Service Area Is Schenectady And The Town Of Niskayuna Area Essay

The Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

The dysfunction of the American health care system implies that not everyone has access to the right medication and medical treatment. Middle-class families and chronically ill patients do not always have access to health care, and when they do they do not receive adequate treatment with regards to hospitalization and medical services or quality of service. The lack of payment reform results in

Unit 2 AssignmentKelley WhitcombKaplan UniversityHI215-01: Reimbursement MethodologiesProfessor Kathleen SobelJuly 20, 2015Medicaid is one of the biggest insurance plans you can get in any state. In the state of Indiana, it is based off of your income. There is a certain amount (income) you have to make to determine if you will receive Medicaid or Healthy Indiana Plan (HIP). HIP is still a form of Medicaid, but you would have to pay monthly cost for it and have certain set of co-pays for certain services that is needed. HIP Plus is the recommended plan for members as it provides health coverage for a low, predictable monthly cost. HIP Plus also covers dental and vision services. If you do not pay your monthly payment you can be removed from

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

Medicaid has grown exponentially after healthcare was expanded under the Affordable Care Act. However, this did not guarantee an increase in access to health care services, as many providers do not accept Medicaid beneficiaries, one of many reasons being low reimbursement rates. This discrepancy in rate reimbursement is further underscored when compared to those

The implementation of the Affordable Care Act has been everything but a smooth transition. The news media enjoys featuring issues found within its policies on a weekly basis. The frequent stories about policy holders losing coverage has the potential to mislead the American public into thinking the insured population is decreasing; however, the truth is that there is a growing problem in the patient to healthcare provider ratio within hospitals.

Contrary to this, anecdotal reports stated that other clinicians sometimes spend more times in checking and treating patients with severe illnesses or who are in critical conditions, which made the physicians care for a greater number of patients with lower acuity. Whenever a physician and clinician bill for the same service, it is very difficult to tell if the physician saw a more complex patient. Due to these uncertainties in comparing their services, the Commission is reluctant in altering the payment differential. From that discussion, every provider must be familiar with some fundamentals about Medicare. First and foremost, there is Medicare Part A, which actually covers skilled nursing home, hospital, and home health charges; and then there is Medicare Part B, which then envelops most outpatient services, the care that patients in particular obtain from a doctor’s office (Fishman, 2002).

Carol Liebau discusses in her article, “ObamaCare Limits Patient Choice”, that hospitals such as Cedars-Sinai and the Mayo Clinic are high-priced and under competitive pressure because of Obamacare. Insurance corporations are in a larger hurry than ever to cut costs (Liebau). However, Americans are coming to realize that those hospitals aren't just thoughtless profit centers. They are pricey because they provide advanced medical care or they offer the specialized treatments that the most ill patients require. Many Americans who had plans they could afford and had access to leading healthcare providers, find that under ObamaCare, they are being excluded from high-quality care unless they want to pay much more for

The Hospital Fairness and Transparency Act, state of Massachusetts, I feel it is important for communities’ to be aware, and to ensure their taxpayer dollars are instead dedicated to safe patient care and necessary services in the Commonwealth, and in other states as well. I find it admirable that Advocates actually provided legislators with a list of hospitals with funds stored in offshore accounts and will urge legislators to demand greater transparency by passing the HPTFA. Today communities are asking more questions related to healthcare facilities finances in their communities. Massachusetts health care costs

The second invention of Obama Care was the consolidation of hospital systems of epic proportions; they would be able to market their risk-bearing health insurance directly to patients.(Gottlieb, 2015, para. 7) During all these

The article that I selected for this week’s review focuses on the reaction of hospitals over the most recent draft of the GOP healthcare bill, The Better Care Reconciliation Act. The bill stands to generate major cuts to Medicaid funding. The bill, which was just released today, is already drawing up skepticism and opposition by hospital groups. Rick Pollack, president and CEO of the American Hospital Association, stated, “If enacted, the Better Care Reconciliation Act would mean real consequences for real people — among them people with chronic conditions such as cancer, individuals with disabilities who need long-term services and support, and the elderly" (Leonard, 2017). Those who are in most need of healthcare services and are on Medicaid

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

The United States has a unique system of healthcare delivery, it is complex and massive. Twenty-five years ago; American citizens had guaranteed insurance, meaning the patient could see any physician and the insurance companies and patients would share the cost. But today, 187.4 million Americans have private health insurance coverage (Medicaid, 2014). The subsystems of American health care delivery are Managed care, military, vulnerable populations and integrated delivery

Wow Hospital (WH) managers also called healthcare executives or healthcare administrators, plan, direct, analysis and coordinate medical and health services. They might manage an entire facility or specialize in managing a specific clinical area or department, or manage a medical practice for a group of physicians. Medical and health services managers must be able to adapt to changes in healthcare laws, regulations, and technology.

It is there for imperative to have separate specialist for general administrative and human resource functions in hospitals. Secondly with the tremendous expansion in health service it has become essential to have specialists or experts not only in two fields but also in other fields of hospital administration so the maximum efficiency can be achieved at the maximum cost. Hence the need for better planning, organizing, staffing, & coordinating hospitals can overemphasized. Hospitals administration can no longer be left to change in the hands of a person who is “jack- of all traders and master of –