Define, compare and contrast fee-for-service and managed health care plans. What are the similarities and differences? Support your response with one citation and specific examples. Fee for service plans “Fee-for-service plans contain a variety of stipulations designed to control costs and to limit a covered individual’s financial liability” (Martocchio, 2014, p. 147). This agreement is that the consumer pay individually for each aspect of the goods or services receives.
Family: Jehmari resides with Doxie Samuels (mother) and Junior Copeland (father) in a 2 family house in Plainfield. Jehmari has a close relationship with his mother. He also have a close relationship with his older sister who does not resides in the family home. CM asks Mrs. Samuels how Jehmari is behaving in the home. Mrs. Samuels reports that this time Jehmari is behavior has improved.
The appropriate health care system to choose for the United States is the socialized health care system. Socialized health care system has several benefits that the whole United States population will enjoy. The first benefit of socialized health care system is extending care. One thing that is evident in the United States is that individuals are dying every day because they lack access to health care services. With socialized health care system in place, every individual in the United States will be able to enjoy health care services irrespective of the social status.
Carolina’s HealthCare System- Blue Ridge’s Strategic Review Carolina’s HealthCare System Blue Ridge has a long history in the foothills of North Carolina. As a non-profit community hospital, they have changed and evolved over the last 175 years in order to provide the best care to patients. Their vision is to “be the best community healthcare system in America” (“Blue Ridge”).
Some of the main issues that are important for the organization of telemedicine in regards to time and scope are the problems associated with coverage and reimbursement. With so many options for payment and coverage for telehealth services in both private and public sectors and their policies have still remained barriers for telemedicine. Even with more substantial changes in Medicare coverage, the state remains the final word on policy and determines what they think is telemedicine, what technologies can be used, where and how telehealth can be performed and what services and providers are eligible by the government for reimbursement. Any person or organization involved in executing a project and, whose interests can be affected
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.
“Healthcare Reform 101,” written by Rick Panning (2014), is a wonderful article that describes, in an easy-to-understand language, the Patient Protection and Affordable Care Act, signed into law March 23, 2010. The main goal of the Patient Protection and Affordable Care Act was to provide affordable, quality healthcare to Americans while simultaneously reducing some of the country’s economic problems. Two areas will be covered throughout this paper. The first section will include a summary of the major points and highlights of Panning’s (2014) article, including an introduction to the ACA, goals of the signed legislation, provided coverage, and downfalls of the current healthcare system. The second part will be comprised of a professional
Studies show that manage care that have a higher level of control on patient care it leads to lower medical cost and hospital inflation on cost(Bundorf, Schulman, Stafford, Gaskin, Jollis & Escare, 2004). Also, manage care controls the fees that are paid to physician and manage medical equipment that is provided to the patients (Bundorf, Schulman, Stafford, Gaskin, Jollis & Escare, 2004). The studies show that it is a spillover for manage care and it affects the no managed care patients (Bundorf, Schulman, Stafford, Gaskin, Jollis & Escare, 2004). Most doctors feel that manage care is a positive step for controlling the cost for healthcare. They also, feel that it have a negative impact on medical care (Deom, Agoritsas, Bovier & Perneger, 2010).
Medicaid, I believe, is an essential program to have and I agree that no one should have to make a compromise or choice to be educated or to be taken care of. Those types of decisions should be part of the rights a person has being a citizen of the United States. I would also agree with that not having dental, and psychiatric services are a negative impact to this program since these vulnerable populations would benefit greatly to these services. Although, having different requirements for different states can be cause confusion and inconsistency for the program, I do not find this to be a negative impact within Medicaid. The majority of individuals that participate in Medicaid are not traveling or moving to other states.