Essay about HSM 543 Week 6 You Decide

The PHO served as a vehicle through which competing hospitals and physicians could bargain collectively with health plans to obtain higher fees for themselves. The owner PHOs, member hospitals, and member physicians canceled contracts with payors and informed them that the PHO would be the sole entity through which they would enter into payor contracts. To contract with the PHO, payors allegedly have had to accept the fixed physician fee schedule and fixed discount of no more than 10 percent off hospital list prices.

Sony have been known worldwide as a Japanese multinational company, its efforts trying to expanding business in United States, have made that Sony acquires CBS Records and Columbia Pictures. Thus, creating Sony Music and Sony Pictures, which represent Sony entertainment. This involved to the company in $1.2 billion of debt, and assigned goodwill assets for $3.8 billion.

Some of the current changes that can be seen in regards to prescription privileges include changes in the ways that physicians and mental health professionals are able to prescribe medications to their patients. According to Brenda Smith of the APA (2012), currently patients receive their medications for psychological conditions by a physician usually without having been evaluated by a mental health practitioner according to the CDC. The trend includes individuals to visit their general health practitioners in order to receive psychotropic medications such as antidepressants and anxiolytics. The problem with individuals receiving these medications from other sources include: deterrence

After going through the case of Margie Whitson, the dilemma is the fact that Margie is looking to have her pacemaker removed which will in turn would end her life. So far, Margie Whitson has had a rough year and has come to the decision that she wants her pacemaker deactivated because she believes it is delaying her death. Her pacemaker is the only thing keeping her heart beating at this point. But even at that, her doctor, Dr. Vijay, refuses to deactivate it due to the fear of legal action/misunderstandings of the ethical and legal acceptability. Margie Whitson is very determined to have her pacemaker removed so she call for Jane Robison, the social

| A disease or condition that affects a greater than expected (normal) number of individuals within a population, community, or region at the same time is referred to as an ____.Answer

b. The emperor Kangxi led the conquest of the island of Taiwan , home to Chinese and Japanese pirates, in 1681. Struggles with a new rival to the north and northwest, manchurians , led to constant conflict and extensive territorial gains for China.

I do not believe my facility is where it needs to be to be complaint with the strategic plan. It just seems like we are making movement slowly. To make the process complete we would need to involve the family practitioner. I am not aware of any such plan. Our hospital rooms all have computers available in the rooms. So it is important to always be aware of who is around you when using the computers and would be able to see private patient information. We also have private and semi-private rooms. It is very difficult to protect privacy in a semi-private room when the other patient is

Those up on the hill have responded with a charge of state and national bills pointed at bringing in a booming healthcare industry that 's pretty much free-for-all. For their part, the networks don 't see what the entire objection is about. They say productiveness and peoples request will keep their guidelines just and within ones means. "The networks are trying not only for cost, but also for class and peoples’ satisfaction. It 's a patron service industry when you get right down to it. The network points to their absolute success in bringing down costs and keeping the mass of network enrollees happy. Each month people across the nation join a network, so it 's plain that, Network care is here to stay in one shape or another.

Middlefield hospital was once a great hospital that served a variety of patients with the best care. Over the past couple years Middlefield has been having some problem because of the new big hospital in the area. With this new hospital coming to the area Middlefield has been losing many of its patients and getting a lot more uninsured or under insured patients.

After reading over the material in chapter 14, it is my opinion that selective contracting should not be allowed to exist between providers and payers. Utilizing selective contracting puts both the payer and the provider in a position to possibly limit the quality of care actually needed by the patient for their own benefit. This benefit doesn’t necessarily have to be in the form of a financial gain, but could merely be in the form of a financial security. Selective contracting appears to place of great deal of power within the hands of the payer, who now has the power to control fees charged by providers, through controlling which providers make it on their list of in plan providers.

The purpose of this memo is to present the partnership analysis. Based on this analysis, I conclude the client needs a partner. MCMPC don’t have enough resources, competencies, and capabilities. They do not do well on their own competing with IMG. They also need more patients and, a potential partnership can help address these issues.

As the president and CEO of Horizon Blue Cross Blue Shield Health Insurance Company, I believe that it is in the best interest of our clients to implement the Horizon Omnia Insurance Plan. For years, medical care providers have been charging outrageous rates for health care at the expense of their patients and that stops today. I believe that our company is on the verge of not only making health insurance more affordable but also making more sense to our policy members. The 2-tierk hospital networking system that we are implementing will provide equal, if not better options and services for our members across the state of New Jersey without the agony of high costs and deductibles. Health care has been the latest conversation piece

Following the analysis and considerations of the basis of the suggested solutions, I will choose the solution offered by our CEO. It is evident that from our financial position, signing the Megaplan as it is will kill our business. Not signing it also puts us at a considerable risk of losing our majority of the consumers. We need a relationship with Megaplan but not on their terms. One of our competitive advantages is that we are the only health provider in the distance. If we decline the offer, the employees will be force to travel for distances to find the Megaplan PPN. They will complain to the employer who will have to revise his position with Megaplan. Writing different terms that do not expose us fully to the vulnerability of the Megaplan

When preparing to negotiate a health plan contract, organizations should review 1) the reimbursement rate for services, 2) the impact the payer will have on the workflow (how responsive the payer is to any and all claims problems, implementation of new policies and procedures, etc.), 3) develop a payer profile (review a year or two of claims history, discuss get any denial issues that the payer should address, and how much revenue the payer brings to the organization), 4) gather feedback from the organization billing department to find out claim processing time, responsive the payer to claims problems, rep knowledge, willingness to problem solve, and so

Risk sharing occurs when both the parties finds the risk and agrees to share the loss that may occurs due to that risk. The co investors and joint ventures get into the risk sharing arrangements by defining their true contribution and limiting their commitments related to their future and financial commitments. The risk sharing arrangements or contracts are usually prevented into the “Outsourcing Transactions” where one has physical control over the process and the other party has been prevented from such control and therefore these kind of arrangements prefer to go on with the “Fee for Service” Model. (1)