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Healthcare Access Term Paper

… Without access to healthcare people can suffer from anxiety, depression, sickness, and stress, and other symptoms that affect not only individuals, but families and communities of that individual as well (ProCon, 2014). Many of the conditions that afflict people are… [read more]


Why Is Healthcare in Germany so Much Better Than in the US? Essay

… Standard prices for medical services are negotiated ahead of time (cutting administrative costs to 6%, "a quarter of what they are in the U.S."), and healthcare providers must stick to those prices.

In the UK, just 2 or 3% of citizens skip doctor's visits when ill but in the U.S. "…a full 25%…didn't visit the doctor when sick because we couldn't afford it…and 23% did not fill a prescription…" or show up at a follow up treatment recommended by a doctor (Klein, 2007). And although Americans pay "more than twice as much as anyone else, we have the lowest satisfaction with our healthcare system," according to Klein, a Washington Post reporter.

In conclusion, the latest data on the Affordable Care Act shows that over 5 million Americans have signed up for health insurance through the market set up by the legislation, and notwithstanding snags in the system as it went into effect, the "Obamacare" law is delivering much of what it promised to deliver (you can't be denied coverage because of existing conditions, etc.). But meanwhile, the polarized situation between Democrats and Republicans in Congress gets more attention than the healthcare issues. The House of Representatives, led by conservative Republicans, has voted 50 times to either de-fund the Affordable Care Act, or drastically change its components.

In conclusion, in Germany everyone is covered completely when it comes to health care and to receive that care they pay according to their ability into an insurance policy. The one downside is that doctors and other healthcare providers in Germany do not feel adequately compensated. In the U.S., the Republicans (and conservative talk show hosts) mercilessly, viciously attack the Affordable Care Act with misinformation and vitriol. Politics has actually made healthcare a more difficult system to develop in the U.S. As it is obvious every proposal from the Obama Administration is met with immediate push-back by Republicans. Right now people in Europe are likely astounded at the lack of civility in the American government and no doubt are incredulous at the way Americans go about reforming a broken system.

Works Cited

Frontline. "Sick Around the World." Public Broadcast System. Retrieved March 27, 2014, from http://www.pbs.org. 2007.

Klein, Ezra. "Ten Reasons Why American Health Care Is so Bad."…… [read more]


Quality Indicator Healthcare Quality Indicators Essay

… For many hospitals, a key step to be taken is the improvement of staffing conditions. A great many hospitals and nursing homes struggle with staff shortages, especially in the area of registered nurses. The direct correlation between adequate staffing and positive healthcare outcomes is especially relevant to a discussion on the readmissions indicator. Here, we project that more adequate nurse to patient ratios would have a positive impact on reducing preventable readmissions.

Specifically, on focus of prevention of readmissions is taking the steps leading up to discharge to ensure that the patient has been provided with a proper and effective treatment plan. Part and parcel to this is providing the patient with a clear understanding of the nature of his or her condition, with comprehensive instructions on taking medication and with a clear set of referrals for follow-up treatment, appointments or self-care steps. This means that in addition to staffing the facility adequately, it will be incumbent upon us to provide comprehensive training and resources so that our nurses can execute these important functions.

Another strategy that will be put into place is informed in the text by Johnson. This outlines a program which has proven successful in the Jersey City Medical Center in New Jersey. Under the terms of the Affordable Care Act, the Center has worked to reduce readmissions by heightening its focus on taking follow-up action for patients who have been discharged. This includes offering home visitations and follow-up phone calls from paramedics and nurses. The primary goal is to ensure that patients who have been released from the hospital have everything they need to execute their personal health plan and that they fully understand the instructions for post-hospitalization treatment. (Johnson, p. 1)

Finally, it will be important to create a working environment in which a patient-centered philosophy of treatment is sought. Here, the focus on the patient as an individual with individual needs, rather than as a collection of symptoms, offers a path to treatment with attentiveness and compassion. This too will reduce the likelihood of a patient being readmitted.

Conclusion:

Though the Affordable Care Act is seen by many as controversial, the pressure that it creates to reduce preventable readmissions is likely to produce positive results. By drawing a direct connection between financial imperatives and this quality indicator, the legislation demands that hospitals work toward making performance improvements.

Works Cited:

Brink, S. (2013). Hospitals Seek to Avoid Penalties by Minimizing Readmissions. U.S. News and World Report.

Johnson, M. (2013). For Hospitals, Obamacare Rollout Makes Readmission Penalties a Top-of-Mind…… [read more]


Objective Term Paper

… " (Christensen, 2013, p. 1) However, as noted by Christensen not everyone purchasing insurance through the exchanges will be on the receiving end of a government subsidy. The result reported is that "people will be forced to see the doctors who agreed to the treat people for a low price rather than their favorite doctor or a specialist across town. The New York Times article freely quotes from consumer advocates who are outraged that these subsidized insurance plans will not be as generous in the choice of providers as those policies purchased in the private market." (Christensen, 2013, p. 1) Ritger states that the determination of whether the "quality of care in the new market is comparable to private offerings remains to be seen." (p. 1)

Summary and Conclusion

Obamacare has both pros and cons to consider although it is yet to be seen whether the positive aspects of Obamacare can offset the negative aspects of this health care reform plan set out by the present administration in Washington. Conflicting reports exist and it is difficult to ascertain in the present what the exact impact the plan will have on the costs associated with insurance for families, employers, insurance companies and the government although it appears that the taxpayers will bear the largest burden for the costs associated with the health care reform plan.

There is also certainly going to be problems associated with the quality of care received in health care services especially in light of the fact that so many more individuals will be accessing health care services at a time when there is already a shortage of doctors and the news demands for healthcare will further stress an already stressed health care provider system.

The costs of insurance are predicted to rise for both families and individuals as well as costs of insurance rising for employers. In addition, the cut-off points for subsidies are so abrupt that even a small raise in pay could result in a family losing their health care subsidy. There are many quirks to be worked out in the health care reform laws of Obamacare and it is likely that many more problems with the plan are yet to be identified.

Works Cited

Christensen, J (2013) Doctor Shortage, Increased Demand Could Crash Health Care System. 2 Oct 2013. Retrieved from: http://www.cnn.com/2013/10/02/health/obamacare-doctor-shortage/index.html

Dorfman, J.(2013)On October 1 Obamacare's Price Tag Will Surprise Americans. Forbes. 26 Sept 2013. Retrieved from: http://www.forbes.com/sites/jeffreydorfman/2013/09/26/on-october-1-obamacares-price-tag-will-surprise-americans/

Mandatory…… [read more]


Social, Cultural, and Political Influence Research Paper

… S. (Crinson, 2009).

An alternate factor in the health care access issue is recognized in instances of urban poor. Information from urban slums shows that newborn and under-five death rates for the poorest forty percent of the urban populace are… [read more]


Healthcare Leadership and Prejudices Article

… HEALTHCARE LEADERSHIP & PREJUDICES

Healthcare Leadership Prejudices

Healthcare leadership has become a more and more important topic over the recent years and decades, and for a number of major reasons. There are unfortunately a number of prejudices that exist even… [read more]


Health Reform Health Care in a Free Essay

… Health Reform

Health Care in a Free Market System

Who influences whom? Where is the U.S. going with "reform"? What would you recommend?

For many decades, the primary influences driving the U.S. healthcare system have been private interests such as insurance companies, commercial healthcare systems and medical supply distributors. Their financial imperatives have driven priorities, which has resulted in a system that is highly profitable to a select few and otherwise excluding of countless Americans. Indeed, the thrust of 'reform' is the redressing of this exclusion through a greater distribution of coverage. The Affordable Care Act pushes for the creation of coverage for a wider cross-section of Americans. However, I would recommend the beginning of a push for universal healthcare coverage through Medicare, Medicaid and a coordination of private insurance programs. Until the cost of healthcare is not an obstacle to the receipt of quality treatment for tens of millions of Americans, the system will be deeply flawed.

- Health Planning and Regulation

Is Government a help or a hindrance in health systems? Be sure to read the Pauly article about Maryland's system of health regulation...

In spite of the objections of some partisan forces to the involvement of government in the regulation of healthcare, the role of government is refining the healthcare system is absolutely critical. The greatest hindrance to achieving a system of quality healthcare in the U.S. has been the role played by wildly unregulated private players. The government has taken decidedly too small a role in regulating the affairs of insurances and providers over the last several decades and the result has been a profit-hungry, exploitive and radically wasteful healthcare system. Because there has been an absence of regulation in the area of…… [read more]


Ethical and Legal Perspectives in Health Care Essay

… Ethical and Legal Perspectives in Health Care

False Claims Act (FCA) was enacted during the Civil War to arrest frequent fraud against the United States government. An individual or a corporation that knowingly presents, or causes to be presented, a false claim of payment to the Federal Government can be prosecuted under this Act (WilmerHale, 2013). The FCA has a very broad scope. It is therefore imperative for any company doing business with the government to be very vigilant to guard against liabilities that come in the context of damages and penalties. A company is deemed to have violated FCA when it knowingly and materially misrepresents the nature of good or service that it provides to the government (WilmerHale, 2013). Misrepresentation can be in form of contractual language or other communications that leads to a government payment. A company can be prosecuted using this Act when it conspires to present a false claim to the government or causing a third party to submit a false claim. Companies can also incur reverse false claim liability when they improperly conceal, avoid, or decrease an obligation to pay the government. The origin of an FCA case is two-pronged. First, the United States itself can originate a case. Second, an FCA case can be filed through a private litigant who brings action on behalf of the United States government under the qui tam provision (WilmerHale, 2013). Private litigants are also called relators. A relator can receive 15 and 30% of any judgment or settlement in the government's favor (Sturycz, 2009). A suit originated by a relator remains under seal while the Department of Justice (DOJ) investigates the claim. The United States Department of Health and Human Services (HHS) in its resolve to implement Patient Protection and Affordable Care Act (PPACA), under the Center for Medicare and Medicaid Service came up with a regulation that required that all overpayments be reported and returned within sixty days of recovery, or by the date a cost report is due, if that date is later. Under PPACA, a person retaining an overpayment past this deadline faces FCA liability.

Student 2

Some of the latest developments in federal settlements, judgments, and complaints filed in the health care realms involve GlaxoSmithKline LLC. GlaxoSmithKline LLC agreed to pay $3 billion to resolve criminal and civil allegations that the company had unlawfully promoted certain prescription drugs, failed to report certain safety data to the FDA, and engaged in false price reporting practices in violation of the FCA (WilmerHale, 2013). GSK is alleged to have engaged in off-label promotion of certain drugs and payment of kick-backs to health care providers. GSK entered into a corporate integrity agreement (CIA) with the HHS OIG. Under this agreement GSK executives had to forfeit up to three years of annual performance pay if found to be involved in significant misconduct or aware of unreported employee violations. Another healthcare settlement involved Abbot Laboratories Inc. Abbot reached a $1.5 billion criminal and civil settlement with the federal government, 45… [read more]


Minorities in Healthcare Services Essay

… Minorities and Healthcare

Healthcare is not the same for everyone here in the United States. Many minority groups, like Hispanic or Latin American individuals have greater trouble accessing quality healthcare, primarily because of the high costs of insurance today. As a result, the quality of the care they receive suffers dramatically. Still, all Americans pay for healthcare to one extent or another. If they are not paying private insurance companies, they are helping support funding of government sponsored healthcare programs, like Medicare and Medicaid; thus, tax payer funds help support the meager public programs that currently exist in healthcare today.

Mexican-Americans, Hispanics, and Latinos often find themselves in situations where they may be receiving poorer quality healthcare compared to white individuals. According to the research, "racial and ethnic minorities are more likely than non-Hispanic whites to be poor or near poor" (Agency for Healthcare Research and Quality, 2010). As such, they often are forced to deal with sub-quality healthcare. Often times, Hispanic minorities are often the largest group of uninsured individuals within a number of communities around the United States. Therefore, "Hispanics under the age of 65 were less likely than non-Hispanic whites to have health insurance (66.7% compared with 87.5%)." (Agency for Healthcare Research and Quality, 2010). As a result, the quality of the care many receive suffers dramatically. When not able to access more expensive facilities, many have to accept sub-par healthcare treatment from urgent care centers that take cash. Here, the research suggests that "Hispanics received worse care than non-Hispanic whites for about 60% of core measures" (Agency for Healthcare Research and Quality, 2010). Many within Hispanic groups here in the United States have trouble accessing quality care, partly because of the high costs of healthcare here in the United States. Healthcare must be made more affordable, especially for those who need it most.…… [read more]


American Health Care After Leading Term Paper

… Meanwhile, Democrats have been more concerned with reducing the influence of the private health care sector. Instead of outright intervention, all the government would have to do to promote meaningful health care reform would be to pursue the private option and eliminate the lobbying process that perpetuates fundamental conflicts of interest in Washington. At the operational level, the fee-for-services model of health care compensation has been proven to increase the cost of national health care while simultaneously providing lower quality of care than results-based compensation in health care (Tumulty, Pickert, & Park, 2010).

As many analysts have pointed out, the model of health care in the U.S. In which eligibility for affordable health care services is dictated more by employment status than by anything else is fundamentally flawed (Reid, 2009). At the same time, the substantially unregulated aspect of the private health insurance industry promotes continual cost increases, especially when combined with government programs that reimburse health care providers for services rendered to program beneficiaries.

A realistic approach to meaningful and comprehensive health care reform in the U.S. would require adopting the positions famously advanced by former Democratic congressman Anthony Weiner and Independent Senator Bernie Sanders throughout 2009 to establish a public option and reject the largely Republican position that health care reform focus primarily on Medicare reform. More broadly, the entire concept of political lobbying must be reevaluated as a matter of public policy. When matched with a shift to a results-based reimbursement model, those three elements should make significant improvements in American health care.

References

Dykman J. (2008). "Five truths about health care in America." Time, 172(22): 42-51.

Kennedy E. (2006). America: Back on Track. New York: Viking.

Reid T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin.

Tumulty K., Pickert K., and Park A. (2010). "America,…… [read more]


Illinois Health Care Initiatives Reform Essay

… Illinois Health Reform

Healthcare Reform Initiatives in Illinois

The federal Affordable Care Act had and continues to have many ramifications for state health insurance regulations and healthcare delivery systems, and several concurrent and/or attendant state initiatives have also reformed healthcare in the individual states. In Illinois, the Affordable Care Act had near-immediate effects on healthcare reform and sparked several state initiatives for healthcare reform, and other healthcare and budgetary concerns in the state were responsible for further or concurrent initiatives. The following paragraphs briefly outline some of the most recent healthcare reform initiatives seen in Illinois.

Along with all other states, Illinois gained the authority to regulate health insurance premium increases following the signing of the Affordable Care Act into law, including the ability to deny proposed rate changes that the state deems are inappropriate for private insurance companies to levy (Graham, 2010). The Illinois Comprehensive Health Insurance Program or ICHIP will also be significantly changed, with cost burdens shifted from enrolled member premiums (which ranged from $12,000 to $16,000-year per person) to a greater reliance on general revenue, cutting most premiums in half or more (Graham, 2010). Perhaps most significantly, Illinois' national record-holding rescission rate was markedly reduced due to the Affordable Healthcare Act's ban on rescissions that occurred for any reason other than fraud (Graham, 2010). With insurance companies less able to drop people found to have a prior reason that would have allowed denial of insurance or a higher rate of insurance premiums, more people would remain covered through their private policies and burdens on taxpayers and on the state would be significantly reduced (Graham, 2010).

Also in response to the Affordable Care Act but showing more initiative and more comprehensive…… [read more]


Healthcare Reform Initiatives in California Term Paper

… The point of programs like this isn't just to use state and federal money to help those who can't help themselves vis-a-vis health care coverage; it is to "…decrease the hospital emergency room use," according to the California Healthline (November 5, 2012). The LIHP program is only available to people without children whose income is less than $7,500, the California Healthline explains. Interestingly, when presidential candidate Mitt Romney spoke about why he would like to remove the Affordable Care Act from federal law, he said there is a healthcare service that is available to everyone everywhere -- the emergency room.

Other recent health reform initiatives signed into law in California include: a) AB 1453 (protects consumers from "junk insurance" and requires insurers to offer "minimum health benefits"; b) AB 1083 (small businesses "…don't get additional premium spikes based on the health of their workforce"); c) AB 1761 (no entity or individual may falsely represent themselves as "the California Health Benefits Exchange"); d) SB 1410 (allows consumers to appeal the denial of benefits and addresses "health equity issues" such as a person's ethnicity and language); e) AB 1580 (streamlines the enrollment process for Medi-Cal); f) AB 1526 (prevents insurers from denying benefits based on pre-existing conditions); g) AB 1869 (requires programs like Medicare and Medi-Cal to "coordinate with veterans programs" (Health Access, 2012).

In conclusion, California has always been a progressive state when it comes to consumer issues. This paper illustrates how the state has created programs that fill in the gaps until the Affordable Care Act is fully implemented in 2014. Californians who are in the low-income group are no different in terms of their healthcare needs, and the state's leaders have worked to see to it that they are given opportunities to achieve healthy lives.

Works Cited

California Healthline. (2012). LIHP in Sacramento County to Cover Only Poorest Residents.

Retrieved November 6, 2012, from http://www.californiahealthline.org.

Colliver, Victoria. (2012). California is most prepared for health care law. San…… [read more]


Healthcare Reform List Research Paper

… This has been one of the most contentious aspects of the ACA. However, despite people's complaints about the government 'forcing' them to buy health insurance, there are many exceptions to the rule and someone 'determined' not to be covered might very well find an applicable exception. Employers will also be subject to more stringent requirements to offer coverage to employees. The ACA will further expand healthcare coverage to the poor by expanding "Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133%" (Summary of new healthcare reform law, 2012, Kaiser Permanente). These methods of expansion are different than the Annals rather vague emphasis on using taxes to fund expanded, subsidized healthcare insurance.

The ACA will also "create state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges, administered by a governmental agency or non-profit organization, through which individuals and small businesses with up to 100 employees can purchase qualified coverage" (Summary of new healthcare reform law, 2012, Kaiser Permanente). Also commensurate with the Annals demand for objective determinants of treatment quality, the ACA will establish "a non-profit Patient-Centered Outcomes Research Institute to identify research priorities and conduct research that compares the clinical effectiveness of medical treatments" (Summary of new healthcare reform law, 2012, Kaiser Permanente). Thus, in terms of expanding coverage to the uninsured, creating highly regulated but competitive exchanges where individuals can buy insurance, and creating objective quality review boards, the ACA seems to reflect many suggestions from healthcare experts.

References

Arrow, Kenneth. (et al. 2009). Towards a 21st century healthcare system. The Annals of Internal

Medicine. 150 (7): 493-495. Retrieved: http://annals.org/article.aspx?articleid=744430

Summary of new healthcare reform law. (2012). Kaiser…… [read more]


Healthcare Policy Issues Research Paper

… Healthcare Policy

Hospital policy issues related to access to care:

Administrator. From the administrator's point-of-view, access to care represents an ethical dilemma. Ideally, all patients would have equal access to care, but the hospital cannot afford to finance care for all. Thus, there needs to be a balance between providing care for those who have insurance coverage, and finding ways to provide the means for those without coverage to pay as well. The administrator therefore must balance the standard of care, the availability of care and the finances of the institution.

Patient. The patient is oriented towards receiving the care that he/she needs. Cost of care is not relevant to the patient, who only wants to get better. This becomes an issue when the patient cannot afford the care he/she needs.

Physician. The physician is guided by the Hippocratic Oath to provide the medical assistance that all patients need. The ability to deliver the highest standard of care is the greatest concern. The physician therefore is oriented towards the highest availability of care.

The politician is oriented towards his/her constituency's needs. In the United States, this varies by party platform. Some politicians therefore are oriented towards the provision of health care, while others are oriented towards the budget aspects of the health care industry. At present, the politician's views of Medicare, Medicaid and the Affordable Care Act can vary strongly by political affiliation but there are few politicians without a plan or an opinion on the availability of health care.

Tax payers must balance the desire for health coverage with the cost of that coverage. As with politicians, views on this issue vary dramatically, ranging from a view to minimize taxes to a view to maximizing care availability in the society.

Board members are oriented towards the mission of the institution. In some cases, the mission is to maximize profit. This can be done by optimizing other outcomes, such as patient outcomes, quality of care or other aspects that can give the business a competitive advantage. Board members are a diverse group, however, and some may not put the financial perspective first, and instead would choose to broaden care.

Staff members are oriented towards a high level of health care, and that also means maximizing the availability of health care.

The cost of care within the system:

The hospital administrator wants to balance the cost of care provision with the revenues generated by that care. The administrator also wants to ensure a high quality of care, but again cost is important.

For the patient, cost is not necessarily important, unless it becomes a barrier to care. Patients whose care is not prescribed by an insurance plan may prefer to receive a number of different options at different price points. Depending on the patient and the ailment, cost could be no issue, or cost could be a major deciding factor in the patient's views on care.

The physician is not typically oriented towards cost, as this is subordinated to medical decisions.… [read more]


Healthcare Industry Term Paper

… "ObamaCare's Secret History." Wall Street Journal. 11 June 2012. Web. http://online.wsj.com/article/SB10001424052702303830204577446470015843822.html?KEYWORDS=healthcare+merger

Examines the alleged collusion that took place under the auspices of pursuing a cost containment strategy within the Affordable Care Act. Article details the secret, quid pro quo interactions and agreements between the White House, Congress, and Big Pharma that eventually led to the creation and passage of the Affordable Care Act. Highlights the interconnectedness of policy decisions and big business.

"For Hospital CIOs, Mergers Complicate Move to Electronic Records." Wall Street Journal. 13 June 2012. Web. http://blogs.wsj.com/cio/2012/06/13/for-hospital-cios-mergers-complicate-move-to-electronic-records/?KEYWORDS=healthcare+merger

Details the challenges facing hospitals moving from paper to electronic health records. This move to electronic medical records, justified on the grounds of improved efficiency, is complicated by the escalation of merger activity, in itself a cost containment measure. These competing cost containment approaches are not always complementary.

Works Cited

Keckley, Paul. "Health Reform Memo- June 11, 2012." Wall Street Journal. 11 June 2012. Web. http://deloitte.wsj.com/cfo/2012/06/11/health-reform-memo-june-11-2012/?KEYWORDS=health+cost+containment

Matthews, Anna Wilde. "Hospitals Consider Merger." Wall Street Journal. 7 June 2012. Web. http://online.wsj.com/article/SB10001424052702303753904577451252116466554.html?KEYWORDS=healthcare+merger

Matthews, Anna Wilde. "WellPoint to Buy 1-800 Contacts." Wall Street Journal. 4 June 2012. Web. http://online.wsj.com/article/SB10001424052702303918204577444953508462104.html?KEYWORDS=healthcare+acquisition

"ObamaCare's Secret History." Wall Street Journal. 11 June 2012. Web. http://online.wsj.com/article/SB10001424052702303830204577446470015843822.html?KEYWORDS=healthcare+merger

Schectman, Joel. "For Hospital CIOs, Mergers Complicate Move to Electronic Records." Wall Street Journal. 13 June 2012. Web. http://blogs.wsj.com/cio/2012/06/13/for-hospital-cios-mergers-complicate-move-to-electronic-records/?KEYWORDS=healthcare+merger… [read more]


Health Care Politics and Policy Term Paper

… ¶ … categories of health policy.

Health policies are a form of the broader field of public policy. What constitutes public policy is difficult to define but it is generally assumed to include any activity by government that affects the… [read more]


Pennsylvania Health Care Term Paper

… The basic role of the organization is to:

Identify opportunities for Pennsylvanians to use HIT and HIE to improve healthcare.

Educate the public providers and policy makers regarding the benefits and challenges of HIT and HIE.

Coordinate the efforts of all Pennsylvania HIT and stakeholders.

Identify opportunities to coordinate with and benefit from federal initiatives.

Develop statewide consensus on established and emerging standards (e.g., data, communication and reporting).

Work with providers, payers, policy makers to define business cases for HIT and HIE (Pennsylvania eHealth Initiative, 2011).

House Bill 2053, Session 2009 -- Freedom of Choice in Health Care Act to provide the rights of individuals to purchase private health care insurance and prohibit certain Federal government action. Designed to make it easier and more cost effective for individuals or employers to pay directly for lawful health care services without penalties or taxes (House Bill 2053, 2009)..

Pittsburg Regional Health Initiative -- Frontline health care initiative in place over last decade to provide patient outcomes, reduce costs, and increase satisfaction. Use of technology and systems to provide excellent care at lower cost. In Pittsburg regional area only at present (PRHI, 2012).

Pennsylvania Health Care Quality Alliance -- Nonprofit coalition of Pennsylvania health care providers and issuers. Designed to improve quality of patient health by developing a consistent, uniform, statewide approach to quality measurement that will:

Enable consumers to find high quality care

Allow health care professionals to evaluate and improve the quality of patient care

Help insurers evaluate the performance of their provider networks (Pennsylvania Health Care Quality Alliance, 2012).

REFERENCES

House Bill 2053.(2009). General Assembly of Pennsylvania. 2829. Retrieved from:

http://www.legis.state.pa.us/CFDOCS/Legis/PN/Public/btCheck.cfm?txtType=HTM&sessYr=2009&sessInd=0&billBody=H&billTyp=B&billNbr=2053&pn=2829

Pennsylvania. (2012). Commonwealth of Pennsylvania. Retrieved from:

http://pa.gov/portal/server.pt/community/pa_gov/20387

Pennsylvania EHealth Initiative. (2011). Retrieved from: http://www.paehi.org/about-paehi/

Pennsylvania Health Care Quality Alliance.(2012). Retrieved from: http://www.phcqa.org/

Pittsburg Regional Health Initiative. (2012). Retrieved from: http://www.prhi.org/

The State of Healthcare in Pennsylvania. (2007). Pennsylvania Health Care Cost

Containment Council. Retrieved from: http://www.phc4.org/reports/sos/07/docs/sos2007report.pdf… [read more]


Health Care Politics and Policy Term Paper

… Ron Paul on Healthcare Quality:

A summary of Ron Paul's beliefs is that the Health Maintenance Organizations have a negative impact on the quality of healthcare services due to the limitations on the available options to patients. I agree with these beliefs because these organizations have primarily increased premiums on healthcare coverage, increased medical costs, and hindered patient access. As one of the major ways for providing managed care, health maintenance organizations are theoretically expected to lower healthcare costs by providing the care providers with rewards to keep the patients healthy.

However, the HMOs have developed as ineffective systems that have negative impact on the quality of healthcare since they facilitate a closed provider network because their approach to cost-containment is problematic. The ineffectiveness of these systems and their negative effect on healthcare quality is evident in the fact that patients have started to revolt against them despite of the popularity in the 1980s and 1990s. Moreover, several concerns have been raised about the ability of the systems as patients have questioned physicians' and insurance companies' motives when denied care services.

In agreement with the views of this politician, the Health Maintenance Organizations were not developed due to free-market demand but because of government monopolies or mandates. As a government mandate, the system has failed to deliver the theoretical benefits and resulted in unexpected consequences (Paul, 2006). Similar to other government intervention mechanisms in the private market, the HMOs have contributed to spiraling medical costs and poor quality of care. Therefore, an outright socialized medicine system or free market health care system could be the most suitable method of reducing health care costs and enhancing quality because every stakeholder in the field is actively involved.

Newt Gingrich Views on Healthcare:

As an individual who is committed to a better health care system for all Americans, Newt Gingrich has been involved in various initiatives that are geared towards improving…… [read more]


Health Care Focus Any American Essay

… As seen in Kansas, as the health care system is such a large part of the statewide economy, allowing for thousands of workers to remain employed to handle the steady stream of business that is funneled in and out of the many health care facilities throughout the state, profits are easy to come by. In allowing the states to act in their own best interest with less regulation and government intervention, could the national economy flourish? Such a question may be answered sooner rather than later with upcoming elections and a growing wish for the nation's health care system to be modified.

Works Cited

Twiddy, David. 2012 March 1. "Health Care Generates $10.2B Payroll in Kansas."

Kansas City Business Journal. Web. Retrieved from: http://www.bizjournals.com/kansascity/news/2012/03/01/health-care-generates-102b-payroll.html?ana=e_vert [Accessed on 6 March 2012].

Health care generates $10.2B payroll in Kansas

Kansas City Business Journal by David Twiddy, Reporter

Date: Thursday, March 1, 2012, 5:23pm CST

Health care remains one of the biggest industries in Kansas, generating a $10.2 billion payroll in 2011 and employing more than 11% of the state's job holders, according to a new report.

Of that total, hospitals are the largest contributors with close to 74,000 jobs and $4.2 billion in direct labor spending.

The Kansas Hospital Association on Thursday released the results of an annual study done in collaboration with Kansas State University Kansas State UniversityLatest from The Business JournalsReport: NBAF changes dramatically decrease risks http://www.bizjournals.com/wichita/print-edition/2012/03/02/andover-stakeholders-collaborate-to.html

http://www.bizjournals.com/wichita/morning_call/2012/02/kansas-leaders-consider-alternative.html Kansas leaders consider alternative funding sources for NBAF labFollow this company that looks at how health care contributes to the state economy.

The report found that all health-sector businesses, encompassing those such as medical labs, veterinarian services and fitness centers, employed a total of 212,252 people in 2011, up from 184,483 the year before.

Total payroll in the sector rose 20% from 2010 with the only area seeing a decline being fitness and recreation centers, which fell from $85 million to $60 million in direct labor income.

Health care operations also were estimated to generate almost $4.7 billion in retail sales in their communities and $295 million in sales taxes.

Last year, hospitals saw their collective labor force swell by 18% to 73,890 and their payroll grow by 30%.

"Hospitals and health services truly represent an economic anchor in our state," association CEO Tom Bell said in a release.

Link: http://www.bizjournals.com/kansascity/news/2012/03/01/health-care-generates-102b-payroll.html?ana=e_vert… [read more]


Health Care Reform Recommendations Healthcare Term Paper

… Finally, the American College of Physicians' third recommendation was actually made in concert with a number of other professional medical organizations and called the "Patient-Centered Medical Home Model." Specifically, "a medical home is defined as a primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective." (Calvo, 2008, p. 10) Medical Homes, called "Accountable Care Organizations" in the new ObamaCare Law, will manage sick patients in a comprehensive fashion, complete with an ethics panel to avoid unnecessary and costly surgical procedures, as well as the ability to decide if plan managers have provided inadequate, or poor care to their patients. Finally, "if it is effective at saving money for a given patient/disease state, it will receive bonuses from Uncle Sam; if not, it will get less money" (Dorin, 2012) Not only does ObamaCare seem to implement the recommendation, it is doing so in an effective and economically logical manner.

The American College of Physicians made a number of recommendations for reforms to the nation's healthcare system, three of which have been specifically incorporated into the "Patient Protection and Affordable Care Act." These recommendations were to increase access for more people to more Primary Care Physicians, reform the payment system for Primary Care Physicians, and to implement the Home Medical Model. These three recommendations are part of the new health care law and are currently being implemented in the real world. Once these benefits are recognized by the majority of the American people, they will see that the new health care law is beneficial to all Americans and will help to preserve the finest health care system in the world.

References

"ACP Issues Recommendations for Healthcare Reform." (3 Feb. 2009). Medscape Today

News. Retrieved from http://www.medscape.com/viewarticle/587754

Health Home: Using the Expanded Care Model of the Collaboratives." The

Disparity Reducing Advances Project. Retrieved from http://www.altfutures.org/draproject/pdfs/Report_08_05_ComprehensiveHealthHome_UsingExpandedCareModelCollaboratives.pdf

Dorin, Adam, M.D. (15 Jan., 2012). "ObamaCare: Healthcare's 'New World Order'."

The Washington Times. Retrieved from http://communities.washingtontimes.com/neighborhood/medicine-and-politics-america/2012/jan/15/obamacare-healthcares-new-world-order/

Gould, Brian, M.D.. (24 July, 2009). "Why Doctors Don't Fear ObamaCare." Real Clear

Markets. Retrieved from http://www.realclearmarkets.com/articles/2009/07/24/why_doctors_dont_fear_obamacare_97326.html

Nash, David, M.D.. (n, d.). Medicaid Physician Payment Rates Hurts Primary Care

Doctors." KevinMD.com. Retrieved from http://www.kevinmd.com/blog/2010/04/medicaid-physician-payment-rates-hurts-primary-care-doctors.html… [read more]


U.S. Health Care System 2010 Term Paper

… 9 million uninsured in 2010 (U.S. Census Bureau.gov. 2010. P. 27), leaves "one third of U.S. adults without recommended care, and one fifth of U.S. adults having major problems paying medical bills" (Schoen, C. Osborn, R. Squires, D. Doty, M. Pierson, R. & Applebaum, S.P. 2). A point that does resonate however is that income is the ultimate "Mendoza Line" for individuals receiving health services. "The uninsured rate was higher among people with lower incomes and lower among people with higher incomes" (U.S. Census Bureau.gov. 2010. P. 27). As a result the proclivity for individuals without insurance coverage is to ignore the necessary care, mainly preventative, which could dramatically impact the long run cost curve downward on health service affordability.

Access and Cost

The Affordable Care Act expands the pool of the insured through private sector exchanges, tax credit enhancements, and greater access to Medicaid. Affordable coverage under either a private health plan, or Medicare and Medicaid allows individuals to utilize the services requisite for long-term health. A legitimate question however, is whether expansion of coverage will in fact explode costs even beyond their already significant upward trajectory? With coverage expansion there will be greater demand pressure on providers, yet this should also drive competitive rigor, allowing for cost containment across the system. As such the Commonwealth Fund, a private health reform organization, estimates that "expenditures for the whole health care system will be reduced by nearly 600 billion in the first decade" (Orszag, P. & Emanuel, E. August 12, 2010. P. 2). The bending of the cost curve downward though requires that the delivery system change concomitantly; with focus on coordinated care across "three 'I' platforms: information, infrastructure,… [read more]


Health Care Reform in the US Term Paper

… U.S. Healthcare Reform

Since the inception of Social Security spearheaded by Franklin D. Roosevelt in 1935, Democrats had desired to include some government health insurance plan for those who could not afford coverage (New York Times, 2011). Historically, insurance companies were notorious for creating barriers for insures who had pre-existing conditions or for the insured who became sick during the coverage term. Such disparities continue to divide the U.S. On monumental proportions between the haves and the have-nots. Subsequently, the issue contains both social and economical underpinnings that have created a gap: 1) people who do not have insurance; 2) costs imposed on employers and insurance companies. Bridging the gap has been addressed by several presidential administrations; however, much momentum was not gained until the Obama administration.

Issue Defined

Undoubtedly, insurance companies make money. In fact, during the recession, the industry was unscathed by societal economic conditions, while all other industries were immensely affected, thus needing government bailouts. Hence, the issue stems from simply financial greed, which required federal government intervention. People need and opponents do not want to pay. Dissension between the Democrats and Republicans continue, as the Republicans appeal the law by eliminating certain provisions, plus will stall financial efforts to enforce state's compliance. Despite all the complexities of diversion surrounding a societal problem, the issue is fundamental. Legal roadblocks purporting violation of certain rights, unfairness of federal mandates imposed on states, cries of financial burdens by insurance companies and employers, and government subsidies all have positive effects on the delivery of health care services in the United States. However, this premise is based on the beneficiary's perspective: uninsured and government.

Effects on Healthcare Delivery

The issue improves access to health care services and accountability of insurance companies. Although the costs must derive from a financial source, all must share in the burden to ameliorate such dichotomy in society. Currently, oversight of health insurers, the expansion of coverage to one million young adults and more protections for workers with pre-existing conditions are already well cemented and popular (New York Times, 2011). Additionally, the law, along with economic pressures, has forced major institutions to wrestle with the relentless rise in health care costs.

Potential Variable Tradeoffs

With any public program or federal mandates, potential trade-offs exists between increased costs and access. Increased costs will be borne by insurance companies who will be required to insure pre-existing conditions and will not be able eliminate coverage for insurers who become ill during the coverage term. Additionally, the law will cost the government about $938 billion over 10 years, according to the Congressional Budget Office, which has also estimated that it will reduce the federal deficit by $138 billion over a decade (New York Times, 2011). Insomuch, the law will require employers with more than…… [read more]


Healthcare Economics Term Paper

… Healthcare Economics

Explain the term Moral Hazard. Explain how the level of morale hazard affects an individual's use of health services.

A moral hazard exists when the possession of an insurance policy increases the likelihood of incurring a loss. Moral… [read more]


Health Care Past, Current Research Paper

… On page 155 Sultz explains that the university medical facilities were given federal grants to research "causes of death: heart disease, cancer, and stroke." By the early 1980s, thanks to taxpayer dollars, the federal government had helped increase the number… [read more]


Healthcare in the United States Research Paper

… What can the United States learn from the case of India? The two nations seem to represent opposing extremes in healthcare. The United States needs to rein in costs on its existing healthcare infrastructure while India suffers from a lack of funding and poor infrastructure. The United States has extensive regulations governing private insurance and medical practice while India's consumers still pay direct fee for service payments to their loosely regulated physicians. The United States is overdeveloped, India is underdeveloped. Both, however, adopt free market principles for determining the price of medical services. The cost and complexity of U.S. healthcare has created a demand for affordable services that India meets through medical tourism at the expense of its own citizens. While medical tourism can be financially beneficial for a nation that lacks healthcare investment, India and the U.S. need to address concerns at home to properly care for the well-being of their respective populations.

References

Arora, N., Banerjee, A.K., (2010) Emerging Trends, Challenges and Prospects in Healthcare in India. Electronic Journal of Biology, 6(2), 24-25

Berman, P., Ahuja, R., Bhandari, L. (2010) The Impoverishing Effect of Healthcare Payments in India: New Methodology and Findings. Economic & Political Weekly, 45(16), 65-71.

Ma, S., & Neeraj, S. (2008) A Comparison of the Health Systems of China and India. RAND Center for Asia Pacific Policy. Retrieved from http://www.rand.org/content/dam/rand/pubs/occasional_papers/2008/RAND_OP212.pdf

Manchikanti, L., Caraway, D.L., Parr, A.T., Fellows, B., Hirsch, J.A. (2011) Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade. Pain Physician, 14(1), 35-67.

National Public Radio: Compare International Medical Bills (2008) National Public Radio. Retrieved from http://www.npr.org/templates/story/story.php?storyId=110997469

Roberts, J. (2009) A History of Health Insurance in the U.S. And Colorado. University of Denver: Center for Colorado's Economic Future. Retrieved from http://www.du.edu/economicfuture/documents/HistoryOfHealthInsurance_CCEF.pdf

Shetty, P. (2010) Medical tourism booms in India, but at what cost? The Lancet, 376(9472), 671-672. doi:10.1016/S0140-6736(10)61320-7

Shiva Kumar, A.K., Chen L.C., Choudhury, M., Ganju S., Mahajan, V., Sinha, A., Sen, A. (2011) Financing health care for all: challenges and opportunities. The Lancet, doi:10.1016/S0140-6736(10)61884-3.

Varatharajan, D., Thankappan, R., and Sabeena, J. (2004) Assessing the Performance of Primary Health Centres Under Decentralized…… [read more]


Healthcare Reform and Occupational Therapy Essay

… Health Care Reform and Occupational Therapy

Because occupational therapy is such an integral part of health care, it is logical that any health care reform would also affect this profession. However, occupational therapy has historically been all but ignored by health care legislation, leaving professionals in the field obliged to frequently make their own interpretations of laws that appear relevant to them. With the newest Health Care Reform Act, the Patient Protection and Affordable Care Act of 2010 (PL 111 -- 148), a new era has arrived for many professionals in the field, as well as for the public.

The new act is President Obama's attempt to make all forms of health care more affordable and accessible to all citizens. This has significant financial and work load implications for health care professionals. During the first phases of implementation, for example, it is expected that care giving facilities such as hospitals will see an influx of patients. These patients will have to be managed more efficiently in less time than the case was before. Occupational therapy can play a significant role in this. (SG2 Report, 2010, p. 7).

Occupational therapists are, for example, often required to provide on-site or home services to patients. With the increasing numbers of patients in hospitals, physicians in these settings may then refer more patients to other care providers, including occupational therapists. When hospital care is non-essential, occupational therapists might then also see an increase in patients who require at-home assistance.

For all care providers, the SG2 Report (2010, p. 7) also states that an increasing focus on excellent it systems will be necessary to handle the increase in patients and to refer them to the relevant specialist care workers. In this way, a more integrated network may be built among hospitals, individual physicians, occupational therapists, and other care providers. In this way, quality care can be assured within a fraction of the time it would require without these integrated communication systems. Overall, this will benefit not only the public, but also care providers in terms of…… [read more]


New Health Care Reform Term Paper

… Health Care Reform Through the Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act ("PPACA") is one of the most controversial pieces of legislation in modern memory. This landmark legislation addresses the nation's long-dysfunctional health care… [read more]


Why Is Covering Pre-Existing Conditions Important to Health Care Policy? Essay

… Pre-Existing Conditions and Health Care Policy

Pre-existing condition is a health condition that client had before he enrolled in an insurance plan. Many insurance companies across the country can deny coverage to people with pre-existing conditions or for that particular condition. Pregnancy, for example, if seen as a pre-existing condition and while a person may coverage for other health issues, she may be denied coverage for her existing pregnancy based on pre-existing clause. This problem affects millions of Americans and each year, a large number of people find themselves without insurance coverage due to some existing health issue. But denial, which works well for insurance companies, hurt those with chronic or prevalent conditions like heart diseases which affect 1 in 3 Americans. [1] It is very more disturbing when a condition like cancer or some other life altering health problem surfaces and a person is denied insurance.

In some cases, the companies may not totally deny coverage but would charge very high premiums for pre-existing on-going condition like asthma or a lingering injury.

Americans are faced with this problem in one a few states. In fact 45 states across the country would discriminate against people with pre-existing conditions by either denying coverage or charging exorbitant premiums or refuse to offer coverage for that precise problem.

In pure statistical terms, 12.6 millions adults were denied coverage recently according to a survey. This is about 36% of adults who sought coverage directly from an insurance company in the last three years. [2]

Another survey showed 10% of all those suffering from cancer were denied coverage or their insurance was cancelled because of this life-changing diagnosis. [3]

In about nine states, even domestic violence is considered a pre-existing condition and a person who has been injured in such an incident will not be covered by their insurance policy because domestic violence existed before they applied for insurance. [4]

There have been solutions to this problem but none has worked well and hence health care reform is strongly needed. For example in some states, there is a high-risk pool that offers medical insurance to otherwise uninsurable adults. However they charge very high rates and generally don't work for most individuals with pre-existing conditions. It was found that only 8% of all uninsurable adults were able to get coverage and the rate was still incredibly high and generally unaffordable. [5] Other problems like annuals caps on enrollment can also leave many uninsured people without any solution.

For this reason, we need to bring changes to our national health…… [read more]


Health Care Reform to Place Our Nation Thesis

… Health Care Reform

To place our nation's health care under the very government that is now at the center of our fiscal problems, and which is piling up debt by the trillions even without health care, while the jobless rate… [read more]


Healthcare System in the Netherlands Term Paper

… Healthcare System in the Netherlands

The Netherlands has a unique concept of 'family physician' known as 'Huisarts' who the primary Doctor responsible for coordinating physical and mental care of patients in his neighborhood. January 2006 saw the launching of a… [read more]


Healthcare Policy Issue and Nursing Strategies Essay

… Nursing

Policy Issue Analysis: The National Nursing Shortage

The healthcare industry is afflicted by a wide array of internal problems, policy issues and systemic flaws. Included among them are the prohibitively high costs of medical treatment, the inaccessibility of healthcare… [read more]


Healthcare Canada Essay

… ¶ … Health Care Systems

Comparison of Canadian and American Health Care Systems

The purpose of this paper is to examine the relative merits of the Canadian and American health care systems in an attempt to determine what the future… [read more]


UK Healthcare Term Paper

… According to Enthoven, the focus was directed towards enabling private practice to develop and forcing more elderly people to independent private nursing homes, where they had to pay from own resources until their money ran out. Within this approach, the… [read more]


Human Resource Issues in Health Research Paper

… This is the case in developing economies where funding for the health sector is significantly limited. Combining such an environment with long working hours compromises the health practitioners' ability to ensure that patients are treated in the right manner. This is also one of the main factors attributing to the increasing number of instances pertaining to medical negligence (Fried & Fottler, 2011).

Another intervention would probably involve conducting public awareness campaigns on proper health care. Health ailments relating to eating habits, hygiene, are attributed to a significant percentage of persons in need of health care services. These campaigns would involve informing and educating the society on the various lifestyles that promote healthy living. This is highly effective in decreasing the demand of healthcare since most of the health ailments are preventable simply by changing lifestyles.

Conclusion

The proper management of human resources is fundamental in ensuring quality service delivery in the health sector. Although there are many challenges that plague human resources in the health field, most of these are founded with funding. With adequate funding, it will lead into an increase in health care professionals, adequate infrastructure and consequently deal with some of the issues relating to poor service delivery. In addition, there is the need to transform the operating culture within medical practitioners in order to deal with the cases of increasing negligence. Effective human resource management strategies are greatly required in order to achieve enhanced outcomes from and access to health care around the world (American Society for Healthcare Human Resources Administration, 2012).

References

American Society for Healthcare Human Resources Administration. (2012). American Society for Healthcare Human Resources Administration ... membership directory. Gainesville FL: Naylor.

Fried, B., & Fottler, M.D. (2011). Fundamentals of human resources in healthcare. Chicago: Health Administration Press.

Fried, B., & Johnson, J.A. (2002). Human resources in healthcare: Managing for success. Washington, DC: AUPHA Press.…… [read more]


EHR Mandate the Electronic Health Term Paper

… Internal resistance to change seems to be a major obstacle (Hanson, 2013), as many of the physicians in particular are older and not particularly tech-savvy. They invent a wide range of excuses as to why EHR is a bad idea, to the apparent frustration of the IT department. The problem, however, is that this resistance has become embedded, and management also returns excuses. It drags its feet on making decisions, and in that time the technology changes, forcing IT to explore the new options, and sending the decision back to management.

There is a high degree of frustration within the IT department, as they feel that they could have implemented EHR a long time ago, but these roadblocks have left the health care provider with ad hoc solutions, and apparently well behind implementation targets. This state of implementation is, however, not uncommon, as many health care providers have resisted the implementation of electronic health records for years, usually for many of the same reasons.

Analysis of Challenges

There are a lot of challenges at this organization, which seems to be behind even others in the area with respect to EHR implementation. There is strong resistance to change, from physicians, management and patients alike. Management seems the most motivated to change, as some in leadership realize that the transition to electronic health records is inevitable and there may be legal consequences should they delay too long. Resistance usually is accompanied by varying excuses, but it is probably futile to give those reasons much credence. At the heart of the problem in this organization is a lack of willingness to change and to embrace new ideas. This is a major problem with EHR implementation throughout the U.S.

Overcoming the challenges is not as simple as education and training, though both of those are required. There is resentment over the idea that EHR is being "imposed" on the organization rather than something that the organization wants to do because it is good. Thus, many people do not seem to see the benefits of electronic health records. It is worth considering that organizations of all types face change, and that there are time-honored techniques for making organizational change happen. Health care organizations that are struggling with EHR implementation would do well to examine some case studies and find ways to overcome resistance.

Another key challenge is the slow pace of change, even where change does occur. While other industries move quickly to introduce new technologies because of the competitive advantages they provide, this organization does not see new technology as an opportunity, but rather as a challenge. Even the framing of this question in this assignment highlights how the industry feels about EHR -- the word challenge is used rather than opportunity. For some reason, the mindset is a problem, and ultimately to properly and effectively implement electronic health records my nearby organization will need to have a shift in its mindset from the very top of the organization.

References:

Davies, N. (2006). Making… [read more]


President Clinton's and Obama's Health Research Paper

… Romney presented these claims in opposition to the recently enacted health care reform plans as he discussed what he would do to improve the current health care system. While some of his claims are true, most of them have been exaggerated as he attempted to win the 2012 U.S. presidential elections. However, Obama's health care policies have raised serious concerns to policymakers, politicians, and the general public, especially with regards to their effectiveness in improving accessibility and affordability of health care services.

Notably, the policy consensus that has characterized Democrats attempts for a major overhaul of the American health care system no longer exists because of the removal of insurance mandate off the table. Nonetheless, Obama's health care policies face further complications since ObamaCare has consistently generated negative poll numbers. Romney's criticism seems to reflect the mood of the public, half of whom have opposed the law since its enactment while 75% oppose the mandate. Furthermore, most Democrats have expressed their political and economic concerns regarding the effectiveness of health care reform. Therefore, the opposition against the policy should not be dismissed as a politically-driven agenda but an issue to be addressed.

References:

Klein, J. (2012, December 17). Obamacare vs. Medicare. Time, 180(25).

Levin, Y. & Ponnuru, R. (2012, February 6). Romney vs. Obamacare: What the Presumptive

Nominee Should Say, National Review, 34-35.

Santana, A. (2012). Obama vs. Clinton on Health Care. Slope Media Group.

Suderman, P. (2012, July). What's Next if ObamaCare is Struck Down? Reason, 44(3).

"The Obama-Biden Plan." (2009). Health Care Agenda. Retrieved…… [read more]


Health Information Improving Healthcare Term Paper

… The CMS indicates that "PHRs help providers get the information they need to treat you in an emergency by quickly sharing information on your medications, allergies, and emergency contacts. You can let others have access to your PHR for just this situation."

Faster, more seamless sharing of health information is seen as an important way of promoting a continuity of care. This continuity of care means that following hospitalization, a patient's care strategy can remain in place and be easily communicated to a primary physician, specialist or other caregiver. In turn, this denotes an opportunity to reduce the likelihood of a patient returning to the emergency room within close proximity to an initial visit. Because there is such a great pressure on hospitals not simply to reduce the occurrence of high readmission rates but also to substantially improve the integration of Information Technologies with which to do so, the Health Information Systems Managers is a critical role-player in the future of most hospitals and healthcare facilities.

Conclusion:

In light of the sweeping changes impacting the healthcare industry today, finding technology-driven solutions for high readmission rates is the most salient issue for the Health Information Manager. Certainly, by exploring ways of improving the infrastructure, format and usage of these health records, said manager may go a long way toward helping patients get better health outcomes, helping hospitals improve their performance and helping the healthcare industry on the whole reign in the wasteful patterns in its past.

Works Cited:

Centers for Medicare and Medicaid Services (CMS). (2012). Personal Health Records…… [read more]


Public Policy and or Program Term Paper

… Home and Community-Based Care

Today, we face many challenges in society. Some of these relate to the costs of living, while others relate to political, social, educational, and a myriad of other issues. One major challenge facing society today, and… [read more]


Health Care Reform Is Term Research Paper

… This bill was introduced on the 10th of February 2011 and on the same day presented to the House Committee on Health Policy. The bill pushes the congress to amend the Patient Protection and Affordable Care Act to adopt tax-favored health plans that compensate the costs of over-the-counter medication (National Conference of State Legislatures, 2012 ).

Health Care Insurance

Out of the four basic functional components of the U.S. health care delivery system, Insurance is more important than the other three. There has been much debate on the healthcare reform with numerous proposed bill, but none draws greater attention than that of insurance (Turner, 2012). This makes insurance the most controversial and the most critical of the three components of the U.S. healthcare.

Human rights organizations are most likely to lobby for insurance in the health care sector. It is highly unlikely for any for profit organization to lobby for such a course; the insurance sector would be lobbying against most popular insurance bills such as the universal coverage. Therefore, those organizations that fights for basic human rights are the most likely to feature prominently in this activity.

Conclusion

The debate on health care in the United States includes issues of right to health care, access issues, fairness, sustainability, and quality as well as the amounts spent by either the state or the federal government. As seen in the preceding paragraphs, there are numerous pending bills waiting approval by various state governments as well as the federal government most concerning the reforms in healthcare. According to World Health Organization (2009), the healthcare in the United States which is a mixed of both public and private care system is the most expensive in the world. This is the reason for such heated denate on the healthcare reform and also the reason for so much legislation on issues related to healthcare on the federal and the statelevel.

Reference

Legislative Information System. (2012). Illinois General Assembly. Retrieved October 7, 2012, from www.ilga.gov.

Michigan House Republicans. (2012). Michigan House…… [read more]


Health Policies Medicare Research Paper

… In conclusion, the United States is not the only Western nation that is going through this challenge; however we are very probable in the worst location in handling the situation, because of our traditional unusual medical ethos and the high public prospects it has shaped. Somewhat than despair, nevertheless, we need to really start viewing the issues being brought here in medicare as a challenge. It is important that we are using the same inventiveness that has provided us the New Deal and style an essentially more reasonable and maintainable health-care organization-one that talks to the moral needs at all heights. If America fails to accept a widened vision along these positions, the viewpoint for health care in America's long-term upcoming is threatening certainly.

Work Cited:

Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.

Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.

Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.

Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.

OMalley, Cynthia, D., et al. "Medicaid Status and Stage at Diagnosis of Cervical Cancer." American Journal of Public Health 96.12 (2006): 2179-85.

Morrissey, Joseph P., et al. "Medicaid Enrollment and Mental Health Service use Following Release of Jail Detainees with Severe Mental Illness." Psychiatric Services 57.6 (2006): 809-15.

Morrissey, Joseph P., et al. "Assessing Gaps between Policy and Practice in Medicaid Disenrollment of Jail Detainees with Severe Mental Illness." Psychiatric Services 57.6 (2006): 803-8.

Levy, Robert A., et al. "MARKETWATCH: The Cost of Medicaid Annuities." Health affairs 25.2 (2006): 444-51.

Lee, Jinkook, Hyungsoo Kim, and Sandra Tanenbaum. "Medicaid and Family Wealth Transfer." The Gerontologist 46.1 (2006): 6-13.

Galbraith, Alison A., et al. "Medicaid Acceptance and Availability of Timely Follow-Up for Newborns with Medicaid." Pediatrics 116.5 (2005): 1148-54.

Alison, Evans Cuellar, et al. "Medicaid Insurance Policy for Youths Involved in the Criminal Justice System." American Journal of Public Health 95.10 (2005): 1707-11.

Tang, Suk-fong S., Beth K. Yudkowsky, and Jean C. Davis. "Medicaid Participation by Private and Safety Net Pediatricians, 1993 and 2000." Pediatrics 112.2 (2003): 368-72.

Landon, Bruce E., and Arnold M. Epstein. "Quality Management Practices in Medicaid Managed Care: A National Survey of Medicaid and Commercial Health Plans Participating in the Medicaid Program." JAMA 282.18 (1999):…… [read more]


Director of Critical Care Research Paper

… Furthermore, the goals of lowering costs, raising productivity levels and developing programs/processes to improve the speed and quality of healthcare are deeply ingrained in my personal practice method. In addition to my detailed career-long achievements in those areas, I am familiar with the nationally-accepted Failure Mode and Effects Analysis (FMEA) and am eager to implement FMEA to accomplish those objectives by proactively assessing risks and potential system failures while creating and refining superior practice systems.

In achieving the ideal of excellent patient care, administrative roles have become second-nature to me. I have welcomed and effectively fulfilled administrative roles as staff nurse, ER Manager and Director of Nurses in critical care settings, necessarily establishing a good rapport with all personnel and employing strong planning and problem-solving skills in the process. Those administrative roles have allowed me to create and refine healthcare systems, measure departmental and practice goals, train and supervise staff, evaluate staff performance, and act as liaison between patients and nurses throughout my career. To that end, I have become accustomed to an interdisciplinary approach that has honed my communication and leadership skills and allowed me to readily work closely with the Departments of Human Resources, Finance, Information Technology and Communications to advance programs and capably manage hospital units and resources.

I am eager to discuss my qualifications at your convenience. Meanwhile, please do not hesitate to contact me for any further information/documentation that will aid in your decision about my enhancement of Critical Care as Director of Nursing III.

Sincerely,

Mark E. Ingold…… [read more]


Administrative Law and Health Reform Essay

… On the state level there are similar problems. States must create new insurance exchanges that offer consumers a choice of insurance plans, establish common rules regarding the offering and pricing of insurance, and provide information to assist consumers in understanding… [read more]


U.S. Health Policy Essay

… Health Policy

The health care setting for this paper on health care policy is the insurance industry ("insurers") that provides coverage for Americans who can afford to pay the ever-higher prices charged for policies. During his campaign for the presidency in 2007 and 2008, during the primaries and during the presidential election campaign against Senator John McCain, Barack Obama again and again mentioned the need for health care reform in the United States. He proceeded as an elected president to carry out his promise to institute reform through legislation.

The Affordable Care Act -- the Legislative Process in America

In 2009, the president began putting together a package that would eventually become legislation. He worked with mainly Democratic members of Congress -- albeit he offered to enlist the support of the GOP, but that relationship never jelled -- to hammer out the bill. Then members of Congress began to hold "Town Hall" meetings around the country to explain the proposals to the public. This portion of the legislation process was a disaster for many if not most of the elected officials that tried to conduct civil meetings.

Headlines told the story: "Town hall meeting on health care turns ugly" (CNN); "Audience shouts Down Sebelius, Specter at Health Care Town Hall in Philadelphia" (Fox News); "Town Hall Meeting Shouted Down…" (Yahoo). One after another town hall meeting became boisterous -- some even violent -- and outside some of the venues men with rifles stood menacingly by, as though they expected to find something to shoot at. The New York Times reported that the disturbances (at least some of them) were being orchestrated by the "tea party" and others "who oppose health care reform" (http://Opinionator.blogs.nytimes.com). Memos from "FreedomWorks" and other lobbying organizations tied to the tea party movement urged protestors to "rock-the-boat early in the Rep's presentation; Watch for an opportunity to yell out and challenge the Rep's statements…the goal is to rattle him, get him off his prepared script…" according to the New York Times reporting.

That having been reported, the actual legislative process and its limitations came into full view in Washington for any citizen who cared to observe. First, what did the Affordable Care Act offer to Americans? To wit: a) holding health insurance companies accountable by making it illegal for them to simply drop a child's coverage due…… [read more]


Healthcare Policy Analysis of Nurse Practitioner in Primary Care or Prescriptive Authority Term Paper

… ¶ … healthcare has been changing over the last decade. The role of nurse practitioners has become ever more important. This paper conducts a policy analysis as a systematic investigation of alternative policy options, for the emerging nationalized healthcare plan… [read more]


Healthcare Finance Term Paper

… Medicare Diabetes Prevention Act of 2013

Healthcare Finance

Senator Franken (D-MN) introduced a bill (S. 452) into the Senate on March 5, 2013 that provides a mechanism through which Medicare and Medicaid recipients, who are at risk for developing diabetes,… [read more]


Ethical Issue of Poor People Not Receiving Same Care as Rich Term Paper

… Spring Health Uninsured Share Policy Ethics

Scarcity ethics nursing

Imagine two possible extremes of either zero safety net at all, or every consumer receiving identical care regardless of ability to pay. A mixture of the two extremes may actually maximize… [read more]


Health Reform Act Research Paper

… " (Flanagan, Miller, Pagano, and Wood, 2010) Starting in 2010, a small employer[footnoteRef:9] is reported to be eligible to "apply for a tax credit if they offer health insurance and subsidize, on a uniform basis, at least 50%[footnoteRef:10] of the… [read more]


Health Insurance Costs Name the Four Acts Term Paper

… Health Insurance Costs

Name the four acts controlling hospital costs through regulations, describe one in full detail. Discuss the evolution of health insurance as a third party payment system and discuss the role of government in health care funding.

Name the four acts controlling hospital costs through regulations, describe one in full detail.

The 1974 Health Planning and Resources Development Act

This Act created a national network of local health systems agencies, state health planning and development agencies, and state health coordinating councils. It shifted federal control of health resources to local agencies in a radical fashion, in an effort to contain healthcare costs. The National Council for Health Policy was created to aid in health planning on a federal level and a new provision was made for federal financial assistance for construction and modernization of health care facilities, specifically outpatient facilities, to contain costs. To further decentralize government health and resources planning, the day-to-day operation of the program was given to ten regional offices (Rubin 1974).

The Omnibus Budget Reconciliation Act of 1980 and 1981

The Acts repealed two increases in tax deductions scheduled to become effective on October 1, 1982. One provision would have, according to a summary of the words of the Act: "liberalized the medical deduction for the elderly and disabled by: allowing elderly or disabled people to deduct medical costs exceeding $25 rather than $35; and by including in the deduction the medical expenses of spouses who were not elderly or disabled."

The Health Insurance Portability Act of 1996

The purpose of the Act, in its own words was to contain costs through streamlining healthcare record-keeping "by encouraging the development of a health information system through the establishment of standards and requirements for the electronic transmission of certain health information."

The Balanced Budget Act of 1997

The Balanced Budget Act of 1997 encompassed the largest cuts in the history of Medicare. Cuts in Medicare accounted for almost one half of the total reduction in federal expenditures. The Act reduced Medicare payments by $119 billion, including $2.3 billion in graduate medical education (GME) payment reductions. "Medicare is the largest single source of financing of GME, which accounted for 7% of Medicare expenditures by 1999" (Phillips et al. 2004, p.71).

Q2: Discuss the evolution of health insurance as a third-party payment system

Healthcare only became a necessity when medical treatment became relatively safe and accurate. In 1929, "the first modern group health insurance plan was formed. A group of teachers in Dallas, Texas, contracted with Baylor Hospital for room, board, and medical services in exchange for a monthly fee. Several large life insurance companies entered the health insurance field in the 1930's and 1940's as the popularity of health insurance increased. In 1932 nonprofit organizations called Blue Cross or Blue Shield first offered group health plans. Blue Cross and Blue Shield Plans were successful because they involved discounted contracts negotiated with doctors and hospitals. In return for promises of increased volume and prompt payment, providers gave discounts… [read more]


Management of Finances in Healthcare Organizations Research Paper

… ¶ … Lead and Manage Using the Balanced Scorecard

The balanced scorecard has proven to be a very significant and important approach and system in strategic management as it has modernized conventional thinking regarding performance metrics (Kaplan, 2002). The balanced… [read more]


Healthcare in 20 Years Research Paper

… ¶ … concrete examples, some of the major participants and components of the present health care services sector. It's suggested that you consider all possible areas, which form this huge portion of our GDP!

In terms of components, the Washington State Healthcare Authority website lists a number of different services that are in within the healthcare services scope. These include ambulance services (ground- or air-based), ambulatory surgery, applied behavior analysis, blood/blood administration, behavioral health services (which is itself very multilayered), chiropractic, dental/dentures, detoxification, diabetes education, dialysis, family planning services, rehabilitative services, hearing aids/hearing evaluations, orthodontics, oxygen respiratory services, smoking cessation, vaccinations, vision correction/maintenance, prescription drugs and the list goes on (Washington, 2015).

In terms of the share of the economy that is healthcare-based, the number is indeed staggering. As noted in Forbes, there was the metric in 2009 that federal, state and local governments accounted for about sixty percent of all healthcare spending. The Affordable Care Act is projected to drive that number up to roughly two thirds, that being about sixty-six percent. Conversely, that would mean that the private sector's share of healthcare services and other related spending will only be about a third of all healthcare spending in the United States. At a federal level, the share of spending is only roughly about a third but involving the state and local figures drives up the total figure a lot. The percentage of healthcare spending to GDP is not much less than a fifth of overall GDP (Conover, 2012).

Question Two

During this time, we can debate the ACA reform law and the many alternatives being advocated. Please begin by focusing on one or two significant features of the "Obamacare" reform law and highlighting both their major purported benefits and assertions made by detractors.

One major component of the Patient Protection & Affordable Care Act (aka ObamaCare) is that there is now a specific ban on precluding people from insurance on the basis of pre-existing conditions. There are a lot of people that say that this is a long-time coming while others suggest that it is less than wise as an idea. A major reason that it is hailed and approved of is because there are many people that are unable to get insurance at affordable rates due to chronic and pre-existing health conditions such as diabetes, heart disease, COPD and so forth. Under the Affordable Care Act, those people are now able to become and stay covered for fairly reasonable rates.

However, there is a major downside to that provision being enacted. Indeed, some (certainly not most or all) of the people that were not insured were the young and/or those that simply did not want to spend the money on insurance…for whatever reason. Those people that choose not to do that are not paying into the system. Indeed, everyone who is insured pays into a pool of money and that money is used to pay claims. The bigger the pool of money, the less premiums tend to…… [read more]


Application of Economic Concepts to Health Care Research Paper

… Financial Management for Health Care Operations

The economic theory of regulation holds that politicians are self-interest maximizers, and therefore regulation will reflect their self-interest. The structure of the political system is such that politicians are dependent on financing to get… [read more]

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