The Affordable Care Act (ACA) requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements for the services. This preventive care coverage requirement, which generally took effect for plan years beginning on or after Sept. 23, 2010, does not apply to grandfathered health plans.
Healthcare -- putting prevention into practiceZafar Hasan
This slidedeck is submitted by Zafar Hasan because one of the trends in medicine for the last 20 years isa focus on prevention and this deck is an outstanding practice primer.
Transitional Care Management: Five Steps to Fewer Readmissions, Improved Qual...Health Catalyst
Reducing readmissions is an important metric for health systems, representing both quality of care across the continuum and cost management. Under the Affordable Care Act, organizations can be penalized for unreasonably high readmission rates, making initiatives to avoid re-hospitalization a quality and cost imperative. A transitional care management plan can help organizations avoid preventable readmissions by improving care through all levels in five steps:
Start discharge at the time of admission.
Ensure medication education, access, reconciliation, and adherence.
Arrange follow-up appointments.
Arrange home healthcare.
Have patients teach back the transitional care plan.
Chronic Care Management in Post-Acute/LTC SettingPYA, P.C.
PYA Principal Denise Hall and PYA Manager Lori Baker presented an educational session, “Chronic Care Management in Post-Acute/LTC Setting” to members of The Vision Group during The Society for Post-Acute and Long-Term Care Medicine’s (AMDA) Annual Conference.
Healthcare -- putting prevention into practiceZafar Hasan
This slidedeck is submitted by Zafar Hasan because one of the trends in medicine for the last 20 years isa focus on prevention and this deck is an outstanding practice primer.
Transitional Care Management: Five Steps to Fewer Readmissions, Improved Qual...Health Catalyst
Reducing readmissions is an important metric for health systems, representing both quality of care across the continuum and cost management. Under the Affordable Care Act, organizations can be penalized for unreasonably high readmission rates, making initiatives to avoid re-hospitalization a quality and cost imperative. A transitional care management plan can help organizations avoid preventable readmissions by improving care through all levels in five steps:
Start discharge at the time of admission.
Ensure medication education, access, reconciliation, and adherence.
Arrange follow-up appointments.
Arrange home healthcare.
Have patients teach back the transitional care plan.
Chronic Care Management in Post-Acute/LTC SettingPYA, P.C.
PYA Principal Denise Hall and PYA Manager Lori Baker presented an educational session, “Chronic Care Management in Post-Acute/LTC Setting” to members of The Vision Group during The Society for Post-Acute and Long-Term Care Medicine’s (AMDA) Annual Conference.
Clinical practice guidelines and quality metrics often emphasize effectiveness over patient-centered care. In this article, the authors offer three approaches to personalizing quality measurement to ensure patient preferences and values guide all clinical decisions.
Safety is Personal: Partnering with Patients and Families for the Safest CareEngagingPatients
The work of NPSF"s Lucian Leape Institute's Roundtable on Consumer Engagement, "Safety Is Personal: Partnering with Patients and Families for the Safest Care" is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care.The report identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health. care.
BPS DCP SIGOPAC Good Practice Guidance in Demonstrating Quality and Outcomes ...Alex King
This report outlines a rigorous, multidimensional framework for evaluating quality and outcomes in psycho-oncology services, which can be flexibly adapted to local needs and priorities.
It aims to challenge psycho-oncology services to develop and standardise procedures that address the clinical and operational aspects of quality, while maintaining a firm focus on the experiential.
The proposed framework focuses on six key domains of service quality:
- Is this service safe?
- Is this service equitable, while also focused on those most in need?
- Is this service timely and responsive?
- Is this service respectful, collaborative and patient-centred?
- Is this service offering effective interventions?
- Is this service contributing to efficient multidisciplinary care?
To address these domains, psycho-oncology services need to draw on multiple, convergent sources of data, including key performance indicators, activity levels, patient self-report measures, feedback from professional colleagues, etc.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
Patients and their loved ones often hold critical knowledge that informs diagnosis. This toolkit from the Institute of Medicine offers patients, families and clinicians guidance on how they can collaborate to improve diagnosis.
Dr Boomla: Eligibility and Entitlement within the NHShealth4migrants
At the MRN conference "Universal Access to Healthcare in the Age of Migration" Dr Boomla looked specifically at the practical implications of proposed changes within the NHS and how this will influence access to healthcare for specific communities.
PFCC INFOGRAPHIC: Six Steps to Patient EngagementEngagingPatients
The challenges of creating patient and family-centered care seem daunting. However, the PFCC Innovation Center of UPMC demonstrates it's easier than you think. In this infographic, you see it begins by engaging patients through a simple six step process.
Over the last few decades, much has been made about the prescription medication epidemic throughout the country. It is important to remember that adults, teens and adolescents throughout the country are not merely abusing prescription medication.
Clinical practice guidelines and quality metrics often emphasize effectiveness over patient-centered care. In this article, the authors offer three approaches to personalizing quality measurement to ensure patient preferences and values guide all clinical decisions.
Safety is Personal: Partnering with Patients and Families for the Safest CareEngagingPatients
The work of NPSF"s Lucian Leape Institute's Roundtable on Consumer Engagement, "Safety Is Personal: Partnering with Patients and Families for the Safest Care" is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care.The report identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health. care.
BPS DCP SIGOPAC Good Practice Guidance in Demonstrating Quality and Outcomes ...Alex King
This report outlines a rigorous, multidimensional framework for evaluating quality and outcomes in psycho-oncology services, which can be flexibly adapted to local needs and priorities.
It aims to challenge psycho-oncology services to develop and standardise procedures that address the clinical and operational aspects of quality, while maintaining a firm focus on the experiential.
The proposed framework focuses on six key domains of service quality:
- Is this service safe?
- Is this service equitable, while also focused on those most in need?
- Is this service timely and responsive?
- Is this service respectful, collaborative and patient-centred?
- Is this service offering effective interventions?
- Is this service contributing to efficient multidisciplinary care?
To address these domains, psycho-oncology services need to draw on multiple, convergent sources of data, including key performance indicators, activity levels, patient self-report measures, feedback from professional colleagues, etc.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
Patients and their loved ones often hold critical knowledge that informs diagnosis. This toolkit from the Institute of Medicine offers patients, families and clinicians guidance on how they can collaborate to improve diagnosis.
Dr Boomla: Eligibility and Entitlement within the NHShealth4migrants
At the MRN conference "Universal Access to Healthcare in the Age of Migration" Dr Boomla looked specifically at the practical implications of proposed changes within the NHS and how this will influence access to healthcare for specific communities.
PFCC INFOGRAPHIC: Six Steps to Patient EngagementEngagingPatients
The challenges of creating patient and family-centered care seem daunting. However, the PFCC Innovation Center of UPMC demonstrates it's easier than you think. In this infographic, you see it begins by engaging patients through a simple six step process.
Over the last few decades, much has been made about the prescription medication epidemic throughout the country. It is important to remember that adults, teens and adolescents throughout the country are not merely abusing prescription medication.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that employers provide former employees and dependents who lose group health benefits with an opportunity to continue group health insurance coverage for a limited period of time. Compliance with the complex rules regarding COBRA coverage can be difficult and mistakes can be costly. Penalties for non-compliance can include IRS excise taxes and ERISA statutory fines.
This Legislative Brief provides practical information and tips for avoiding these penalties and other risks, such as lawsuits to compel coverage and adverse selection of COBRA coverage.
Patient Resource: Medicare Observation Versus Admit DaysTerri Embry RN BS
This resource provides information a patient, their advocate or a health care professional can use to learn about this topic. Hyperlinks are embedded to allow for self guided research and is encouraged.
Part of the "Fourth Annual Health Law Year in P/Review" held at Harvard Law School on January 29, 2016.
This symposium featured leading experts discussing major developments during 2015 and what to watch out for in 2016. The discussion covered hot topics in such areas as health insurance, health care systems, public health, innovation, and other issues facing clinicians and patients.
This year's Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, the New England Journal of Medicine, Health Affairs, the Hastings Center, Harvard Health Publications at Harvard Medical School, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund at Harvard University.
Visit our website for more information: http://petrieflom.law.harvard.edu/events/details/fourth-annual-health-law-year-in-p-review.
Strengthening primary care is central to employer-driven efforts to lower health spending, enhance patient experience, and improve population health outcomes. This action guide provides four concrete steps employers can take to increase receipt of high value primary care.
Keeping Up to Date With Wellness Regulations 2015benefitexpress
Learn about the latest developments in wellness programs. A review of EOCC's legal action against wellness programs will be covered and steps to avoid legal action will be discussed.
· Psychiatric Mental Health Nursing. Scope and Standards of Practi.docxoswald1horne84988
· Psychiatric Mental Health Nursing. Scope and Standards of Practice.
Review the Scope and Standards of Practice from APNA (American Psychiatric Nurses Association). If you are an APNA member you can access the book free of charge. The link in this section will link you to the book but you will have to log in. It is a good idea to join APNA. You can also buy a print copy if you desire; it is inexpensive. The book is not a required reading. I have provided the standards here.
The standards are taken directly from APNA Scope and Standards of Practice 2ndedition (2014).
Assignment for this module:
Take each Standard and give several examples of how you will follow these standards in your practice. Please, only list just a few bullet points to address each standard. Ex: Standard 1: Assessment—what screening tools will you use? Will you meet with the pt and family together or separate or both? How much time will you allow for a new patient eval?
As a NP will need to know your scope of practice. You cannot rely on someone else to know your scope.
Standard 1: Assessment
· Collect and synthesize comprehensive health data that are pertinent to the healthcare consumer’s health and/or situation.
Standard 2: Diagnosis
· Develop standard psychiatric and substance use diagnoses
Standard 3: Outcomes Identification
· Identify expected outcomes and the healthcare consumer’s goals for a plan individualized to the healthcare consumer or to the situation.
Standard 4: Planning
· Develop a plan that prescribes strategies and alternatives to assist the healthcare consumer in attainment of expected outcomes.
Standard 5: Implementation
· Implement the identified plan
· Coordinate care delivery
· Employ strategies to promote health and a safe environment
· Provide consultation to influence the identified plan, enhance the abilities of other clinicians to provide services for the healthcare consumers, and effect change.
· Use prescriptive authority, procedures, referrals, treatments and therapies in accordance with state and federal laws and regulations.
· Incorporate knowledge of pharmacological, biological, and complementary interventions with applied clinical skills to restore the healthcare consumer’s health and prevent further disability
· Provide structures and maintains a safe, therapeutic, recovery-oriented environment in collaboration with healthcare consumers, families and other healthcare clinicians.
· Use the therapeutic relationship and counseling interventions to assist healthcare consumers in their individual recovery journeys by improving and regaining their previous coping abilities, fostering mental health, and preventing mental disorder and disability
· Conducts individual, couples, group, and family psychotherapy using evidence based psychotherapeutic frameworks and the nurse-client therapeutic relationship
Standard 6: Evaluation
· Evaluate progress toward attainment of expected outcomes
Standard 7: Ethics
· Integrate ethical provisions in all .
Health Insurance & Prior authorization Requirements: Its Impact and Recommend...mosmedicalreview
Insurers use prior-authorization to ensure medical necessity. Medical peer review can be initiated when a prior authorization request or a claim is denied.
Health Reform Alert - Implementation Guidance FAQsCBIZ, Inc.
The ACA’s governing agencies (Labor, HHS and IRS) have issued their 18th set of implementation FAQs, further defining certain aspects of the Affordable Care Act, as well as how the law coordinates with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Following are highlights of this guidance.
Learn more at www.cbiz.com
Standard of Care Costs vs Study-Related CostsTrialJoin
In order for a study to be conducted properly, the sponsor and the site have to negotiate a fair and mutually agreeable budget. When we’re talking about budgeting for a study, there are many separate items and things to be considered.
One of the most intriguing points in a budget is the difference between Standard of Care costs and Research-Specific (study-related) costs. Clinical research is an area where it’s required that the sponsors disclose every dollar and every single amount which they pay to doctors they work with, and for this reason, calculating the standard of care costs is important when preparing the budget for a study.
How to Administer Wellness Programs in Today's Regulatory Environmentbenefitexpress
Are you struggling to make sense of the recent legislative updates surrounding employer sponsored wellness programs? Perhaps you are trying to decide whether to continue with current wellness plans, modify your plans without guidance from the EEOC, postpone new wellness programs or discontinue them all together.
It’s a complicated landscape ripe with several options for “next steps” for employees and plan sponsors of wellness plans in 2019 — with perhaps the biggest barrier of all being that employers cannot measure the risk of wellness plans at this time.
To help guide you through this maze of options, watch our one-hour webinar on-demand to learn what rules remain after the EEOC’s regulations were found invalid and what rules have to be met in 2019 in order to offer a valid wellness program.
How to administer wellness programs in today's regulatory environment
This webinar covers:
Requirements under HIPAA
Requirements under the Internal Revenue Code
Requirements under ERISA
Requirements under GINA
Requirements under ADA
Requirements under ACA
Standard Of Care Costs vs Study-Related CostsAnand Butani
In order for a study to be conducted properly, the sponsor and the site have to negotiate a fair and mutually agreeable budget. When we’re talking about budgeting for a study, there are many separate items and things to be considered.
One of the most intriguing points in a budget is the difference between Standard of Care costs and Research-Specific (study-related) costs. Clinical research is an area where it’s required that the sponsors disclose every dollar and every single amount which they pay to doctors they work with, and for this reason, calculating the standard of care costs is important when preparing the budget for a study.
Here, we’ll help you differentiate standard of care costs and study-related costs, so that you are able to prepare your budget in the best way possible.
Watch this expert-led webinar to learn effective tactics that high-volume hiring teams can use right now to attract top talent into their pipeline faster.
Accelerating AI Integration with Collaborative Learning - Kinga Petrovai - So...SocialHRCamp
Speaker: Kinga Petrovai
You have the new AI tools, but how can you help your team use them to their full potential? As technology is changing daily, it’s hard to learn and keep up with the latest developments. Help your team amplify their learning with a new collaborative learning approach called the Learning Hive.
This session outlines the Learning Hive approach that sets up collaborations that foster great learning without the need for L&D to produce content. The Learning Hive enables effective knowledge sharing where employees learn from each other and apply this learning to their work, all while building stronger community bonds. This approach amplifies the impact of other learning resources and fosters a culture of continuous learning within the organization.
Aashman Foundation Summer Internship .docxAmanHamza4
The internship opportunity I had with “Aasmaan Foundation” was a great chance for learning and professional development. Therefore, I consider myself a very lucky individual as I was provided with an opportunity to be a part of it. I am also grateful for having a chance to meet so many wonderful people and professionals who led me though this internship period.
I am using this opportunity to express my deepest gratitude and special thanks to “Munish Pundir” “Director “who despite being extraordinarily busy with “her/his” duties, took time out to hear, guide, and keep me on the correct path and allowing me to carry out my internship at their esteemed organization.
I further want to thank Prof. Shikha Gera, who helped me to better understand concepts of professionalism and become a better person and employee in my life.
I would also like to thank my parents and friends who helped me a lot during my life and this internship period. I perceive this opportunity as a big milestone in my career development. I will strive to use gained skills and knowledge in the best possible way, and I will continue to work on their improvement, to attain desired career objectives. Hope to continue cooperation with all of you in the future.
1. This ACA Overview is not intended to be exhaustive nor should any discussion or
opinions be construed as legal advice. Readers should contact legal counsel for
legal advice.
PREVENTIVE CARE COVERAGE
Under the ACA, non-grandfathered
group health plans:
Must cover certain preventive care
services; and
May not charge copayments,
coinsurance or deductibles for
those services when delivered by a
network provider.
ADDED GUIDELINES FOR WOMEN
Additional coverage guidelines apply
for women’s preventive care services,
such as:
Well-woman visits;
Breastfeeding support;
Domestic violence screening; and
Contraceptives.
Preventive Care Coverage Guidelines
The Affordable Care Act (ACA) requires non-grandfathered health plans
to cover certain preventive health services without imposing cost-
sharing requirements for the services. This preventive care coverage
requirement, which generally took effect for plan years beginning on or
after Sept. 23, 2010, does not apply to grandfathered health plans.
Additional preventive care guidelines for women took effect for plan
years beginning on or after Aug. 1, 2012, requiring non-grandfathered
health plans to cover women’s preventive health services without cost-
sharing. Also, special rules regarding contraceptive coverage apply to
religious employers, including churches and other religious-based
institutions, such as schools, hospitals, charities and universities.
This ACA Overview describes the preventive care coverage guidelines
that apply under the ACA.
LINKS AND RESOURCES
On July 19, 2010, the Departments of Labor (DOL), Health and
Human Services (HHS) and the Treasury (Departments) issued
interim final rules regarding coverage of preventive care services.
In August 2011, HHS issued additional preventive care guidelines
for women under the ACA.
A list of recommended preventive services is available at:
www.healthcare.gov/what-are-my-preventive-care-benefits.
Provided by Encompass HR Solutions