To the Board of Directors of Southside HMO: As the Chief Executive Officer (CEO) of Southside Health Maintenance Organization (HMO), I am providing a detailed report of my strategies and recommendations to make sure that the quality and management processes of our healthcare organization are being provided to all members. There has been a complaint filed against the Southside HMO that patients that are enrolled in the Health Plan are not receiving quality healthcare delivery. Southside HMO provides healthcare services for over 495,000 members located in the eastern region of the United States. These strategies and recommendations are for resolving any complaints of denial of healthcare services for referrals to see a specialist by primary
“Medicaid is the single largest payer for mental health services in the United States and is increasingly playing a larger role in the reimbursement of substance use disorder services” (Medicaid. org, 2015). The Affordable Care Act addressed the need to provide care for those suffering from mental health illnesses or substance abuse by introducing Medicaid Expansion. Medicaid Expansion would offer coverage to an additional 30% of uninsured American suffering from mental illness (Nami.org, 2015). Mental health continues to be the “black sheep” of health care.
Phase One (Sessions 1 through 3) • The session 1 and 2 consists of the assessment of the client’s clinical problems and background information. Questions relate to her clinical problems, including (a) the nature of her problems (depression and difficulty with making decisions), (b) reason of seeking psychotherapy, and (c) previous attempts to deal with the problems. For the background information, the client’s histories are assessed in the areas of intimate/family relationship, educational/vocational activities, past history of psychological treatment, and physical condition. Session 3 primarily consists on the further functional assessment around her coping skills (e.g., avoidance) in the areas of interpersonal relationships. Phase Two
Certainly, I'd be happy to provide examples from the current US healthcare system to illustrate each of the six strategies: Promote integrated care delivery: One example of integrated care delivery is the patient-centered medical home (PCMH) model, in which primary care providers coordinate care across different settings and specialists to provide comprehensive and patient-centered care. Implement payment reforms: One example of payment reform is the shift towards value-based payment models, such as accountable care organizations (ACOs), which reward providers for delivering high-quality care at a lower cost. Invest in information technology: Electronic health records (EHRs) are a prime example of healthcare IT, which can help providers access
Serious Mental Illness (SMI) and Substance Use Disorders (SUD) each involve symptoms that can be rather debilitating. Approximately one half of the individuals diagnosed with a severe mental illness such as schizophrenia or bipolar disorder experience co-occurring substance use issues (Brunette et al., 2008). Individuals with a dual diagnosis of SMI and substance use are particularly vulnerable with complex service needs (Tsai et al., 2009). As a result of the high prevalence and serious consequences of these disorders, there is an increasing need for comprehensive treatment options to simultaneously address both issues.
Integrated healthcare is key to eliminating mental and physical health disparities by addressing the needs of people based on their differences in their race, socio-economic status, and culture. An integrated healthcare organization is competent of responding to a community with challenges of long standing health disparities. Healthcare professionals in an integrated system are cross-trained in both physical and behavioral health to handle the challenges of mental and physical health disparities. It improves the quality of care of the population by lowering costs, enhancing patient access, and improving the life of both individuals and families. The con of addressing the long standing health disparity is managing the care of patients and
The public system for mental health treatment functions more as a crisis management system that aims to solve problems over the long term. For example, a man in crisis is brought back to a hospital by the Mobile Crisis Intervention Team (MCIT), only days after he had been discharged from two weeks of hospital treatment. The Mental Health Act policy prohibits psychiatric facilities from holding people against their will unless a strict set of requirements are met. Having this in the Mental Health Act, hospitals become a revolving door for mental health treatment: they respond and help, but often do not effectively treat patients for long-term improvement. In 1963 the More of the Mind policy deinstitutionalization process began in Canada, which came from the Canadian Mental Health Association’s.
Assignment Wk. 7: Interview Subject The purpose of this paper is to introduce the Mental health counselor I have chosen to interview for my final project. In this paper I will include the specialties, the age groups and the modality of clients she services. Further I will explain, why I chose to interview Ms. T Licensed Mental Health Counselor Interviewee
Physicians and Hospitals go hand in hand when it comes to the medical care of patients, and it is this relationship that allows the patients to receive the care they need and deserve. It is also this relationship that we as health care administrators need to understand. In order to fully understand this relationship we need to define the concept of the integrated physician model. We also need to explain the importance of clinical integration in the strategic planning process, and the dynamics of and controversies surrounding accountable care organizations and alternative approaches to the current health system. I will also explain the advantages and disadvantages for hospitals and physician’s models.
Team members can then form an agreement on the prospective goals and processes involved in their treatment. This process allows the leader to create a therapeutic environment where the members can feel free to disclose their feeling about the therapy. Forming therapeutic inter-relationships between the group leader and members is vital in any working relationship whether voluntary or
Bodenheimer and Grumbach (2009) express that all healthcare systems strive to ensure patients receive the health care they require in a suitable place and time. However, they may all accomplish this through different methods to one another. Two distinct formats a country may operate under is the Regionalized Model and the Dispersed Model (Bodenheimer & Grumbach, 2009). The Regionalized Model is a structured system where the primary, secondary and tertiary levels of care are discrete, and primary care is the foundation (Bodenheimer & Grumbach, 2009).
The Health Field Model The Health Field Model (HFM) is the conceptual framework that is used by different health care organizations or in individual research projects to evaluate the prevalence, awareness and management of diseases in the community (Pittman, 2010). The HFM, a determinant health model is developed by Bob Evans and Greg Stoddart in 1990. The HFM provides a broad spectrum for understanding health, and the factors that interfere with, and influence the health of individuals in the community. There are features to put into consideration for, in determining the factors that affect many diseases; hypertension, diabetes, and heart disease, or influence of health on a community (Kindig & McGinnis, 2007).
UnitedHealth Group is a particularly broadened health and well-being company headquartered in the United States, and a leader worldwide in helping individuals live more beneficial lives and helping improve the health system work for everybody. We are focused on presenting inventive methodologies, items and administrations that can enhance individual wellbeing and advance more advantageous populaces in neighborhood groups. Our center abilities in clinical aptitude, propelled innovation and information and well being data remarkably enable us to meet the developing needs of a changing healthcare environment.
The text book, The Theory and Practice of Group Psychotherapy by Irvin D. Yalom with Molyn Leszcz begins with the preface of the fifth edition. In the preface, Irvin D. Yalom introduced Molyn Leszcz as his collaborator and how they met at Stanford University in 1980. He then discussed how they both worked hard collaboratively to combine old and new material to make this edition. Their goals for this edition were to prepare student therapists for the present-day workplace and to keep the current methods from decaying, so that students can gather wisdom and techniques of the field when they get the opportunity to utilize those methods as therapists. Yalom briefly talked about what each chapter in the text would discuss.
These are: diagnosis &early intervention; rational use of treatment techniques; continuity of care; wide range of services; consumer involvement; partnership with families; involvement of the local community; and integration into primary health care. The idea of community-based mental health care is a global approach rather than an organizational solution. Community-based care means that the large majority of patients requiring mental health care should have the possibility of being treated at community level. Mental health care should not only be local and accessible, but should also be able to address the multiple needs of individuals.