Managed care

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    Baumgartner 10/24/2014 HIMS 1410- Principles of Insurance Instructor: Jazmine Konyek BlueCross BlueShield Association (BCBSA) is a company that consists of more than 450 independantly, and locally operated BlueCross BleShield plans that give health care coverage to more than 80 million Americans. The BCBS is located in Chicago, Illinois, and establishes standards for new plans and programs, Assists local plans with enrollment activities, national advertising, public education,…

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    Utilization In Healthcare

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    year, 2024 United States Government and local governments will have spent at least half of its national budget on healthcare according to a recent study issued by the federal government (Luhby, 2015, para. 9), which is in part due to the Affordable Care Act. In addition, the government has estimated by 2024 that the cost of healthcare for each person will rise at least 5.8% per year (Luhby, 2015, para. 4), which in some way is due to the rising age of the American population. Therefore,…

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    Introduction The health care system is plagued with access disparities, utilization management issues, and inequality of care. For years health care compensation was quantity driven; however, current state is all about quality of care. The million dollar question is “How do we improve our health care delivery system?” Efforts to improve patient outcomes, access to care, equality of care, and better management of health care costs are ongoing. In fact, the Institute of Medicine (IOM) aims for…

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    “I would never want to be kept alive artificially,” 39 year old quadriplegic French man, Vincent Lambert stated to his wife before his motorbike accident in 2008. However, Vincent has remained in a vegetative state since, causing controversy about his condition and whether he should be allowed to choose to end his life. According to French Law, his wife has the capacity to make a decision about her partners’ life; causing controversy between his family and furthermore reignites the debate on…

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    branding in health care can be considered more important compared to any other industry. The reason rests behind the philosophy of health care pertaining to an individual 's most prized treasure: life. A health care organization 's brand should facilitate a deep level of trust and respect to its consumers. Without it, patients will be more reluctant to place his/her life in the hands of a caregiver. The ensuing research describes the importance and use of branding within the health care…

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    HMO Advantage Plan Essay

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    traditional Medicare. Some of the weaknesses of Medicare managed care is that the choice of healthcare provider and medical facilities are limited, prior approval is necessary from a primary care physician for specialists services, surgical procedures, medical equipment, and other health care services which is not required under traditional Medicare, and members are covered only for healthcare services received through HMO except in emergency and urgent care situations (Beik, 2014, p. 165). In…

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    Dolby English 3 14 December 2016 The Health Care System Is In Need of Help Ever since we were born we have depended on health care to keep us alive so far, so shouldn’t it all just be made simpler? In a survey done in 1998 by the Health Conference Survey, 59 percent of Americans believe that America’s health care system is in need of major changes (Nordhaus 156). While 36 percent of Americans believe minor changes are needed (Nordhaus 156). Since the health care system is complex it also has…

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    the same year. In early 1895, the orphaned children were relocated to a home for boys and girls that had been erected in Zelienople, PA. On June 6, 1895, exactly one year to the day after Dr. Passavant’s death, the Passavant Memorial Home for the care of Epileptics was dedicated, with Rev. William Alfred Passavant, Jr. as the first superintendent. Additional buildings were added at Rochester as growth from the original 24 residents continued. Passavant…

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    7. Managed care seeks to control health care costs through controls on price, demand, and supply. Describe at least 5 common strategies by which it does this. Include some discussion of each to at least identify the mechanism and intent of the strategy. Health Maintenance Organizations (HMOs) A member of HMO is required to pick a primary care physician as a gate keeper to coordinate all services. The chosen primary care physician will also be the person who refers a member to another…

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    1. Briefly describe the Medicare program (who in general is covered/ eligible and the basic structure of the program- the parts & what overall each covers). Medicare (Title 18) is a program that provides health care to individuals who are 65 years or older, disabled, or individuals with fatal kidney failure. A basic four-part structure is used to construct the foundation of Medicare, Part A: hospital insurance, Part B: supplementary medical insurance, Part C: Medicare advantage, Part D:…

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