Fee-for-service payment model. In Fee-for-service (FFS) model‚ services are paid for separately‚ that allows incentives for the providers to give more treatment‚ as the payment for these services‚ rather than being dependent on quality of care‚ are based on quantity of care. (https://en.wikipedia.org/wiki/Fee-for-service). With the implementation of ACA‚ various payment methodologies have been developed by payers to shift the healthcare system from volume-driven to value-based. The idea behind doing so
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August 5‚ 2013 Sicko Reaction Paper This was a very powerful movie that brings to light‚ and seems to maybe exaggerate some of the problems in the American health care system. It was amazing to me to see the difference between socialized healthcare in other countries compare to the healthcare system in the US. There seem to be multiple pros and cons to consider including cost‚ time for treatment‚ and community attitudes toward these systems. It was impressive to see the socialized counterparts
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(2007). Research Challenges for Electronic Health Records. American Journal of Preventive Medicine; May2007 Supplement‚ Vol. 32‚ pS104-S111‚ 0p Furnas‚ B. (2009). American Health Care since 1994: The Unacceptable Status Quo. 2009. < http://www.americanprogress.org/issues/healthcare/report/2009/01/08/5465/american-health-care-since-1994-the-unacceptable-status-quo/> January 8‚ 2009. Zywlak‚ W. (2010). U.S. HEALTHCARE WORKFORCESHORTAGES: HIT STAFF. 2010. < http://www.himss.org/content/files/csc_us_healthcare_workforce_shortages_hit
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Advanced practice registered nurses (APRNs) are registered nurses who work with a physician as either a specialty care providers or a primary care provider. They work side by side with other healthcare providers and their main focus is to provide an atmosphere of family oriented care. The family nurse practitioner’s (FNP) can assess‚ diagnose‚ perform different exams‚ and also prescribe medications to patient of all ages from infant to the elderly. The FNPs also play an important role in educating
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and the Role of the Community/Public Health Nurse When considering the evolution of healthcare and the role of the nurse in the United States‚ many people might first consider this in the context of the hospital setting. While the history of acute care is an important area to consider‚ it is imperative that equal attention be given to the history of public health and the role played by the nurse in this segment of the healthcare continuum. The purpose of this paper is to outline the history of
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health care providers is a common problem seen throughout the United States. This shortage is in both the inpatient and outpatient setting. It is essential that the nation looks for creative ways to provide patients with needed medical care in a timely manner. The utilization of Advance Registered Practice Nurses (APRNs) has shown to be very effective in this healthcare provider crisis. This paper will discuss the significant role that a Family Nurse Practitioner (FNP) has on health care and what
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The Utilization Management Program of the Naval Hospital Guam facility is one which is designed to ensure that high quality‚ cost efficient health care is delivered to all members of the community. The Utilization Management Division is responsible for implementing a Utilization Management Plan which will monitor the appropriate usage of the health care facilities‚ services and its resources. These services may include utilization reviews‚ case management‚ discharge planning and outcome-based evaluations
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author mainly concentrated on differences between managed care and public health and he mostly talked about the disadvantages to public health departments due to managed care systems such as‚ decline in grants . Whereas 2nd editorial clearly explains about the advantages of collaboration between Managed Care and Public Health. It also clearly explains how managed care world and public health antagonize each other. The fact is that managed care and public health are co-dependent in the most straight
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Achieving and Maintaining Accreditation in Managed Care Accreditation is a process by which an impartial organization (URAC) will review a company’s operations to ensure that the company is conducting business in a manner consistent with national standards. For a physician and a nurse after they receive their degree they have to do continuing education courses every year to maintain their licensing with that particular state. These classes are generally known as CME’s (Continuing medical education)
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was established to maintain the quality of care in health plans. NCQA was established in 1990 to monitor health plans and improve healthcare quality. Their focus is to measure‚ analyze‚ and improve healthcare programs. The NCQA has developed a report card of accredited health plans that consumers can access on their website. There are currently 41 states that recognize the NCQA accreditation for both their Medicaid managed care and commercial managed care programs. Additionally‚ the NCQA has a physician
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