Reimbursement In Nursing

Need for renovation The hospital that the clinic is attached to is opening a brand new facility and has decided to expand their community support by opening a family medicine clinic that will utilize the hospital resources. The community is a wide range of working classes, low income, poor, and rural families that must travel some distance to reach health care providers. Attracting patients that need primary care and continued health care will drive referrals to the ancillary departments in the hospital. This increases revenue for the hospital.

Quantity & Quality of Healthcare: Increased Mortality Rural Americans depend on their community hospitals as critical component of the area’s economic and social material. These hospitals are usually the largest or second largest employer in the community, and often stand alone in their ability to offer highly-skilled jobs. According to, The Opportunities and Challenges for Rural Hospitals in an Era of Health Reform; “For every job in a rural community, between 0.77 and 0.3 less jobs are created in the local economy, spurred by the spending of either

Even though this money is being awarded to providers in rural areas, the nation continues to have a shortage of rural health providers (Derksen, & Whelan, 2009). One solution would be to increase this grant money or make it even more available for specialist. Again, the problem with this solution depends on the grant money being available for use. Another concern is that this change takes time; the access to care improvement needs to happen now. Lastly, when the provider has gotten the loan repaid there is not always a motivation to stay in the rural area. If providers leave, problems involving continuity of care

The united states have a unique health care system of delivery that pursues to target some specific areas. The health reform, Patient Protection and Affordable Care Act also called the Obama care (2010), which holds the promise of universal health coverage under government mandates. With a predominant role that is

Traditionally, it is custom that patients to travel to the provider. Although it is possible to create an establishment for patients to visit providers, Mullin & Stenger (2013), advise patients choose home care in which the provider travels to them. According to Buchan, Couper, Tangcharoensathien, Thepannya, Jaskiewicz, Perfilieva, & Dolea (2013), the World Health Organization provides favorable recommendations to procure health care professionals into the rural environment. These recommendations include providing further education opportunities, improved living conditions, career development programs, incentives such as public recognition, and a safe and supportive work environment. Another essential recommendation is to implement jobs for multiple scopes of practices and varieties of health care workers. It is important that health care providers have the support of a multidisciplinary work staff to implement safe and efficient

Given our rural veterans' and other non-veterans need for access to high quality healthcare, allowing nurse practitioners to practice with full authority in the rural and underserved areas will increase access to care, decrease lengthening delays in healthcare delivery, decrease healthcare costs, and promote patient safety. This is why I urge you to move forward with the proposal to recognize nurse practitioners to practice within their full scope in the rural and underserved urban

Individual Learning Project 1 Liberty University Accounting for Decision Making February 14, 2016 Company Analysis and Evaluation Project A Federally Qualified Health Center (FQHC) is a health center that allows patient who might otherwise not receive the critical primary care that they may need. These types of facilities help to fill crucial access gaps, allowing patient to pay according to their income on a sliding fee scale. “Congress passed FQHC-enabling legislation as part of the Social Security Act in 1989 and the application process and requirements for federal qualifications are governed under the Public Health Service Act” (Hennessy, 2013). There are approximately 1,200 main health centers that deliver care with over

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary

Single-Party Payer The current inflation in health care cost in the United States has gotten everyone troubled and in search for new ways to adapt or stomach these constant increases. A recent online article posted on Fortune website states that the expected cost of healthcare would grow 6.5% through the upcoming

“The Tax Equity and Fiscal Responsibility Act (TEFRA), signed into law September 3, 1982, mandated the development of a prospective payment methodology for Medicare reimbursement to hospitals.” http://sunlightfoundation.com/blog/2009/09/08/slug/. It changed Medicare reimbursement from a fee for service to prospective payment system. Which is where there`s a reimbursement method where`s there an amount of payment determined in advance of services being performed. The rates are done annually. Reimbursements for inpatient care by a classification scheme called diagnosis-related groups. If the patient might have to stay longer in inpatient care more than average days, the hospital may lose money on that patient.

 The new and improved health care system in America seems to fall short for many people. The Affordable Care Act made history after President Obama signed it into law on March 23, 2010. This bill is going to create a change in how the current system operates which has kept

Medicare Rural Hospital Flexibility Program and Critical Access Hospitals BACKGROUND Significant health disparities between rural and urban populations have been a major concern in the United States. One prominent factor contributing to the disparities is lack of access to quality care in rural areas which is closely associated with challenges faced by rural health care providers (National Rural Health Association, 2007). Rural hospitals are the key health care provider in rural areas, offering essential health care services to nearly 54 million people (American Hospital Association, 2006). They face a series of challenges such as workforce shortages, rise in health care costs, difficulty in finding access to capital, difficulty in

• the population that the health center caters to must be identified as an unserved or underserved one

Challenges in Rural Communities A challenge that many rural communities are dealing with is the lack of primary care physicians, specialist, understaffed hospitals, and transportation. “Only about ten percent of physicians practice in rural America despite the fact that nearly one-fourth of the population lives in these areas” (National Rural Health Association [NHRA], n.d., para. 2). Although, there are programs designed to improve patients access to hospitals and physicians in rural areas, provider access for these patients remains a barrier. Technology can bridge some of the gaps of care for these patients and it can be beneficial in many ways. With enhanced technology, primary care physicians and patients will be able to have support, access to quality care, improvement in self-management skills, which ultimately, will improve a patient’s health. To assist physicians with delivery of optimal care and for patients to be able to go to scheduled wellness visits with physicians, a new approach to solving rural health barriers are needed.