Managed care

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    Evolution Of Healthcare

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    hands, no indoor plumbing and raw sewerage running through the streets, leeches as part of care…it almost sounds like a horror movie; but this is a fairly accurate description of early hospital care throughout the world. Originally known as ‘houses of God’ most of these primitive hospitals were little more than a few beds to provide care to the ill, infirm and insane who had no family or means for other care (Gormley, 2010). Between 1860 and 1930 a number of “almshouses”, the predecessors to…

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    enjoyed the best health outcomes in the world; however, according to the World Health Organization the United States health system ranks 37th of the surveyed countries worldwide (Colorado State University-Global Campus, 2014). This is one reason many managed care organizations offer case management to achieve optimal wellness for their members while reducing costs. The following information comes from the unique perspective of a case manager…

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    Healthcare Clinical integration is a collaborative effort between different types of clinicians that work with patients to ensure quality care. The efforts can also reduce health care costs. Many studies have proved the benefits of clinical integration in improving patient outcomes and reducing health care costs (Clark, Savitz, & Pingree, 2010; Conrad, 1993; Managed Care Weekly Digest, 2011). Others on the other hand, have only analyzed the effects of specific chronic problems to reduce cost…

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    Rural Health Issues

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    less practicing physicians with a shortage of specialists. Lower pay to primary care physicians is deterring many from choosing the field. Rural areas tend to be poorer and residents have a harder time obtaining health insurance coverage. Rural residents face various economic, social and cultural factors that influence how they receive health care. The Affordable Care Act provides a method to increase access to care through Medicaid expansion and tax credits; however, many of the rural residents…

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    Implementation Plan The solution proposed by this author includes, the use of risk assessment and implementation of interventions based on risk stratification to prevent readmissions. Interventions include, care coordination, home health care and remote monitoring as needed. Three presentations will be engaging senior leadership and associates to ensure an effective implementation. Initially, the recommended process will be presented during a one to one meeting with the Senior Vice President…

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    Apr Role In Health Care

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    shortage of health care providers is a common problem seen throughout the United States. This shortage is felt in both the inpatient and outpatient setting. It is essential that the nation looks for creative ways to provide patients with needed medical care in a timely manner. The utilization of Advance Practice Registered Nurses (APRNs) has shown to be very effective in this healthcare provider crisis. This paper will discuss the significant role that an APRN has on health care and what skills…

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    the patient risk of falling (Boenecke, Choi, Lawler, Ponatoski & Zimring, 2011). Then, I will consider the patient age since, increased age increases the patient risk for falling (Given et al., 2011). Finally, I will explain the plan to the patient care technician assigned to my patients because patient safety is our number one goal. One patient falls a month or one patient fall in six months, is one patient fall too…

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    Reimbursement Model Essay

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    There a plenty of reimbursement models. Not all reimbursement models fit each health care situation or health care setting. Sometimes reimbursement arrangements or models with providers include some combination of different repayment methods. There are key differences in each reimbursement model. Each reimbursement model has types of care that are parallel or work together. According to Kongstvedt (2009), “At a simplistic level there are two basic ways to compensate open panel physicians for…

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    Research shows there are common payment methods: fee schedule Resource Based Relative Value Scale from Medicare. Charges are paid at a percentage. Fee schedule generated from the payer. Fee scheduled generated from Relative Value for Physicians (RVP) scale. The payment method that will be explained in this paper will be Resource-Based Relative Value Scale. The research has define Resource-based Relative Value Scale as the value of medical services associated with time and skill level needed to…

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    as an agent of change, there are numerous encounters of unselfish desire to teach and serve others. I believe the core of nursing is also driven by this the desire to provide unselfish care and service to others. In my role as an APN, I will continue to maintain a holistic view by not only providing physical care but also spiritual and emotional support to patients. I will focus on these commitments when considering future employers and seek to find corporations that correlate with my…

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