Integrated Health Care

Integrating behavioral and medical health has not been properly addressed due to stigmas and lack of education. Behavior health is more common today and costly. In efforts to integrate and improve patient outcomes and provider experiences there are many ways to achieve this goal such as train medical providers, train behavioral practioniers and embed behavioral providers in primary care settings. Cigna’s approach can help promote behavioral awareness and respond

Examining the affordable care act (ACA) the expansion of Medicaid will affect the manage care in a big impact (Stefanacci, 2012). According to Stefanacci (2012)manage care organizations will run into the problem of finding primary care providers(PCP) for the more people that will sign up for Medicaid. The affordable care act will have a positive effect on manage care in the long run. I will help alleviate the use of the emergency department for a primary care physician (PCP). It promotes a more healthy population. Help individuals manage their health better by providing them preventive care and reduce the cost for everyone

One of the first things we will discuss is what an integrated physician model actually is. As defined by our text book “an integrated physician model is the result of a series of partnerships between hospitals and physicians developed over time.” Since that is the text book definition lets try and clear it up just a little bit. The integrated physician model really is a very generic term that is showing an effort by both the physician and hospital for a very wide range of purposes. For instance, optimize cost and clinical outcomes, and for a hospital and physician to work under a cohesive structure.

There are many stakeholders involved with health care administrations. Those stakeholders can be patients, health care physician, insurance providers, pharmaceutical manufactures, hospital organizations, community clinics and government. Each different stakeholder has their own individual vision of health care administration. This causes conflict due to the nature and differences in vision. which then can cause conflicts among each stakeholder involved. A patient is going to have a different idea of how a health care should be managed. This in contrast to the way a physician may think the administration should be managed. Furthermore, each different stakeholder involved would have their own ideal reasons to why the health care administration

In the past there have been arguments between agencies and professionals over funding and arguments over who does what, which obstructed closer professional working. A number of strategies have now been developed that focus on improving co-operation for the benefit of those using services.

1. Have began the process of updating the forms for Psychiatric Evaluations as well as the forms to document follow-ups visits (Medication Management). The purpose is to improve the flow of information, simplify its use, assure the appropriate content, and facilitate arriving to the appropriate billing codes.

Nursing has become a very dynamic role as it is constantly changing and evolving. The number of people entering the nursing field continues to increase. The responsibilities nurses are held accountable for are very diverse and demanding. Mental health nursing is one of the many diverse fields a nurse must be educated in. A nurse must be competent in attending to a patient’s mental health as it is something that pertains to all patients regardless of race, origin, or religion. “There is growing recognition that health services must move beyond the responsibility of simply providing clinical and curative services to increasing attention on the benefits of promoting mental health and well-being” (Wand and White, 2007, p. 404). The focus of this

‘’When person, and the interests of a person should be at the centre of all relationships. People and where appropriate their carers, must be recognized as partners in the planning of services which should be integrated and based on collaborative working across all sectors’’ (Health, Social Services and Public Safety)

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

This article looks at alliance between Health plans and public health agencies. They discuss how public health care plans have similar needs also may have similar needs for the expertise and clinical capacity to serve vulnerable and underserved populations. Health care plans that are in place now to assist people with having access to health care. Public health has serve under advantage people for several years. According to the article, many public health agencies provide services such as prenatal education and counseling, childhood and adult immunizations, family planning and birth control, chronic disease screening, and diagnosis and treatment for sexually transmitted diseases, HIV and AIDS, and tuberculosis.

In the Pioneer ACO pilot program, Medicare will give the ACO a population-based payment worth 50 percent of the estimated cost of care for the payees in the third year of the program if the costs are below the benchmark. Providers will only receive 50 percent of their typical payments in the form of fee-for-service reimbursement, and the ACO will determine what share of the population based payment each provider should receive (Shafrin,2011). The goal of both these project is basically to move towards more integrated care. Medicare put forward a proposal for health care agencies to participate in both the Medicare Shared Savings Program and the Pioneer Accountable Care Organization (ACO) pilot

Accountable Care Organizations (ACOs) are comprised of doctors, practitioners, and hospitals, to give healthcare services to patients. The goal of coordinated care is provide high quality of care through an integrated service model while avoiding unnecessary duplication of services and preventing medical errors. The ACO is evaluated through a quality metrics to assess care provided to patients in a cost efficient manner.

A strength of PMHS service coordination units is that services are aimed to assist the “whole person.” We meet consumers at their levels, work on what is important to them and create an individualized approach to help each consumer. Additionally, strength of the unit is paperwork. From intake to closing, paperwork provides structure to the unit and stands something tangible for both consumers and SCs to see their progress, even if they still have more work before obtaining all of the consumer’s goals. On the other hand, limitations include a disproportion number of SCs compared to other unit. SCs caseload ranges from 21-26 consumers. SCs are drained and lack self-care when out in the field, which together results in poor execution with notes,

The Affordable Care Act (ACA) sanctions the practice of Accountable Care Organizations (ACOs) to bring the advancement in health care space by enhancing the care quality, emphasizing patient’s safety and reduce health care costs in Medicare. This program was begun on January 1, 2012. Its target is not to create any demonstration project, instead it aims to produce an entity which can directly contract with Medicare. The Centers for Medicare and Medicaid Services (CMS) explain ACO as an association of health service providers, i.e. hospitals, physicians, insurers, and others allied with patient care reform that will work together to undertake accountability for the quality of patient care, and how money is spent

Some mental and behavioral disorders follow a chronic course. The needs of patients and their families are complex and changing, and continuity of care is important. Some of the measures to ensure continuity of care include: