Th Case Study 2: Anthem Blue Cross Blue Shield

There is an established business with a name of Business Pub. This is an organization that requires educated and professionally skilled people to work positions at their organization. A lot of employees that work regular positions, such as administrative, human resource, sales and technology have a bachelor’s degree for the position he or she works. Yet, positions, such as executive, managers, chief executives and other leaders are required to have a master’s degree in the position he or she works. Executives in charge have faced a great deal of environment changes that need a lot of leadership and management skills.

Which under the current design addresses long- term care for a limited amount of time, such as for rehabilitation purposes. These services cannot be received outside of a Medicare-approved facility, which means the person cannot reside in their home and receive the long-term care assistance under the current system. Therefore, we propose to amend this portion of the program to extend the funding for long-term care to include home care. Which consist of the relatives receiving monetary compensation for their care. Under the current policy, 41% of the Medicare budget of $50,000,000,000 is being advocated this particular area.

You are a new physician setting up your practice in a new town. You are researching the different MCOs offered in your area and are considering becoming a physician for one of these networks. You have also invited the sales representatives of several healthy plans to speak with you about the benefits of choosing their plans. Based on the above scenario, answer the following questions: • What effects would join an MCO have your clinic regarding staffing, patient volume, and financial stability?

The Accountable Care Organizations are a coordinated effort between healthcare providers to ensure the best quality of care delivered to the patients and at the same time at a reduced cost. This means that health care providers will voluntarily come together to form the ACO and patients will be able to get treated by any provider in the organization. Apart from that, it will reward the providers for delivering quality care. Even though the ACOs is comparatively a new concept, but its certain concepts and features are closely related to early managed care organizations (Barnes et al.,2014). Both MCOs and ACOs rely on the creation of physician network, promotion of member health and resource management to control costs.

1. Consider key elements of ACA provided on p. 11 in the textbook. Pick any two and discuss. Whether a particular element of ACA has been already successfully implemented? What are the pros and cons of this element?

Based on your research, respond to the following: What was the name change for HCFA? It was renamed the Centers for Medicare and Medicaid Services in July, 2001. What were the documented reasons for the change from HCFA to the organization’s current name?

Prior to the implementation of the Affordable Care Act (ACA), few people anticipated employer-provided health care would disappear as a major player in the United State healthcare arena. However, ACA adoption and has put more than 169 million employees at risk for losing their workplace coverage. Several studies indicate employer-based coverage will decline rapidly over the next decade as the traditional US system is displaced by the healthcare exchange system. While consumers grapple with finding affordable coverage options and providers adjust to the new norms, there is another wrinkle in the mix. In January, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced the agency's push toward value-based and alternative reimbursement models.

Patient Protection and Affordable Care Act, or ‘Obamacare’ was the expansion of Medicaid program across the states. Charles Barrilleaux and Carlisle Rainey look at why state government have opted out of the Medicaid expansion. They find that Obama’s 2012 vote share and the governor’s partisanship better explains the disapproval to Medicaid expansion, rather than measures of need, such as life expectancy or the number of people that are uninsured. Charles Barrilleaux and Carlisle Rainey find that a Republican governor is a higher percentage point more likely to oppose the expansion than Democratic governors. Whereas, the results show that the percentage uninsured in the state to have a small positive effect on the probability of opposition.

Major Healthcare reforms have been established in the past half a century despite the above-list challenging factors. The reform focused on coverage on millions of American citizens through Children Health Insurance Programs, Medicare and Medicaid. Between 1934 and 1939, there was the National Health Insurance New Deal. This period was characterized with growing income inequality with unemployment standing at 25% of the total population (Starr, 2013). There prevailed increased levels of unpaid medical bills with the poor being assisted by welfare agencies to sort out their medical bills.

The Effects of Regulations on Managed Care and IDS Managed Care is a health care delivery system organized to manage cost. The legal and business imperatives of managed care pervade our national healthcare system, the regulation of managed care depends on who contributes to the plan and who bears the risk for paying for the insured services. More than 170 million Americans receive health care coverage or benefits through some type of "managed care" setting.1 By 2007 about 20 percent of these services are directly provided by a health maintenance organization (HMO), while the majority are served through other managed arrangements, 60 percent in Preferred Provider Organizations (PPO) and 13 percent in Point of Service (POS) plans. Beginning

MCO played an important element that aided the corporatization of the United Sates (U.S.) health care system (chap.3). Managed care first started to emerge in the 1900s with the flat fee payment method developed by companies who employed physical labor workers. By the 1970s to 1980s managed care grew expectantly. The HMO Act was passed by Congress in 1973. Later HMO gave birth to the dual choice mandate which was the main contributor to the rapid growth of HMOs.

The first chapter begins, appropriately enough, by attempting to thoroughly define what a social problem is in general. However, before the chapter even began, I was struck by its earnest title page. There’s something simple, yet powerful, about the picture they selected of a young boy, who can’t be more than 7 years old, holding up a sign that states forthright “Save America.” It’s an image and statement that effectively communicates a philosophy which I believe holds a lot of truth; that the choices we make today as citizens and members of society will impact and therefore hold more importance for the next generation, the children being born today. The decisions today’s leaders make will vastly change the future for the next generation;

The Importance of a Company’s Culture The culture of a company is one of the most important and sometimes overlooked factors in an organization. The culture can increase employee engagement and increase productivity which will allow a company to reach its goals, “From productivity and engagement in the organization’s day-to-day, to an employer brand that naturally fuels recruiting efforts, to creating a lasting brand that customers immediately recognize, there’s no escaping it – culture radiates outward into the marketplace” (Straz 2015). The culture can have a great impact on the employees. Employees thrive in a positive working environment and the ability to engage with their managers without fear of retaliation.

Adriana’s Insurance Adriana’s Insurance Overviews The name of the company is the name of the founder of the company herself Adriana Gallardo. There are over 50 offices of The Adriana’s Insurance over the California State with the founder residing herself in the office at Glendora California. Established for money than 2 decades, The Company is also looking forward to establish other of its branch offices as well in other states of the country. The company has already had their license of selling the auto insurance in Arizona, Utah, Nevada and Illinois along with it Texas has even got the permission selling all types of insurance there.

When changing a company’s organizational culture may goes well Changes in technology, the markets, societal values, workplace dynamics and the global economy have all contributed to creating an external environment that is constantly on the move, unpredictable and often devastating for companies that are unprepared or unable to respond accordingly. Many companies today are thus forced to either change or adapt their organisational culture to keep up. (Burnes, 2004) Furthermore, with global mergers and acquisitions at a seven-year high in 2014 (Roumeliotis, 2014) and set to increase further due to companies’ desire to outdo rivals and widespread investor support for such deals, knowing how to manage changes in organisational culture has become