After an annual $100 deductible per person, the Fund will cover 80% of the cost for covered items provided the expense is reasonable and customary. There is a maximum payment of $5,000 per person in any calendar year. The following items are covered under this benefit: Emergency ambulance/nonemergency ambulance or ambulette if medically necessary ($2,500
Wrong site surgery is the second most reported sentinel event according to reported sentinel event statistics to The Joint Commission. Lack of communication and human error have been directly linked to wrong site, wrong procedure, and wrong patient surgical mistakes. National Patient Safety Goals were established by The Joint Commission to enhance patient outcomes in numerous strategic areas. The purpose of this research poster presentation is to provide background information on the National Patient Safety Goal: Prevent Mistakes in Surgery, the evidence-based guideline of time out, clinical application of time out and its impact on nursing, and identify methods to disseminate related information. A literature review was conducted that includes
California Medicaid program, also known as Medi-Cal is the largest Medicaid program in the nation. With the rollout of Medicaid expansion in 2014, the Medi-Cal is suffering an unsustainable high ED use rate. The identification of a model of care to direct patients to the appropriate setting for care has emerged as a top priority for the state’s health policy. Safety-net clinics play a pivotal role in delivering both primary and specialty care to millions of low-income people, and yet we know little about their performance under different health care delivery models. With the implementation of Patient-Centered Medical Home (PCMH) in early 2012, where the clinics integrated patient engagement, health information technology, coordination of care, quality of care and access to care to their daily practice, it would be interesting to find out the impact of this model on the healthcare utilization of Medi-Cal beneficiaries.
SUPPORT: There has been an astronomical rise in concern about high health care costs among people and members of congress. There is an increased awareness that despite the higher costs, health care system is not producing the better outcomes. And as member of the political system, we do not want health care spending to affect other economic indicators. CONCLUSION: Despite higher spending on health care, the U.S. health care system ranked last on patient safety, efficiency and equity according to the Commonwealth Fund survey. Our aim should be reduction of high healthcare costs without decreasing people access to health care or sacrificing quality.
There are many patient safety concerns in today’s healthcare system. One that is not on the forefront, but is still a prevalent and concerning issue, is lack of infection control in outpatient or ambulatory settings. Since there has been a large transition of care from the hospital setting to an ambulatory setting, there is a necessity to improve infection control secondary to patient notifications and outbreaks within the past years1. Ambulatory settings include all outpatient clinics. An example is an ambulatory surgical center ASC), which increased in numbers by 50% from 2001 to 20082.
I was shocked when the Cleveland Clinic Foundation announced that they were no longer accepting Caresource insurance which is part of the Medicaid program. I knew that this was going to affect a lot of people who count on Cleveland Clinic Foundation for their care. Also, our advancements in technology have been astonishing but still present as a concern because of the cost to purchase, operate, and maintain the equipment is a huge investment in which sometimes the federal government provides financial coverage. In summary, these predicted increases in health care costs must be looked at in terms of prevention and/or cure and effective planning for the the future must start
Finally to summarize my learnings from the course HCA 6280, I want to mention the top five ethical issues that are facing the future of health care industry. First, managers are challenged to create a balance between the quality and efficiency. Due to the fact that there is no consistent framework to measure efficiency, this concept has remained vague and needs more literature research. Second, the disparity in access to care is the biggest dilemma of the U.S. health care system.Third, Due to the increase in the number of baby boomers more healthcare professionals are needed than before to provide coordinated care for chronic diseases. Healthcare managers need to focus on recruiting more competent professionals and create strategic planning
I also support the individual mandate for health insurance coverage, but the cost containment needs a serious attention to make health care more affordable. Without it, cost sharing will be difficult, and the Affordable Care Act (ACA) will be unsustainable. The U.S. is the highest spender on health care per capita among industrialized nations. My friends and family in Japan are always shocked to hear how much I spend on health care in this country. I learned that the ACA addresses several cost containment strategies, such as patient-centered medical homes, accountable care organizations, bundled payments, and programs to reduce readmissions and hospital-acquired conditions.
Some methodological issues and challenges that are unique when it comes to medical issues in mental health are sometimes hard to understand or explain. The main issue is having funds to do the research. We see constant budget cost and smaller budget allocations in mental health and many federally funded programs are being completely changed or cut. Some are harshly reduced, and the relationship between government and private sector providers is being readjusted (Inouye, 1983; Klerman, 1974). Therefore, new research on the effectiveness of mental health services have brought more challenges to researchers because off budget cost and approval of research We have seen this change more in the science research field.