OMAS Model

Improved Essays
1) Is this a condition that has lasted or is expected to last for at least 12 months?
Definition of Insurance Type
This study sought to specifically compare children with public insurance to those with private insurance. Medicaid was defined as Medicaid alone or dual Medicaid/Medicare coverage. Private insurance was defined as job-based, other directly purchased, or exchange coverage.
Definition of Care Consistent with the Patient-Centered Medical Home
The OMAS survey did not explicitly ask respondents whether their healthcare was delivered through an accredited PCMH model. This study uses the term CC-PCMH which required that respondents meet the following criteria: (1) Has an appropriate, usual source of care such as a doctor’s office; (2) Has a personal care provider (PCP); (3) Has had a visit with their PCP in the past year; (4) PCP communicates effectively with the family; (5) Received necessary urgent care on the same or next day; (6) Received needed after-hours care without any issues; (7) Received needed specialty care without problems.12
…show more content…
An adult proxy answered questions related to the child’s health status, emergency room use, and number of hospitalizations. They were asked about the time their PCP spends with them and whether they explain things well. We assessed access through questions related to sources of care, delayed care, problems getting needed care, days waited for urgent care, ability to get after hours care, and difficulties seeing a specialist. The unmet needs assessed were dental, vision, prescription, and other

Related Documents

  • Decent Essays

    Tittle 2: A Case Study

    • 491 Words
    • 2 Pages

    Tittle 2: The role of public program discussed cost expansion through the utilization of the Medicaid State program. Many individual who fall short of being qualified for state Medicaid program may become eligible because of the federal government mode of available funding for the expansion of the Medicaid program. It also the special program for uninsured children. Matching rate by the federal government for the funding of the CHIP program-tittle 2.…

    • 491 Words
    • 2 Pages
    Decent Essays
  • Improved Essays

    Patient Case Study Essay

    • 485 Words
    • 2 Pages

    I choose, this case because of the patient’s interesting background. The patient is an immigrant and was married to local female. The patient is not working and his family cannot afford for any expensive medical treatment. As an immigrant the patient are not subject to any government support, especially in medical treatment. Due to his poor financial status, patient are unable to undergo haemodialysis and buy medication for his diseases.…

    • 485 Words
    • 2 Pages
    Improved Essays
  • Superior Essays

    Betty Neuman System Model

    • 1343 Words
    • 6 Pages

    Finally, the practitioner prepares a quantitative summary which will enable the clinician to determine the level of prevention and intervention: primary, secondary, or tertiary intervention. Thus, this level establishes the diagnoses, family plan of care, goals, and outcomes. Each family member receives a color code and completes a qualitative summary of the inventory, which is used in developing the family care plan (Mischke & Hanson,…

    • 1343 Words
    • 6 Pages
    Superior Essays
  • Improved Essays

    Introduction Thesis Development and Purpose The Affordable Care Act (ACA), which is commonly known by the unofficial name of ObamaCare is an American healthcare transformation law of the land expanding and improving access to care while minimizing spending through government regulation and taxes. This is a Patient Protection and Affordable Care Act, and a health modification law signed on March 23, 2010 by President Barack Obama. The main reason why this healthcare reform was started is to provide more Americans with affordable health insurance, and improvement of health insurance. In addition, there was a need to regulate the insurance business and to reduce the healthcare expenses in United States (US).…

    • 1311 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Reimbursement of services provided by hospitals is becoming increasingly dependent on patient satisfaction scores. Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) surveys are used to determine patient satisfaction. Most of the questions in this survey are directly related to patient care. Patient satisfaction scores can affect a hospital’s ability to attract patients positively or negatively and increase reimbursements to their facility.…

    • 582 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Managed Care Failure

    • 694 Words
    • 3 Pages

    CMS (2015) informs us that in 1990's managed care plans managed reducing costs by negotiating discounts from providers and used lower cost settings (i.e., hospital versus ambulatory surgery center). As consumers required less restrictive care their utilization increased and such health expenditures increased. This is not because the managed care organizations (MCO's) have failed or they do not contain costs, it is a function of consumer demand. MCO's work diligently to control costs by ensuring the care is delivered in the safest cost effective setting, managing staff patient ratios, leveraging size to obtain the lowest possible price and standardizing the supply chain. MCO's can effectively manage costs, especially when compared…

    • 694 Words
    • 3 Pages
    Improved Essays
  • Decent Essays

    here are several differences between Medicaid and Medicare, which are both federally funded health insurance programs. Medicare provides federal funded health insurance to people over the age of 65, dialysis patients and young disabled people. Medicare patients must pay a deductible and out-of-pocket expenses that are not covered. Medicaid provides federal and local funded health insurance for low-income families.…

    • 155 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Medicare and Medicaid are both key programs in the social insurance program. However, they are different from each other and they are indeed vulnerable in different ways. Medicare originally served as an insurance for the old people just like Social Security. People would see it as an entitlement as they would think it would be great if we can get health care in exchange for the service we provide for the country. There are two parts of the Medicare at the beginning, part A which is hospital insurance and part B which is medical insurance.…

    • 556 Words
    • 3 Pages
    Improved Essays
  • Great Essays

    The Importance Of Nursing Values In Nursing

    • 1436 Words
    • 6 Pages
    • 13 Works Cited

    Nurses are champions in adapting to change and identifying creative measures to help modify their practice, so it is not surprising that they are eager to meet these challenges head on. The assumption has been made that the delegation of physician care to FNPs will lead to better use of resources, however nurses must continue to be mindful of the possible risks and implications that may accompany these demands. Sacrificing nursing values cannot be tolerated. It continues to be a slippery slope as nurses cross the line into a medical role while maintaining a nursing framework. Having a concrete understanding of nursing theory and nursing values will help preserve the nursing identity during the newest healthcare…

    • 1436 Words
    • 6 Pages
    • 13 Works Cited
    Great Essays
  • Improved Essays

    The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government (Medicaid, 2015). Children's Health Insurance Program (CHIP) provides health coverage to more than 43 million children, including half of all low-income children in the United States. The federal government sets minimum guidelines for Medicaid eligibility but states can choose to expand coverage beyond the minimum threshold.…

    • 1208 Words
    • 5 Pages
    Improved Essays
  • Decent Essays

    The predominant beliefs and values in the United States that have driven the development of the health care system is our economy, culture growth, technology, physical environment, and American culture. All of these beliefs & value plays and important role in our health care system. The health care system quad-function model makes up the basic components of the health care delivery system which are financing, insurance, delivery, and payment. In order for the system to work the health care system need all of these components to come together. As the health care system continue to evolve I feel that health care reform will not be a problem and that the beliefs & values that played an important part in the U.S will continue to be driven by…

    • 129 Words
    • 1 Pages
    Decent Essays
  • Great Essays

    LPN Scope of Practice Paige Pence John Wood Community College NUR-190 April 30, 2017 LPN Scope of Practice The nursing profession is essentially like all other professions, with different levels of experience and education, requires different titles and level of practice followed. Inside the nursing practice there are different levels of caregivers that you work alongside, each of them having a different reason for being there. For example, in a nursing home you will work alongside non-certified personal, certified nursing assistants, licensed practical nurses, registered nurses and many more qualified care givers.…

    • 1650 Words
    • 7 Pages
    Great Essays
  • Improved Essays

    Cost Effectiveness, Quality of Care, Sample Calculation The purpose of this paper is to present the references supporting the cost effectiveness, and quality of care provided by nurse practitioners (NPs). The paper will also provide sample calculation of NPs proposed cost effectiveness in comparison to primary care physicians. A systemic review of 27 studies comparing the effectiveness, quality, and safety of care provided by NPs to that of physicians concluded that similar or better health outcomes were achieved in patients cared for by NPs compared to the patients cared for by physicians in primary care settings (Stanik-Hutt, Newhouse, White, Johantgen, Bass, Zangaro, Wilson, Fountain, Steinwachs, Heindel, & Weiner, 2013). Another systemic…

    • 357 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    APRN Role

    • 1167 Words
    • 5 Pages

    As a future advanced practice registered nurse (APRN), it is essential I understand my role and the impact I will have not only within my community, but at the state and national level as well. I will use my education and clinical training to develop the necessary skills to assess, diagnose and treat patients. It is essential as an APRN, I develop a plan of care that incorporates health promotion and disease prevention strategies. Lastly, my goal is to integrate a Christ-centered worldview approach into my daily practice. My purpose as an APRN is to be influential in all aspects of my patient’s life.…

    • 1167 Words
    • 5 Pages
    Improved Essays
  • Great Essays

    I will give a rationale for each diagnosis and describe how I would intervene and evaluate for a successful plan of care. Key Components of a…

    • 2071 Words
    • 9 Pages
    Great Essays