Washington Healthplanfinder: A Case Study

Reinvest current net income into interest accounts for future variable health care costs for years to come

As Executive Director, I will provide staff leadership for Better Health Association. Our goal for the company is to improve the well-being of individuals. Audiences of all ages will be able to take part in learning about living a healthy lifestyle and developing the skills needed to make healthy choices to prevent diseases and ameliorate conditions for those already afflicted with illnesses. Over the course of the next year, It is my responsibility to develop and lead the staff, management structure, dedicated to achieving the mission for Better Health Care Organization. I plan to make significant changes to our organization, to help guide individuals in Central Ohio, to living a better and healthier lifestyle. My goal is to empower the staff with the training needed to meet our company’s standards.

Poor nutrition in the United States is indeed a scary factor that continues to lead our citizens to chronic healthcare conditions. The article notes “Health People 2020 states the most affected are non-White, Hispanic adult populations are disproportionately affected by obesity” (Kaiser Foundation Hospital, 2014, p. 6)

As Executive Director, I will provide staff leadership for Better Health Association. Our goal for the company is to improve the well-being of individuals. Audiences of all ages will be able to take part in learning about living a healthy lifestyle and developing the skills needed to make healthy choices to prevent diseases and ameliorate conditions for those already afflicted with illnesses. Over the course of the following year, it is my responsibility to develop and lead the staff, management structure, dedicated to achieving the mission for Better Health Care Organization. I plan to make significant changes to our organization, to help guide individuals in

Health rule challenges continue, even as October 1, 2015 looms. Individual insurance benefits fluctuate as employers scramble to control costs, making it increasingly difficult for hospitals and physicians to stay on top of diverse policy provisions and exclusions. Myriad new regulations and mandates for providers and employers also means more responsibility for paying for health care services falls into the hands of patients. Large medical groups and care facilities rely on next generation revenue cycle management (RCM) solutions and medical billing software to automate their workflow and improve reimbursement rates. However, smaller practices and ancillary service providers may still be in the dark about emerging technology and tools to help them control costs without compromising care.

The FQHC PPS encounter rate includes the cost for all services FQHCs provide to Medicaid and CHIP patients, including medical, dental, behavioral health and pharmacy. HHSC is required to set MCO premium rates to sufficiently cover the costs of the FQHC reimbursement rate; that is done

will have a higher premium. These patients must pay the adjustment plus the standard premium

The Better Care Reconciliation Act would phase out Medicaid expansion beginning in 2021, a larger timeline compared to the House of Representative's health care bill, though cuts would be deeper. Older people under 65 years old would pay five five times as much for coverage than younger people, compared to the current 3-to-1 ratio.

The current paper examines the Disproportionate Share Hospital Payment Reduction CMS 2367F rule which was effective on November 18, 2013. The Disproportionate Share Hospital Payment Reduction CMS 2367F is Federal Legislation that was implemented due to the Affordable Care Act. The rule was initially proposed by the Centers for Medicare & Medicaid Services (CMS), HHS on May 13, 2013. The proposed rule was to implement the provision of the Affordable Care Act that reduces Medicaid Disproportionate Share Hospital (DSH) allotments.

| Prospective Payment System (PPS) first began in 1980 with a small number of hospitals partitioned into three groups according to their budget positions---breakeven, surplus, and deficit--- prior to the imposition of DRG payment (Diagnosis- related group). The PPS as DRG’s had been designed to limit the share of hospital revenues derived from the Medicare program budget, and in spite of doubtful results in New Jersey, it was decided in 1983 to impose DRG’s on hospitals nationwide.

The first piece of legislation (one legislation I discussion 2 pieces of that) discuss is section 101 part of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a bipartisan legislation signed into law on April 16, 2015. This law was created to replace the current law in that time Medicare reimbursement schedule with, the revolutionary idea of new program supposed directed focus on the quality, value and accountability of the national health care program. The CMS describe MACRA as a modern system new payment framework, supposed rewarded the national health care providers to obtain the better care instead of more service, looking for value over volume. The information’s observed in the interview provides consistent points

Medicare Access and CHIP Reauthorization Act is a bipartisan federal legislation signed on April 16, 2015 amended as title XVII of the social security act to reform the payment methods that Medicare pays to the physicians for the services rendered by creating Quality Payment Program (QPP) which repeals the Sustainable Growth Rate (SGR) formula for Medicare part B payments, reauthorization of the Children’s Health Insurance Program and implements a rewarding system to physicians for value of care rather than on the volume of services by combining the existing physician quality reporting programs under the Quality Payment Program. The main emphasis of MACRA under this Quality

CCBHCs are entitled to receive enhanced payment via a Prospective Payment System (PPS), which is a method designed to reimburse providers based on the anticipated costs associated with serving the people in their community. This is beneficial because CCBHCs will be able to receive payment for numerous activities that are not usually funded through the current funding streams. For example, CCBHCs can receive payment for services rendered outside of the clinic itself, for peer services, telehealth, care coordination activities, and

Kaiser is able to respond to the challenges set forth because they continue to evaluate what changes need to be made and how to make them successfully. The strategic plan allows for an overview of where the facility is currently standing. This allows for any changes that are made internally or externally to be evaluated at the time of the change instead of after the change has been made and it is too late. The strategic plan helps to have a faster response time because there is already plan in place so it is easier to see where the changes are made and how to correct them without the facility suffering.

The Federal Employee Health benefit program is the largest employer health insurance program in the United States, insuring about 3 percent of all Americans. There are 133 plans, offering 188 coverage options that are participating in the FEHBP as of 2003. Preferred provider organization (PPO), fee-for-service plans, and Health Maintenance Organization (HMO) all offer options. The government’s contribution toward the cost of the beneficiary’s premium is “lesser of 72 percent of the average FEHBP plan premium, weighted by enrollment, or 75 percent of the premium for the plan chosen” (Karen Davis) .