Case Study: Metropolitan Health Plan

The Basic Health program could be structure in several ways. It could expand programs such as Medicaid and CHIP and contract with managed care plans on behalf of its Medicaid and CHIP beneficiaries outside the private insurance market. These changes would allow both programs to continue as a "separate program with a separate financing mechanism and risk pool from that of Medicaid and CHIP, but would leverage the state's existing infrastructure for information technology, contracting, rate setting, and other function" (Angeles, 2012). Alternatively, a state could expand the Medicaid managed care by increasing the number and types of service through different network of providers, other than those that serve Medicaid and CHIP beneficiaries (Angeles,

Memorial Healthcare System is a public hospital system that was established in 1953. This system, also commonly referred to as the South Broward Hospital District, seeks to provide exceptional medical care to the South Florida community. There are a total of six hospitals in the network, including Memorial Regional Hospital, Memorial Regional Hospital South, Memorial Hospital Pembroke, Memorial Hospital West, Memorial Hospital Miramar, and Joe DiMaggio Children’s Hospital.

On this date worker received a call from Ms. Kimbrell, Medicaid Caseworker. Ms. Kimbrell stated Mr. Duncan's nephew who is living at the residence in Curry would need to fill out a Statement from Dependent Relative/Community Spouse form. Because he is living in a home, Mr. Duncan is part owner. She also stated Mr. Duncan would be denied institutional Medicaid because he was not transferred to a long-term facility. However, he could receive hospital Medicaid because he was in the hospital longer than 30 days. The transfer penalty does not apply to hospital Medicaid but if Mr. Duncan ever applies for institutional Medicaid, they would need the person who purchased the home from Mr. Duncan to provide something showing the amount of money he spent

Kaiser Permanente Colorado is proud to offer a program that allows safety net primary care providers to electronically request advice from select Kaiser Permanente specialists. Currently eight speciality departments participate in this program that supports safety net primary care providers, the patients are uninsured and below the federal poverty level.

We are committed to giving our patients the highest level of care regardless of ability to pay.

Volunteering at Kaiser Permanente played a significant role in my decision to pursue a career in healthcare as a physician. When I was observing a physician repair a head laceration, there was a disjunct communication between the patient and physician. Because I am fluent in Vietnamese, I understood the patient’s fears as she muttered words in her native language that expressed her confusion and fear while the physician attempted to console her in English. When I explained the doctor’s processes in her native language, Vietnamese, she was elated someone could reassure her worries, especially when family members do not understand enough English to comprehend the situation. Through various observations of nurses, physicians, and Emergency Department

Arrowhead Regional Medical Center (ARMC) is a 456-bed teaching hospital located in Colton California. Out of the 456 beds, 90 beds are behavioral health and 366 are inpatient hospital beds. ARMC is a comprehensive inpatient and outpatient health care facility providing multitude of care including: primary care, specialty care, trauma care and houses the only burn center for four counties. Moreover, ARMC has 9 residency programs which are accredited by ACGME and AOA, both are known entities in graduate medical education. Furthermore, Arrowhead Regional Medical Center’s Ambulatory department operates over 40 specialty clinics and 4 family health clinics. Three of the family health clinics are off site located in Fontana, Rialto and San Bernardino. ARMC covers about 98% of Medi-Cal patients through the coverage plan of IEHP and Molina.

BlueCross BlueShield of Pennsylvania offers health insurance plans such as Medicare, dental, vision, and individual and family insurance. Individual and family plans are distinguished as platinum, gold, silver and bronze plans. Other plans include catastrophe and multi-state plans.

Trinity Community is challenged with two current healthcare trends. The first trend is related to Medicare and how doctors are paid on Medicare claims. Medicare’s primary coverage group is for people older than 65 years of age. Medicare also covers some people under 65 that have certain disabilities as well as people of any age that have End-Stage Renal Disease. Year after year, lawmakers have been trying to fix a part of the Medicare law that would cut payments to doctors. Since the late 1980’s, the cuts would continue to grow annually and eventually exceed a 20% pay cut.

In 2010, President Obama signed the Affordable Care Act (ACA) which put into place health insurance reform with the purpose of providing health care access to those who are uninsured and underinsured. The goals of the law are to make health care affordable, accessible and higher quality. In 2013, open enrollment began and now that three years have passed, it is time to evaluate how this law has impacted Ohioans (U.S. Department of Health and Human Services, 2014-a). In this paper, I will discuss health care reform in Ohio, examine positive and negative outcomes, and look at the effect of the ACA on health care economics.

Although the executive committee does not include behavioral health, psychiatrists, Mazhar Munir, MD, and Philip Creps provide critical behavioral health leadership. This team is charged with not only ensuring exceptional care for the underserved, but also keeping the organization afloat amidst the seas of fierce competition from rivals like Spectrum Health and Mercy Health.

The first section to be filled out on the CMS 1500 form in boxes one through 13 include patient demographic information as well as insurance information. This information is captured to ensure the proper claim is associated with the correct patient.

The Chicago Medical District consists of research facilities, labs, a biotechnology business incubator, a raw development area, four major hospitals, two medical schools, and over forty healthcare facilities. The Chicago Medical District is only a few miles from the world famous Chicago Loop where visitors can enjoy museums, exciting entertainment, and more. Some of the popular places nearby include the United Center, the home of the Chicago Bulls, the Money Museum at the Federal Reserve Bank where visitors can learn about the money museum in the USA and view examples of what money used in times past looked like. Check out this list of hotels and vacation rentals nearby so that when you’re ready to turn in for the night, you don’t have to

I chose to search for a health insurance plan that would serve well for myself, my spouse, and my child that would be considered a minor. I chose to look throughout the gold plans due to the possible income from both my spouse and I within the future. My listed income between my spouse and I would be around $110,000 10 years from now, considering where I know I am going in life as of right now. The two insurance plans that caught my eye were the AmeriHealth New Jersey: IHC Gold EPO Community Advantage $10/$20, that consisted of $950 monthly premium, a $2000 deductible, and a $8,500 out of pocket maximum; the AmeriHealth New Jersey: IHC Gold HMO

It was in 1977 that the United Healthcare United Health group was founded by Richard Burke. The headquarters of the company are in Minnetonka, Minnesota. This organization works towards the betterment of people's health, it help them in living a healthy life by providing them with the kind of health care that would be best for them. The main focus of United Healthcare which is a major division of the United Health group is to provide the people with better health benefits and coverage.