Health Care Case Study

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.

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.

1. Managed care plans (PPO/HMO) have had different successes in medicine and dentistry. Explain those differences and why you think they have occurred.

One in every four Canadians will be affected by lung disease over the age of 35 and the rate is predicted to increase (Gershon, 2013). These statistics demonstrate that every Ontarian, if not affected themselves, knows someone who is. North East Ontario (NEO) is a vast area and has a significant population with CRD (LELHIN,2014). Access to a northern PRP requires significant travel for patients (OLA, 2017;Crighton, Ragetlie, Luo, To, & Gershon, 2015). The geographical distance creates barriers to accessing PRPs.

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

At your request I have reviewed the Boards electronic case folder in the above-referenced matter, paying particular attention to the resumption of treatment in 2017.

The article describes about the two main perspectives related to the contracting for Managed Care Services including from the general issues to specific details in a deep of contract and many practical issues as well as the specifics of each provider type. In modern medical industry, Managed Care Service contracting process is becoming more important because complex business relationship in medical industry goes through the renewed Government regulations and accreditation requirements, and it always require high quality of care accompanying with additional risk by the service providers. The author points out the negotiation is very essential for both sides, and in order to endorse on very good written agreement, both sides obligate to be aware their rights and responsibilities as well as all

Patient Ms. A. H. admitted with hopelessness, and pain. Complains of anxiety over financial situation in her family.

The concept of data sharing has evolved over time from its infancy in the 1980s. The Institute of Medicine formed a committee to explore the development of computer-based patient record. In 1991, the committee released their report on the CPR and urged its implementation within a decade (Sayles, 2013). Their viewpoint was the technology was needed to improve health care. Their definition did not begin and end with defining just the data elements, but also encompassed the applications involved. Many of their initial ideas are still in use today, such as decision support systems and practitioner reminders and alerts. Although many developments have occurred in the 25 years from this initial report, the EHR is still not

It appears Carl’s monthly United HealthCare premium in the amount of $499 & United Healthcare- Medicare Medical Insurance in the amount of $93 for the month of July has not been debited from his Citi checking account. These payments were set up as a monthly auto debit and I have not seen a debit in the past week. These payments normally are deducted on or about the 5th of the month. We do have log in information to pay the $499 premium using his Citi personal account information; However we do not have a way to pay the $93. Would you happen to know if Carl may have cancelled or changed

Having an already limited number of doctors, there is slim competition between these practices causing a decrease in motivation to persuade customers, increase facilities, or give patients superior care. In comparison of Canada and the United States, Bazuik claimed that what she likes about the United States health care is the competition between doctors. “They are consistently advertising and promoting that they have better business and better facilities. Everything is basically full in Canada, so they are not worried about winning over patients” (Bazuik). This competition in the United States forces doctors’ offices, hospitals, and other health care providers to give each and every patient the best care possible. This makes citizens feel

The term quality in the healthcare setting is well studied (Sheps, 1955; Donabedian 1966, 1988, 1990, Campbell et al., 2000) just as the need to increase the level of it (IOM, 2001; Kelley & Hurst, 2006). In a similar manner, Participants associated eHealth with increased level of care quality due to many factors. A commonly emerging theme related to this was the online access or access to information from distance, which was previously noted by Fernández-Luque, (2015) or Chang & Chang (2008). This finding contained two additional interesting dimensions, which are a bit in contradiction. Participant 4. and Participant 8. mentioned the experience of accessing patient information out-of-office hours (e.g. from home). On the contrary Participant

Healthcare.gov is one of the most amazing idea, a propellor to solve many of healthcare’s current problems in the US. The number of uninsured people were rising and led to the overall increase of prices for healthcare. To provide everyone with healthcare the only solution was to increase the insured population. The health insurance exchange (HIX) which was healthcare.gov biggest task was to create a market place to facilitate a free market economy for the health insurance sector. This would enable price transparency - which is usually absent in healthcare, reduced cost - due to the savings in advertising, marketing and time for everyone, and greater access to healthcare insurance. Apart from these there were also certain

In reciting of her journey, Michelle made it evident that it was both professional and unprofessional behaviors which impacted her experiences with triple positive breast cancer. The key components of Patient care relationships are built up on integration, decision making, communication, and collaboration. (Nicoloro-Santabarbara, J., Rosenthal, L., Auerbach, M. V., Kocis, C., Busso, C., & Lobel, M. (2017). In the code of conduct, section 2.3 ‘Shared decision- making’ signifies that making decisions based on healthcare is the ultimate responsibility between practitioner and patient who may wish to involve their family. (Medical Radiations Practice Board of Australia, 2014). Cancer triggers psychological difficulties in responding to the treatment

Within this case study, I will discuss the care I gave to a child in an outpatient's clinic. In accordance with the code of conduct (NMC, 2015) the patient will be referred to as ‘Eve' in order to protect confidentiality. Eve has a condition called Bardet-Biedl syndrome (BBS) which can affect many systems in the body. The signs and symptoms of this condition vary among affected individuals, even among members of the same family (Forsythe and Beales, 2013).