The group observed and analyzed was held at Kaiser Permanente, Psychiatry Department. The Intensive outpatient program (IOP) is held three times a week and each session is three hours. The purpose of the IOP program is for group members to explore and resolve their problems. Kaiser endorsed their mission is: “to provide high-quality, affordable health care services and to improve the health of our members” and the IOP’s purpose clearly addresses this mission statement. This is Kaiser’s most intensive outpatient treatment and the group therapy is sometimes used as an alternative to hospitalization; it is common for group members to exhibit acute symptoms of anxiety and depression throughout group sessions.…
Single Party Payer System & U.S. Healthcare System In 1965, the Medicare and Medicaid systems, which insure senior citizens and people whose earnings fall under the poverty line, were enacted by President Lyndon Johnson (WHO and Schallhorn, September 2017). This created a large federal healthcare system that covers millions of Americans.…
Medicare (Title 18) is a program that provides health care to individuals who are 65 years or older, disabled, or suffer from kidney failure. Medicare has a basic four-part structure: Part A, which is hospital insurance, Part B, which is supplementary medical insurance, Part C, which is Medicare advantage, and Part D, which is prescription drug coverage. Part A and B make up what is known as traditional Medicare. Part A concerns hospital insurance, this is financed by payroll taxed through employers and employees. Part A pays for a portion of inpatient hospitalization, nursing care, home health care, and hospice.…
What are two issues of physician reimbursement some are the practice expenses, doctor’s income and the reimbursement rates. The physician reimbursement is what the insurance company paid your physician for his services. Physicians cannot negotiate with the insurance company about the cost. Managed care organizations are trying to control the cost of health care but it’s not working.…
In this didactic piece Canadian Medicare: We Need It and We Can Keep It by Duckett and Peetoom, the authors delved into aspects of Canadian medicare that need to be refurbished to ensure the system remains sustainable. The book describes medicare in the past and how healthcare around it has changed, inevitably meaning medicare needs changes as well. The main goal the authors depict for medicare is the idea that “the right person enables the right care in the right setting, on time, every time” (p. 50). The authors drew on many different points to support this goal as well as offer ideas on ways to adjust medicare . With favourable ideas on aspects of medicare that needs change as well as suggestions on how ordinary citizens can get involved,…
The system of care currently implemented by the United States is an aggregation of programs created to target subpopulations with specific concerns. This model allows policymakers to address smaller communities with likeminded goals and needs. Medicaid serves over 70 million people, providing them with insurance and relatively inexpensive benefits. Medicaid funds many health centers, hospitals, and long-term care facilities in low-income areas, but many more providers refuse to see Medicaid patients due to lower payment rates. Federally standardized reimbursement rates might ensure fair payments for providers and accessible and affordable care for beneficiaries, but one national program may not meet the patient needs and financial conditions of each…
Bankers Life Medicare Supplement The question in most people’s minds, especially seniors is what are supplement plans? A Medicare supplement plan is basically meant to compliment your primary Medicare plan commonly referred to as the Original Medicare. This means that once you qualify for the supplement Medicare Plans you can get extra coverage that you currently don’t get with your existing or Original Medicare Plan. It offers you a chance to get cover for an extra set of health care services that you have to choose.…
Primary Care Physician: The primary care physician can help the patient by monitoring the blood sugar level, which can slow the progression of the diabetes and help with the patient peripheral neuropathy and her walking difficulty since her primary physician already knows Betsey’s medical history and is more affordable for Betsey than going to a specialist. Moreover, the primary care physician can treat Betsey’s deep vein thrombosis and pulmonary embolism, which caused pain, sores and swelling with her legs. If Betsey’s medical conditions get under control, her walking issue might get better. 2. Physical Therapist:…
The Medicaid program has been in existence for quite some time. It was originally…
The Affordable Care Act decision could have been an expansion of the powers of the federal government under the Commerce Clause. Instead, Roberts sought to redefine the penalty as a tax, so to avoid defining it as a power under Congress power to regulate interstate commerce. Although I agree with Roberts reasoning so as not to uphold the law under the commerce clause, I also find the redefining of the individual mandate as a problematic precedent. However, I believe the greatest issues with the decision are actually the issue of Severability and the way in which the Medicare expansion was struck down. The implementation of the Affordable Care Act over the last few years have shown by making the Medicare expansion essentially optional it has…
In the U.S., 50 million people depend on the Medicare program for their health needs, and the taxpayers bear the burden of $600 billion per year to fund the program. Therefore, the program’s administration is compelled to curtail Medicare related fraud, abuse and wastage of resources that add up to about $58 billion annually – or approximately 10 percent of the budget. For the last two decades, Medicare fraud has infested the program like an incurable cancer with over $1 trillion compromised. With the ever-expanding complex program, how would it be possible to develop and use a range of tools as a panacea to increase an oversight and scrutiny that would eventually lead to proper and efficient use of scarce resources in the future?…
The Medicaid program was made into law in 1965. It is sponsored by the state and federal government. The federal government pays fifty-seven percent and the state government pays the remaining forty-three percent. Pew Research Center provides information to the public about the issues going on around the world said, “Medicaid is the largest public health insurance program in the United States, covering both acute and long-term care for over sixty-six million low-income Americans” (Medicaid). Medicaid eligibility is based family income in relation to the federal poverty level.…
In “Mama Might Be Better Off Dead” we encounter a family’s struggle with the healthcare system, and how they are faced with disparities that could possibly be fixed with interventions. Three major ones were Medicaid, race, and lack of preventative care. Although Medicaid was created to assist the poor, its regulations on who is poor enough to receive it becomes problematic. Its income restrictions are very tight, that it only covers half of the poor people who need it.…
What started Medicare or plain and simple what is Medicare? If you’re under the age of 65 you may have no earthly idea what it is, and if you don’t you’re definitely not alone. Medicare can be defined as the federal health insurance program for people who are 65 and older, though some younger people with disabilities do qualify for it. The idea of Medicare came about in 1912 when President Teddy Roosevelt began the platform for health insurance. It didn’t catch on until 1945 when Harry S. Truman sent a message to congress calling for the creations of funds for national health insurance.…
Doctor’s Hospital is an acute care facility in a small town. Due to a major financial disruption they had to transform their organization’s governing structure. As a result, they did not consider the impact of CIO in IT and they turn CIO’s full-time job into a part-time job. Therefore, Doctor’s Hospital faces many information system challenges. Along with that hospital is undergoing 3 phase construction.…