Health Care Utilization Essay

The types of managed care are differentiated by definition, operation, structure, and information needs. `HMOs were the most common type of MCO until commercial insurance companies developed PPOs to compete with HMOs' (Douglas, 2003, p.331). `HMOs are business entities that either arrange for or provide health services to an enrolled population after prepayment of a fixed sum of money, called a premium' (Peden, 1998, p.78). There are three characteristics that an HMO must have. The first is a health care financing and delivery system that provides services for members in a particular geographic area. Second, is ensured access to a complete range of health care services, health maintenance, treatment, and routine checkups. Last, health care must be obtained from voluntary personnel that participate in the HMO. The five HMO models related to the participating physicians are the Staff

President Obama signed the Affordable Care Act on March 23, 2010. This law puts in place widespread health insurance reforms that expanded out over the last 4 years and continues to change the lives of many Americans today. Health care reform has been an extensively debated topic for multiple years, and the ACA is the first effective attempt at passing a law aiming to make health care not only affordable, but accessible for all individuals. The law impacts many Americans including, children, employers, government programs which includes federal and state, health plans and private insurers, health care coverage, health care cost, and the quality of care received. The main goal of the law is to expand health care coverage, broaden Medicaid eligibility, minimize and regulate health care cost, and improve the health care delivery system. In order to improve the health care delivery there have been new consumer protections established and an increase access to affordable care.

After you define each term, describe in 40 to 60 words the health care setting in which each term would be applied. Include at least two research sources to support your position—one from the University Library and the other from the textbook. Cite your sources in the References section consistent with APA guidelines.

In the space provided, write each term’s definition as used in health care. You must define the term in your words; do not simply copy the definition from a textbook.

The Affordable Care Act, also known as Obamacare or ACA, is the health reform law enacted in 2010 by Congress. The official name of this reform is the Patient Protection and Affordable Care Act. Many provisions of the law are already in effect and the rest are going to continue to develop until 2022. After a year of intense political wrangling, the health reform initiative was passed by Congress. Even though it falls short of providing universal coverage, it is unlike the Clinton proposal. The Affordable Care Act was intended to expand US citizens’ and legal residents’ access to health insurance coverage, control future costs, and improve the functioning of the healthcare delivery system. It improves access to care and balances spending through regulations and taxes. Healthcare has always been a crisis in the US and the Affordable Care Act contains hundreds of different provisions that address these aspects. The Affordable Care Act increases the quality of health insurance at an affordable price so all Americans can have access to it. In exchange, most people who can afford to obtain health coverage must by 2014 or pay a per month fee. The ACA offers Americans a number of new benefits. It sets up a Health Insurance Marketplace where we can purchase federally regulated and subsidized Health Insurance during open enrollment. It expands Medicaid to all adults in many states, as well as improving Medicare for seniors and those with long term disabilities. Obamacare expands

In the space provided after each term’s definition, summarize a health care management scenario that illustrates the importance of the skill, concept, procedure, or tool to which the term refers. In the scenario, you may wish to consider the following:

The Affordable Care Act of 2010 expanded access to health insurance in the United States to millions of uninsured individuals. Early findings indicate that there have been significant reductions in the rate of uninsured among the poor and working age adults. Consequently, the number of adults who did not get needed health care because of cost declined as well as the number of adults who reported problems paying their medical bills. Hpwever, despite the many advances the Affordable Care Act provided towards health care reform, there are still flaws to the system.

The Affordable Healthcare Act makes healthcare and health insurance more affordable and more available to more Americans. It is able to do this by new consumer protections, rules and regulations on the healthcare industry. This is shown when creating a marketplace for subsidized insurance, and reforming and expanding public healthcare programs. These include Medicare and Medicaid. This act can also include measures to cut the growth in healthcare spending in the United States.

On March 23,2010 the Affordable Care Act (ACA), also known as Obamacare, was signed into law. This act aims to provide affordable health care coverage for all United States citizens. “The Affordable Care Act affirms the core principle that everybody should have some basic security when it comes to their health care.” (President Obama) It will provide insurance to more than thirty million people who have been previously uninsured, and will be achieved by expanding Medicaid and extending federal subsidies to the lower and middle income Americans to aid in purchasing private coverage. Although many attempt to view it in a completely positive or completely negative way it affects all aspects of the health care industry in various ways.

The Affordable Care Act(ACA), or Obamacare, is a new law that aims to make healthcare more affordable, increase the quality of healthcare, and expand access to healthcare. In order to provide these benefits

Throughout the last half of the 20th century, employers have acted on their own to regulate health costs by requiring employees to join health maintenance organizations (HMOs). More than 100 million Americans are under managed care. However, many patients and doctors complain that HMOs impose too many regulations and sacrifice healthcare quality. HMOs are undergoing a high level of scrutiny due to criticisms that the network is controlling and jeopardizing the healthcare system of the nation.

The Affordable Care Act also known as Obamacare increases the quality, accessibility, and affordability of health insurance for all types of people with various financial status. In exchange, people who do not have an insurance would have to pay an additional fee for not having han insurance. This policy would make more people get an insurance and receive benefits as they grow old. This would ensure that it is not cheap for the people who are actually able to pay for their service. This law, stops insurance companies from dropping you when you are sick, protects against gender discrimination, expands free preventative services and health benefits, expands Medicaid, improves Medicare, requires larger employers to insure their employees. This would ensure equality for all patients are patients would not be abandoned when they are severely sick or not able to pay for their treatment. This also creates a marketplace for subsidized insurance providing tens of millions individuals, families, and small businesses with free or low-cost health insurance, and

The Affordable Care Act (ACA) was enacted in March, 2010. The purpose of this law is to reform public and private health insurance systems resulting in expanded coverage for millions of Americans by the year 2023. Full implementation of the Act, will result in a reduction of the number of uninsured U.S. citizens by more than one-half (Rosenbaum, 2011). The ACA “expands Medicaid eligibility to include all individuals and families with incomes up to 133 percent of the poverty level” (Riggin, 2013).

which care is delivered by a specified network of providers who agree to comply with the care

A pre-existing condition is a health problem that existed before you apply for a health insurance policy or enroll in a new health plan. A pre-existing condition is a health problem that existed before you apply for a health insurance policy or enroll in a new health plan. A pre-existing condition can be something as common and as serious as heart disease, high blood pressure, cancer, type 2 diabetes, and asthma. These are some chronic health problems that affect a large portion of