Decisions, Decisions The first decision case study is regarding a single female preparing for a job interview. She senses that her probability of getting hired could be adversely affected by her marital status; hence, she is contemplating whether or not to wear her diamond engagement ring during the interview. The case study features a column section in The Wall Street Journal which queried several women on this topic.…
Due to Medica exiting the Medicaid Program marketplace. My organization Hennepin Health membership is expected to increase by at least 20,000 recipients. The adaptive challenges, my organization continuously faces is a delay in claims payment from our vendor TMG. An increased membership will result in an overflow of unresolved claims issues. The most difficult, challenge is we assigned new processes, due to an individual’s lack of claims knowledge or someone enhanced skilled sets.…
Companies are increasingly reluctant to pay for their employees’ insurance because it’s no longer a cost-effective way to keep a stable workforce. Thomas 3 Insurers are wary of covering individuals with serious medical problems--and HMOs apply extra scrutiny to their treatments--because those people run…
Health care access is very important. It allows all people to get care from many different places around the world. There are many ways that access to health care impacts the people who use it. Heath care access impacts, the physical, social, and mental status of people, the prevention of disease and disability, treatment of conditions, quality of life, and life expectancy (Access of Health Services, 2016). For people to have access to quality health care it is vital that health insurance provides adequate coverage, service, workforce, and provide it in a timely manner.…
Natalie Dixon, information generated from government and scholastic sources have previously highlighted the continuing disparity in health care in general. Across the globe there are contrasting policies and systems that have been implemented to meet the requirements of those nations constituents. Some are remarkable in their approach to delivering health care, the quality of care and their specific level of government control. The Affordable Care Act had both its positives and negatives in its designed approach to a continuing issue, but the fact remains and has been documented that for every action there is a reaction. Some of the negativities have complicated the issue, but then again it all depends on which side of the bandwagon one wishes to address or champion in their approach.…
The landscape for transgender healthcare has been radically impacted by the passage and implementation of the Affordable Care Act [ACA]. The ACA paved the way for the state and country to address the discrimination and barriers to accessing care that many transgender people have experienced. Over the past few years there have been significant changes to trans-specific healthcare coverage, which can be attributed to the clarification of Senate Bill 2 and the state and federal mandates. In this paper I will discuss the laws more in-depth, how they affect Kaiser Permanente specifically, and some recommendations on how to support fully inclusive healthcare. Background…
The Affordable Care Act legislation has been the catalyst for changing how health care is delivered in the United States. A plausible next step is to evaluate how health care is being paid and by whom. The government and larger private insurers are very powerful and have a palpable influence on health care options. Moving to a government operated one payer healthcare system is intriguing and has been accomplished in Canada and other countries.…
The purpose of this paper is to discuss the importance on medical billing and coding. Medical practices have the option for staying in-house or the option of outsourcing to a professional billing service when it comes to Third Party Collections systems. Advantages and disadvantages will be discussed for proper understanding on what decision to make, especially for brand new medical practices. Especially, because a medical practice’s cash flow depends on their billing department, the more statements they can get out to patients and claims to insurance companies, the sooner they’ll be bringing money into the practice (MBAA, 2016).…
Affordable Care Act plans enforce higher out-of-pocket costs on customers than other coverage options. In order to keep costs low, many insurance company’s plans use a limited network of doctors and hospitals. To make matters even more restricted, access to doctors as become challenging in states that have expanded Medicaid because many practitioners are opting out of the program due to diminishing compensations. A Modern Healthcare article reveals that “the expected costs of Medicaid expansion during the next ten years will fall just short of $1 trillion, according to the [Congressional Budget Office]. That compares with $803 billion spent on premium and cost-sharing subsidies in the ACA 's exchanges”…
In contrast, in 2006, a family plan cost grew to $18,142, and employees paid $5,277. This trend is also supported by the charts in Document 7, which display a relationship between cost increases and increases in those being covered by health insurance. The existence of these relationships makes perfect sense, as those who were previously unable to get affordable health insurance due to pre-existing conditions were now able to join the pool (Document 9). This has led to a surge in costs for healthy individuals and has led to the cancellations of plans utilized by approximately 2.6 million individuals.…
In 2010, The Affordable Care Act, commonly known as Obamacare, was implemented across the United States to address the foremost issues in today’s Healthcare. These problems include lack of accessibility to quality healthcare, growing cost of care, and quality of care. While the affordable care act addresses concern of access to care for the underprivileged, it creates other new complications regarding cost and quality. Obamacare has succeeded in making care more accessible and now millions of Americans are now newly insured under government subsidized healthcare exchanges. However, the cost of care for those previously insured from either their employer or privately has increased dramatically.…
Instead of cost decreases the Obamacare has caused major cost increases. One area the costs have continued to increase is in the Employer-Sponsored market. Family premiums for the employee-sponsored plans have rose almost 32 percent between 2010 and 2016. These statistics were provided by the Kaiser Family Foundation. In regards to the individual market, the new rules and regulations of Obamacare’s…
"The Affordable Care act (Obamacare) main focus is on providing more Americans with access to affordable health insurance, improving the quality of health care and health insurance, regulating the health insurance industry, and reducing health care spending in the US." Yet five years since the implementation of Obamacare, 30.1 million people lost there private insurance,because it did not meet the 10 essential health benefits. Another 3-5 million people will lose there company sponsored health insurance, since companies find it cheaper to pay the penalty than buying there employees health insurance. Also medications will become more expensive due too new taxes that will increase prescriptions for individuals. Americans will find it cheaper…
But now in this day in time it has expanded into future expectations such as being a payer through public-sector programs like Medicare and Medicaid, they are providers for services to military, veterans, and indigenous populations, and lastly they are supporters of the education and training of many care providers (Barton, 2009). Under the categories of players, financing is consisted of your big time employers, governments (Medicare & Medicaid), and individual self-funding. Insurance is your well-known companies like Blue Cross/Blue Shield; delivery is your hospitals, physicians, nursing homes, and medical equipment vendors. Lastly to break down payment could mean third-party claims processors. (“The Uninsured and The Difference Health Insurance Makes,”…
These mergers and acquisitions have reduced overall costs for business processes and have spread out some financial risks and have increased their market share. This has allowed better negotiating influence with insurers, other medical centers, physicians, and the government. The horizontal and vertical consolidation of healthcare providers has demonstrated lower business costs but increased costs to consumers and insurers that have revealed a disturbing nationwide…