Discussion 1 patient teaching
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The patient's course of treatment would depend on their condition. If their condition is critical, such as cardiovascular issues, they may be admitted to the CVICU or if neurological problems, the neuro-ICU. They would remain there until stable and then possibly transferred or discharged. Public hospitals must accept all ER patients but private hospitals can redirect. If unemployed, the patient could apply for Medicaid to cover costs. Instead of paying individual providers, patients pay insurance agencies as a lump sum. Policy influences treatment decisions, as doctors may question admitting patients to more intensive and expensive ICU care unless truly needed due to reimbursement rates. Physicians also tend to be cautious about discharging to avoid penalties for readmissions within 30 days.
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H Presentation1healthcare
The document discusses various aspects of the US healthcare system. It provides an overview of different types of health insurance plans including private insurance, Medicaid, Medicare, SCHIP, TRICARE, VA plans, and IHS. It notes that while healthcare is considered a human right and everyone is eligible, many people remain uninsured due to the high cost of coverage. It also addresses options for those who lose their job, such as COBRA, and provides an example of the medical bills incurred by someone without insurance.
HEALT CARE
The document summarizes issues with the current US healthcare system including high costs, large number of uninsured, restricted access to care, and high administrative costs. It presents single-payer healthcare as an alternative that could provide universal comprehensive coverage for all Americans through tax funding, reduce costs, improve access and choice, while maintaining physician autonomy and quality of care. Medical students would have lower debt under such a system.
Week 2 systems and policy_Shalee Belnap
The document discusses healthcare policy and systems in the United States. It outlines the goals of the Affordable Care Act to expand insurance coverage and examines its impact on nursing demand. There are two main divisions of healthcare policy - private sector plans through employers or exchanges, and public plans including Medicare and Medicaid. Private plans vary in structure, while Medicare eligibility is based on age or disability and Medicaid eligibility is based on income level. The EMTALA law requires emergency treatment for all patients regardless of ability to pay.
A health insurance roadmap
A health insurance roadmap takes a look at some simple solutions to the complex issues facing health insurance, medicare, medicaid, long term care insurance, and the high cost of health expenses in retirement.
This will work because so much of this is already in place and a lot of the rest would be quick and easy to implement. As in all areas, knowledge is power. Consumers can take control of your insurance portfolio by becoming educated about insurance. Better education and understanding will lead to positive results for consumers and for the insurance industry.
6Accessing Health CareLearning ObjectivesAfter rea.docx
6
Accessing Health Care
Learning Objectives
After reading this chapter, you should be able to:
• Identify where access barriers originate.
• Examine the organizational barriers to accessing health services as experienced by
vulnerable populations.
• Explain the financial barriers to accessing health services as experienced by vulnerable
populations.
• Consider ways to improve access to health care.
• Explain the politico-social forces affecting access to health care.
Courtesy of Beerkoff/Fotolia
bur25613_06_c06_173-194.indd 173 11/26/12 2:49 PM
CHAPTER 6
Self-Check
Answer the following questions to the best of your ability.
1. Which populations face access barriers to health care in both financial and orga-
nizational forms?
a. vulnerable
b. naturalized citizens
c. employed
d. school-age children
Critical Thinking
The text states, “More physicians abandon small private practices in favor of joining large health care
conglomerates.” Do you think that these larger corporations would be more willing to accept Medicaid
patients and thus increase accessibility?
Introduction
Introduction
Though institutionalized racial segregation ended decades ago, many would argue that Americans continue to be segregated by
socioeconomic class. Economic status determines
where people live and attend school, and even
where they go to the doctor. Vulnerable popula-
tions face access barriers to health care in both
financial and organizational forms. For example,
many physicians do not accept patients on Med-
icaid, and many who do limit the number to a
certain percentage of their practices or a certain
number of appointments per week. This creates
an organizational barrier to health care access for
Medicaid recipients. At the same time, many low-
income people struggle to find the money to pay
for services that aren’t covered by Medicaid or the
co-pays on the services covered by their employ-
ers’ insurance, thereby creating a financial barrier
to access. As more physicians abandon small pri-
vate practices in favor of joining large health care
conglomerates where they can improve reim-
bursement rates and lower malpractice insurance
rates, and more people receive Medicaid or Medi-
care, reliable access for the vulnerable becomes
increasingly tenuous.
Courtesy of Sheri Armstrong/Fotolia
Though a patient may be covered by
Medicaid, many are unable to take full
advantage of that coverage because of
physician-imposed limits and restrictions.
bur25613_06_c06_173-194.indd 174 11/26/12 2:49 PM
CHAPTER 6Section 6.1 Organizational Barriers
2. Many physicians limit the number of what types of patients to a certain percentage
of their practices or to a certain number of appointments per week?
a. HIV/AIDS
b. elderly
c. those on Medicaid
d. charitable cases
3. Many low-income people struggle to find the money to pay for what services
covered by their employers’ insurance?
a. enrollment fees
b. wag ...
The ABC’s of Health Insurance
The document discusses key aspects of health insurance in the United States. It notes that 46 million Americans are uninsured and highlights the high costs of medical care without insurance. It then defines common health insurance terms like premiums, deductibles, co-pays, and provider networks. The document concludes by emphasizing the importance of having health insurance to avoid financial ruin from medical costs and access necessary care.
Current System Issues and Their ImpactsIntroductionBefore we .docx
Current System Issues and Their Impacts
Introduction
Before we can discuss change and innovation in our health care delivery system, a strong understanding of the current system is necessary, including how it functions, what types of incentives are at work, and how the different entities inside it work with and impact each other.
What Elements Drive Our Current System?
There are several key drivers of the existing system, and among these are the money, providers, payers, and consumers. When examining the behavior of any system, it is useful to look at the series of rewards and consequences that drive behavior. In health care, this means that much can be learned about the system's behavior by following the money trail. What things are reimbursed, under what circumstances, and with what outcomes? Under what circumstances are consequences, such as not getting paid, applied? In the current system, payments are highest for procedures, and proceduralists such as surgeons, gastroenterologists, and interventional cardiologists are all paid much higher fees than are family practice physicians, pediatricians, or hospitalists, all of whom manage medical care. Hospitals function under the same premise. Approximately 75% of the revenue for the average community hospital comes from surgeries, and another 12% comes from diagnostic imaging procedures. Additional amounts come from cardiac diagnostic and interventional procedures. So, approximately 90% to 95% of revenue comes from performing procedures on patients rather than providing management of diseases through medications or other noninvasive treatments. Thus, the system is focused on rewarding procedures that lead to "curing" and focused away from medical management of chronic diseases or prevention of disease and illness.
Financial Elements
Without doubt, money is one of, if not the, most powerful drivers of system functioning. For a classic example, we can look at the old fee-for-service payment methodology prevalent in the 1960s and 1970s, and contrast it with Medicare's implementation of diagnosis-related groups (DRGs) as a payment mechanism in 1983. Under fee-for-service health care, providers used whatever procedures, equipment, and supplies they felt were needed for care, and they submitted a bill that charged for each item. The payors received the bill, corrected any errors, and then issued a check for the corrected amount to the providers. If a provider wished to make a larger profit, they could provide more services or billable items to increase the payment. It comes as no great surprise to note that utilization of services and cost both rose rapidly under this methodology, since there was no incentive to be frugal. When Medicare changed its reimbursement to DRGs, the system began to experience the impact of being paid one flat fee, set by DRG, for the entire admission, regardless of how much care was rendered. For example, if a hospital provided care at a cost below the DRG payment, it was ab.
Stfm new orleans april 2011
The document discusses the growing interest in coordinated and integrated healthcare delivery through models like patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). It notes the potential benefits of these models, including improved quality of care and reduced costs. Specifically, it cites evidence that Geisinger Health System achieved a 9% reduction in total healthcare costs and lower hospital admission and readmission rates through implementing a PCMH-based accountable care model. The long-term goal is for PCMHs and ACOs to transform healthcare delivery in the US to a more coordinated, high-value system focused on primary care.
Go to Previous section To Partner or Not to Partner with a Retail Co.pdf
Go to Previous section To Partner or Not to Partner with a Retail Company Case for Chapter 5
Nancy H. Shanks University Healthcare System (UHS) has been a major player and been
successful for over 100 years in a large west coast metropolitan area. It operates an EMS system,
is a Level 1 trauma facility, is affiliated with a major medical school, has associations with
feeder hospitals around the state, maintains centers of excellence in many areas of medicine
(including cardiac, cancer, and womens and childrens care), is known for conducting cutting-
edge research, and is viewed as one of the preeminent leaders of medical care in the community,
as well as the state. That said, the UHS leadership team has begun to recognize that they may be
out of sync and that the world of health care is rapidly changing. Consumerism is becoming one
of the waves of the future. After reading several recent articles and reports about disruptive
innovation and how other large health systems around the country are beginning to work with
retailers to provide services, to connect with consumers, and to potentially channel patients to
other services within their health care systems, the UHS leadership team thinks that it may be
time to consider moving in this direction. In particular, the team recently noted that Kaiser
Permanente, one of its major competitors, had begun partnering with Target, had set up walk-in
clinics in several Target stores, and was staffing the clinics with Kaiser employees. Kaiser had
also hired a Director of Consumerism who was spear-heading its ventures into consumer directed
health care. UHS has always operated from a volume-oriented mindset, but now knows that this
too is changing. The Centers for Medicare and Medicaid Services (CMS) is moving toward a
value-based approach in reimbursing for Medicare patients. CMS does not want patients to have
surgery, be discharged quickly, sent home, and then readmitted with complications. CMS also
doesnt want to pay for a second admission and wants better quality and outcomes for patients.
That is, CMS wants patients to be sent home, have their care coordinated, not experience
complications, not have to struggle through multiple hospital stays, and not be exposed to
nosocomial infections. While the leadership always thought UHS was providing the best health
care, the institution now realizes that it has focused on providing mainly medical care in an
inpatient setting and has done little to keep people out of the hospital and to promote health and
wellness. Its time to start thinking outside the box and to change the organizational mindset.
UHS has, however, never done anything like this and really doesnt have the expertise to do it.
This is going to force the leaders to make some significant changes in many different areas and
to involve several different departments in brainstorming how to approach partnering with a
retail organization to deliver care at different sites.
Questions:
1. What are the fac.
January 31st 2012 healthcare cost reform
The US spends the highest percentage of GDP on healthcare of any developed nation yet ranks only 37th in terms of effectiveness. The primary business model for US healthcare is fee-for-service which incentivizes providers to perform more services, including unnecessary ones, in order to increase profits. Alternative models like capitation could help contain costs by providing set budgets for lifetime patient care. However, moving entirely away from fee-for-service is difficult due to resistance from both providers and patients to loss of choice and income.
Heritage Health Insurance: Eligibility, Renewal, & Benefits
In this article, we will cover the basics of heritage health insurance and Nebraska's Medicaid expansion program. Renew the heritage health insurance easily.
Saving American Healthcare and paying for it, the Rick Wagner Bill
This document proposes a plan called the Rick Wagner bill to provide universal health insurance coverage in the United States. Key aspects of the plan include providing all adults with a government subsidy to purchase a private health insurance plan of their choosing. The funds for the subsidies would come from redirecting most of what employers currently pay in health insurance premiums into a national healthcare fund. The plan aims to lower costs by reducing administrative waste and requiring small copays that can be worked off through community volunteering. The goal is to stimulate the economy while expanding access to affordable health insurance for all Americans.
Onc july atlanta 2011
Patient-centered medical home initiatives in several states have shown promising results in improving access to care, quality, and cost control for Medicaid patients. Oklahoma saw a $29 per patient annual reduction in Medicaid costs from 2008-2010 alongside increased use of preventive care. Colorado expanded Medicaid access from 20% to 96% of pediatricians at lower costs. Vermont saw 21-22% decreases in inpatient care use and costs from 2008-2010 alongside 31-36% drops in ER use and related costs. Washington state's acute care spending was 18% below average with 35% fewer inpatient stays per beneficiary. Overall, these initiatives demonstrate that the patient-centered medical home model can positively impact Medicaid programs.
Mental Health Care In Prison
- The program aims to systematically follow up with suicidal individuals who call the National Suicide Prevention Lifeline or are discharged from partner emergency departments.
- The goal is to promote continued support and monitoring of at-risk individuals after an initial crisis contact or emergency department visit.
- Grant funding will be provided to support eligible applicants who can demonstrate their ability to properly manage follow-up services for suicidal individuals.
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Chapter 5
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Chapter 6
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Discussion 1 patient teaching
- 1. + U.S. Healthcare System MSNV 603 – Systems, Policy, & Contextualization: Impact on Healthcare Kevin Lipa
- 2. + How the US healthcare system works: what could be the course of treatment for this patient if they become very ill and started their experience at the ER? The course of treatment for the patient will vary depending on the patient’s condition. If a patient is in critical condition due to cardiovascular causes they may be admitted to the CVICU or if they are having neuro-related problems they may be admitted to neuro-ICU. Here you will be admitted as a patient until you are no longer in critical condition where then you will be downgraded or placed in another room with lower acuity or possibly be discharged home or rehab depending on your needs. Publicly funded hospitals are also required to take in any patients who turn up at the ER but not privately-owned hospitals where they can be redirected.
- 3. + How would they pay for their healthcare experience? (the patient does not have a job at this time) The way the US Healthcare system works is rather than individually paying each responsible healthcare worker in your healthcare team, you will be paying a lump sum to an insurance agency instead. So for example, instead of paying each doctor, nurse, or the hospital or their services you will instead pay through an insurance such as Medicaid (Mason, 2016, p 170). If a patient has no job at this time they can easily apply for Medicaid and depending if it is a public hospital, public funds can pay for the patient at the time being.
- 4. + How does policy influence this process and the patient’s financial responsibility? A doctor admitting a patient into the hospital may question his decision whether a patient is sick enough to be admitted to the ICU or IMC or maybe just for observation; and this is due to the fact that there are different reimbursement rates for each. If a patient is admitted to the ICU without having the need to be admitted for intensive care, he may pay for what is unnecessarily needed. Patients may also stay longer in the hospital if the physician has doubts of discharging a patient. That is because physicians or hospitals may not be reimbursed for readmissions less than 30 days. So physicians are typically more cautious than not.
- 5. + References Mason, D. J., Gardner, D. B., Outlaw, F. H., O’Grady, E. T. (2016). Policy & Politics in Nursing and Health Care. (7th ed.). St. Louis, MO. Longworth, M. D. (2015, July 17). Healthcare Reform: 4 Changes That Affect Patients. Retrieved October 31, 2017, from https://health.clevelandclinic.org/2013/09/healthcare- reform-4-changes-that-affect-patients/