has a history that compels me to give credit where it's due. Many years ago I downloaded a fifth–edition template from
an unspecified author's web site at Northcentral University. I modified the template extensively and repeatedly for my own
purposes and in the early years I shared my highly–modified templates only with my own students. By now, I have edited this
document so many times in so many ways that the current template bears virtually no similarity to the old Northcentral document.
I want to be clear, however, that I am in debt to an unknown author who spared me the inconvenience of having to create my own
templates from scratch. Keywords: writing, template, sixth, edition, APA format, self–discipline, is, good Abstract An abstract is a
single paragraph, without indentation, that summarizes the key

Quality Improvement in Nursing
Mary, a 79 year old patient has gotten up from bed without assistance to use the restroom. She falls on the way and hits her head
leaving her with a huge laceration and possible subdural damage. This is the third fall this month on the unit; changes must be
made in order to address the policies to prevent falls. Policy changes are one of the many issues that a quality improvement nurse
will address in her field. Nursing is a growing and evolving field that changes with new initiatives, government regulations, and
technology. There is great demand in the field and new nurses are constantly called to meet the needs of patients. As the population
of our country ages, the number of nurses needed to meet these demands will increase. The field of nursing does not just involve
the direct care of patients. A number of careers within the field support policy, management, and coordination of patient care.
Quality Improvement nursing is one career that can be obtained by a registered nurse that does not involve direct patient care.
Quality Improvement nursing involves initiating policies and changes within the facility to improve patient care as well as lower
facility costs, increase patient safety, and increase nurse satisfaction. This career has grown drastically in the last few decades due
to health care reform acts, insurance regulation changes, and advances in technology. The position of quality improvement requires
a unique set of skills and training, a higher salary matrix, as

Medicare and Medicaide Essay
Medicare and Medicaid together "are the single biggest contributor to [the United States] long term [budget] deficit." This idea
was expressed by President Obama during his 2011 state of the Union Speech. After saying this, the president said that health care
costs need to be reduced, including these two services. Medicare and Medicaid are beneficial to those who receive their services,
and the criteria for eligibility currently allow many to qualify for either program. This is most likely the cause of the major deficit
that the president spoke of. However, downsizing or eliminating these programs to lessen the deficit will affect many people and
their ability to receive healthcare.
In 1965 President Johnson signed both Medicare and ... Show more content on Helpwriting.net ...
Yes Medicare is supposed to be an insurance program that helps the needy aging population. I personally don't want to strip seniors
of their essential benefits, but it is affecting me and my future; with the inevitable raise of taxes, shrinking defense, and squeezing
of other domestic spending– everything from the FBI to college aid (Samuelson, 2011, para.1). Many seniors count on these
services but we as a nation need to make changes to help the future retirees. According to Samuelson, Obama said we must "win
the future," but our massive federal debt will keep growing because, without restraining spending on retirees, there's no path to a
balanced budget" (Samuelson, 2011,para.2). This shows true in Medicaid too, "The social safety net [Medicaid] for the growing
ranks of poor Americans would be further strained (Samuelson,2011, para.2). It would also be helpful to screen people better so
they don't abuse this system. If Medicaid would verify assets they can weed out the people who don't deserve these services. This
will cut costs by verifying better eligibility, which in turn will be less wasteful. This is all very scary for the future, interest of our
country. "From 2012 to 2021... Social Security would rise 27 percent and Medicare, 32 percent"(Samuelson, 2011,sec.3) In my
opinion with the higher life expectancy of our nation we need to move the age for Medicare benefits up higher to reflect the
increase in life

Healthcare In The United States vs. The United Kingdom Essay
Compare and contrast healthcare in the United States and United Kingdom
In the contemporary world, America is one of the greatest countries. From the polio vaccine to Coca Cola, United States is mother
to many inventions. As Americans, we enjoy higher quality living standards than most other parts of the world. This pleasure–
oriented lifestyle makes a lot of other nations envious of us. And with the envy comes antipathy. For the time it has existed, the
American healthcare system has been a subject of scrutiny and debate.
The United States health care system ranks 37th in the world. Statistically, it's bizarre how United States is amongst one of the
most advanced nations in the world and the fact that it spends more on its healthcare ... Show more content on Helpwriting.net ...
Other government funded programs are funded out of general tax receipts.
However, this system has been a part of a never ending healthcare debate. Many argue that this system underperforms habitually as
the deliverables are in no match to the amount of spending. The discussion has largely been based on government–mandate of
universal health coverage plan and the costs of the healthcare in the country. This structure has repeatedly been questioned on it
access, efficiency and quality. Several feel that the beneficiary is not the average American but insurance companies and health
care lobbyists. Like everywhere else, where there is refute; there is reform. In the year 2004, the First Lady of the United States,
Hillary Rodham Clinton's attempt to reform the healthcare scene by criticizing its basis and offering remedies was defeated by the
Congress. In 2007, filmmaker Michael Moore's, Sicko; denunciated the American healthcare system and how it affects its people.
Although it censures the healthcare system we have, Sicko also highlights the healthcare practices in UK. The United Kingdom of
Great Britain and Northern Ireland is a sovereign state located in the continent of Europe. The English ruled over most parts of the
world for several decades and set standard for others to follow. It is said that no one in the world is better than the English for
quality and service. And such is true for healthcare.
The healthcare system

HCS 235 Week 2 Completed Health insurance matrix
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 model first used? What kind of ... Show more
This insurance encouraged people that had this basic form of insurance to get a second opinion on their medical issues especially
elective surgeries. You had to pay for services that you were receiving right away. Indemnity insurance system is on a retrospective
payment system. This is where you are automatically responsible to pay the fees for seeing the provider. Then you will be
reimbursed for the cost a latter date. You are responsible to take care of any charges that you make incur. The insurance company
is responsible for covering costs of care as well as you are. You will pay for the cost of seeing your PCP of your choice and you
will get reimbursed for the services that you just received. It is a classic way of making sure that if you are really in need of seeing
a provider then you will figure out a way to make that happen without incurring so much that the provider could be out money in
the long run. You have open access to indemnity insurance. You have the right to choose your PCP and it doesn't matter what your
insurance may like. This makes things very convenient considering many people go to the same doctor for the vast majority of
their life and solely rely on them for their treatment or care. Indemnity insurance is nice in the aspect that you get to choose your
health care provider as well as you will be reimbursed for you services that you received. I know that most people couldn't afford
that right away and with

The Effects Of Medical Tourism
Introduction Medical tourism is trending as time goes on and as the population increase throughout the world. Medical tourism is a
concept where individuals from their native countries, visit foreign countries to receive the medical attention they need that is not
available in their native country (CDC, 2016). This is further divided into outbound and inbound, inbound refers to the patients
coming to the country and outbound refers to the individuals leaving the country (Horowitz et al, 2007). First world countries tend
to hold most medical tourism out of all the other countries due to the perception of better medical care, but it comes at a very high
cost, thus developing countries are building state of the art medical facilities to ... Show more content on Helpwriting.net ...
With progressive upgrades in developing countries, medical tourism is becoming a viable option. Unorthodox locations for
medical tourism such as Malaysia, Brazil, and India are becoming pioneers in state of the art medical treatments and equipment
(Pashley H.S, 2012). For example, Turkey, India, and Singapore hold the most Joint Commission International Accredited
hospitals in the world (Pashley H.S, 2012). Visiting developing countries is not only cost efficient, but treatment effective as well;
individuals seek medical tourism due to ridiculous wait times and/or very expensive treatment. If an individual were to get a heart
bypass surgery in the land of the free, it would cost 80% more than in any developing country($130,000), and a waiting period of
2–10 years depending on emergency (Hodges J.R et al, 2012). Hospital revenue and the economy are major aspects that hospitals
and medical tourism operators have to consider and from the profit, India is seeing due to medical tourism is sought worthy; India
has anticipated $2 billion industry in 2015 from inbound medical tourism alone (Henderson, 2014). Traveling to foreign countries
can deem beneficial for those that are uninsured/underinsured and for those individuals who are not in an urgent emergency or are
placed on a long waiting period (Pashley H.S, 2012). In terms of Canadian Medical Tourism, individuals not only receive superior

Argument for a National Health Care System Essay
EXECUTIVE SUMMARY
The U.S. Department of Health and Human Services (HHS) stated that "The health of the individual is almost inseparable from the
health of the larger community and that the health of every community in every state and territory determines the overall health
status of the nation." It has now become clear that our economy in terms of healthcare insurance is not healthy; the healthcare
system in the United States spends 1 cent of every healthcare dollar in the prevention of diseases and 99 cents on the cure. Our
healthcare system is the most expensive and yet arguably among the least cost effective in the developed world. Despite the
highest per person health care spending among the Organization for Economic Cooperation ... Show more content on
Helpwriting.net ...
It is a patchwork of loosely connected financing mechanisms varying in terms of sponsorship and provider type. It also reflects the
age, health and economic status of the specific patient groups that are being served. Considering the growing number of Americans
who are uninsured for health care and the low ranking of the United States among a variety of health indicators, one may say that it
is a disappointing financing system. These observations provide a basis for supporting our position for a national health care
system. Where possible, comparisons will be drawn between the United States and other countries. Special focus will be paid to
similarities in the public and private financing components of the system, reimbursement of various provider categories and trends
that we may expect to see in the future.
Overall, the role of health insurance as a financial channel will be mentioned. Monetary business objectives will be contrasted with
the altruistic goals of health care as a humanitarian service. The benefits of shifting health care management altogether to the
government will be discussed, emphasizing its positive effects on the businesses of the employers and the performances of the
employees in the United States. EMPLOYERS BENEFITS National Health Care System benefits employers by lowering their
current health care costs. Companies need the National Health Care System now more

Manage Care and How It Has Affected and Changed Health...
Manage Care and How It Has Affected and Changed Health Care Manage Care and how it has affected and changed Health Care
"Managed care embodies an effort by employers, the insurance industry, and some elements of the medical profession to establish
priorities and decide who gets what from the health care system." (JAMA.2001; pg. 285:2622–2628). Manage Care is part of the
Health Care system since 1973 is known as the system that finances and delivers health care to individuals enrolled under their
plans. Manage care is intended to reduce the unnecessary health care cost in America through a variety of mechanism that includes
medical necessity review programs, economic incentives for physicians, beneficiary cost sharing, control of ... Show more content
The restrictions on health care services and reimbursements that are intended to reduce health care cost by discouraging
individuals from using care inappropriately. The discouragements of inappropriate care have done nothing else but affect the
quality of care that patients receive and their health. It is amazing when people's freedom of choices in the physician and health
plans they want becomes limited to them it can ultimately reduce their health. (JAMA.2001; pg. 285:2622–2628) How has this
event impacted the historical evolution of healthcare? Prior to the year 1760 and now I can say that health care has evolved in the
United States. My prior knowledge of health care is that it was a system of home care remedies with doctors with little training to
our now complex technology and bureaucratic system. With the birth of medical insurance, technological advancement, and the
professional utilization of doctors, it would be very ignorant not to say that health care has evolved from what it was to what it is
now. Manage care has definitely become part of that evolution and has impacted it as well with allowing the healthcare system to
becomes nothing much than a growing cooperation whose business is making a profit from healthcare, and not providing the
quality, reasonable cost, and necessary medical care when

Questions On The Environment And The Healthcare Industry

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