Health Insurance Coverage: A Case Study

Electronic health records can provide many benefits for providers and their patients, but the benefits depend on how they 're used. Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria. The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States. The Health Information Technology for Economic and Clinical Health (HITECH) Act provides the Department of Health & Human Services (HHS) with the authority to establish

Under the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA, or the Stimulus Act”), certain eligible providers are eligible for financial incentives for following and documenting “meaningful use” of a certified electronic medical record system. According to the HRSA, “in July 2010, the Centers of Medicare & Medicaid Services (CMS) published a final rule which established three phases of the EHR Incentive Program. The three stages of Meaningful Use are designed to support eligible professionals and hospitals with implementing and using EHRs in a meaningful way to help improve the quality and safety of the nation’s healthcare system.” The end point here is not that having an electronic medical record will allow for a

The American Recovery and Reinvestment Act was created to improve the efficiency of how health organizations will improve patient outcomes and accountability, aid in coordination of that care; improve and promote effective health management across organizations, as well as align incentives with good patient outcomes. It was designed to use electronic health records with in and across health organizations in order to improve the outcomes of medical care. In order to do this correctly, health and medical organizations must “meaningfully” use the programs that are available in order to receive any incentives given by Medicaid and Medicare.

America’s Health Insurance Plans (AHIP). (2011, September 9). Rising Health Care Costs. Ahip.org. Retrieved October 22, 2013, from http://www.ahip.org/Issues/Rising-Health-Care-Costs.aspx

It is important to understand that, meaningful use regulation established objectives that healthcare organizations such as hospitals and other healthcare facilities have to meet in order to be qualified for the center for Medicare and Medicaid services. Many healthcare organizations are making progress when it comes to meaningful regulations. There was a recent survey that shows that a lot of healthcare organization began using some type of electronic health record so as to be able to input patients, data, information, allows healthcare providers to establish clinical notes and to be able to write prescription and transfer patients’ information from one provider to another (Lopez, 2014).

The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA), is legislation aimed at the adoption and “meaningful use” of health information technology. CMS was authorized to establish incentive programs for eligible Medicare and Medicaid providers who adopt, implement, upgrade, or “meaningfully use” certified electronic health records (EHR). The term “meaningful use” is an acknowledgement that improved health care is not the product of technology but a method to exchange and use health information to support clinical decisions at the point of care.

Data show that the number of uninsured Americans has greatly reduced over the past 2-3 years. However, prior to the adoption of various provisions of the Affordable Care Act (ACA), there were over 41 million people uninsured in 2013 (Kaiser Family Foundation, 2014). The number of people without health insurance, especially children, has steadily increased throughout most of the past decade. Children without health insurance are more likely to suffer from preventable and treatable illnesses, including their long lasting related effects, than their insured peers (Majerol et al, 2014). Majerol et al. also demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.

Issue: 4.6 million Texans are currently uninsured without access to affordable healthcare due to the state’s refusal to expand Medicaid or provide additional public health coverage options. Section 1115 of the Social Security Act gives the Secretary of Health and Human Services the authority to approve states’ experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs.

The perspective I have about the recent efforts to help the uninsured in the U.S is it has come a long way towards positive change since the 1950’s till now. The Patient Protection and Affordable Care Act of 2010 (ACA)/ Obama Care, has provided the uninsured with medical insurance and access to reduce the risk of health issue through prevention. The law expands eligibility for public insurance, use of federal subsidies to make private coverage more affordable, new rules on insurers and employers to make coverage more accessible, and require all Americans to have some form of health insurance (Knickman and Kovner, 2015). The outcome of this enactment; 5 million Americans enrolled in state Medicaid programs, 8 million received public subsidies,

The Affordable Care Act (ACA) caused some of the issues central to the expansion of Medicaid. Some of the major challenges in Affordable Care Act (ACA) the improved access to more individuals. According to Levitt, Claxton, and Damico (2013), the Affordable Care Act expansion increase limitation to families under 65 whose income is at or below 133% of federal poverty guidelines. This leads into significant growth in eligibility of newly coverage populations. Medicaid provide an opportunity to identify successful enrollment and renewal practices, strategies to ensure access to care, effective models of person-centered and coordinated care, and payment systems that align financial incentives with goals for quality and cost. (Paradise, 2015). Especially

According to the National conference of Country legislature, the 50 state-owned legislatures cooperatively "create thousands of health strategy verdicts each year," not comprising the verdicts prepared by native administrations, which often direct hospitals, and secluded organizations, such as underwriters. These verdicts can comprise budget annexations, requests for doctors attaining their authorizations, which amenities are enclosed by assurance, how individual health information is accomplished and which inoculations children must obtain, among many others.

The Affordable Care Act (ACA) was signed into law March 23, 2010, and aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance, and contain the rising costs of health care for individuals and the government( APTA ,2013).

I am a big proponent of the health care department and the services that it provides especially when I couldn't afford health insurance. I feel that we really need to re-think how we are handling our substance abuse and mental health facilities.

Let me start by staying how affordable is affordable? The Affordable Care Act (ACA) otherwise known as the Obama Care is a health care coverage that is invented for those people who cannot afford to pay for high insurance cost. According to the market place (2014), most people who bought the insurance coverage stated that the “coverage is affordable”. This is factual for those people who have low income and are “paying under 125 dollars per month” Marketplace (2014).

On this date worker received a message from Misty Jenkins, social worker for HealthSprings Insurance. She stated Mr. Duncan was not doing well and someone needed to do a safety check on him. Worker returned Ms. Jenkins call, learned Mr. Duncan went to the ER on Friday 2/12/16, and was diagnosed with a UTI. HIs doctor Dr. Brassfield refused to admit Mr. Duncan to the hospital and sent him back to Laurel Gardens (Mr. Duncan was discharged from the hospital on 2/9/16 and returned three days later with a UTI.) Ms. Jenkins believes Mr. Duncan's discharge to Laurel Gardens was a bad discharge from the hospital. Worker explained to Ms. Jenkins that Dr. Brassfield refused to state Mr. Duncan was mentally or physically unable to care for himself. Therefore,