Managed care

proposed changes The barriers to action There used to be significant resistance and minimal incentive for preventing readmission in many layers of health care. It is now true that there has been more awareness and attention to the problems and issues regarding readmission to acute-care hospital, regardless of location of care such as ambulatory care or SNF. Therefore, it is also true that numerous researches and papers published to solve this issue by various interventions and programs reflect…

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. Need for APN It is by no surprise that patient’s healthcare needs are becoming more demanding. Primary care providers are being utilized more…

they decide to make themselves less accessible to these patients with Medicare. Doctors that actually do provide for Medicare are paid these pre-determined fees for each task, and therefore it doesn’t matter if they provide high quality care or low quality care, they are being paid the same amount (How Entrepreneurs Could Solve Medicare 's Problems). Recipients of Medicare can be paying up to three different sets of premiums and they have great…

Urgent care began in the late 1970s and was created to meet a need in a community. The growth from the 1970s – 1980s was slow and steady in comparative to the concept “doc in a box” that one could see without appointment gained popularity. The industry, subsequently gained its respect and vast expansion over the past twenty (20) years as a viable place to receive healthcare when one could not get into one’s “regular” physician (Urgent Care Association of America). The last five (5) years, the…

covers hospital stays, Medicare Part B covers doctor’s office visits; both insurance plans follow the traditional insurance model. Medicare Part C is originally known as Medicare+Choice (M+C) is referred to as a Medicare Advantage plan follows a managed care insurance model. Medicare Advantage plans are Medicare approved private health insurance plans that can be used by individuals enrolled in the Original Medicare A & B coverage. Medicare Advantage…

Reorganization of the health care system was a strategy that came into favor in the early 1970s. Those who espoused this strategy believed that the problem with the health care system originated with faulty incentives that market forces could correct. As such, the structured competition that result from reorganization should allow the health care market to right itself, thereby lowering costs and improving the quality of care. There are three major factors that help explain the appeal of…

Therefore, nurses? responsibility, the nature of care, and nurses? role has also changed. This paper is centered around the evolving health care changes and its impact on the nursing profession, including a continuum of care, accountable care organization, medical home, and nurses managed health clinics. Furthermore, this paper is presented to three nurses colleague and their opinion and feedback are discussed. In the 21st century, health care practices have changed rapidly compared to previous…

The article describes one of a number of issues that affects not only the relationship between a physician, a patient and the managed care network, but also offers an observation/or opinion in regards to the impact of the Patient Protection & Affordability Act. Depending on which side of the argument one may wish to champion, advocate or proponent, there are and will always be too sides to the story of any legislative act. Legislative action originates from a myriad of influences that may wish…

Information Set(HEDIS), Health Paln Survey, Affordable Care Act(ACA) Centers for Medicare and Medicad Servcies( CMS), Health Maintance Organization, Accrediation, SOAP(Subjective, Object, Assessment, Plan), PPO(perferred provider organization) I. INTRODUCTION UNDERSTADNING THE HEALTH CARE TREAMENT PROCESS WHICH BEGINS WITH YOUR PHYSICIAN…

Many people agree that health economics is ethical, political, and monetarist the views on scarcity within the health care industry. The economic evaluation of the U.S. health care system includes two major insurance groups to consider, Capitation, and Fee-for-service, of which, can help determine effective health policy. The role of economics in health care focuses primarily on the function of a market-price economy, thus the value of supply and demand can determine the quantity and price of…