The US Healthcare System
Contents
Introduction 1
Extension of public health and creation of Medicare and Medicaid 1
Pricing and reimbursement 2
Medicaid 3
Introduction
The US healthcare system is fragmented, with various stakeholders interacting to create a complex network. There is a mix of public and private players, with the government funding healthcare for certain sections of the society while the majority of the population has private health insurance sponsored by employers. However, a significant minority of the US population remains uninsured and has little access to healthcare services. The US healthcare system has several other issues such as rising healthcare costs and poor health relative to other developed nations. The country leads the …show more content…
Part-B :- supplemental medical insurance (against monthly fee) In 1997 Medicare as a whole covered 38 million people utilization of Part-A and B was 87% of enrollees. (DeButts, 1997). Title XIX of the social security act of 1965 gave rise to Medicaid as part of the federal state welfare structure to aid America’s poor population. It allowed federal funding for state run programs. In order to provide basic health service including hospitals in patients and out patients service laboratory and X-ray services and physician services.
The articles state that healthcare quality standards are an extremely important aspect of health care development in America. They state that developing quality standards help in improving the accountability as well as the responsibility of the doctors and the medical staff. Bringing in measures to motivate them by using performance based incentives is a good measure to ensure that there is adequate level of quality in service.
The first article describes the advantages of quality standards whereas the other describes the disadvantages, problems and reasons for reluctance in their acceptance. The articles stand contradictory views as the perspectives differ. Yet, they help provide an insight into Medical quality …show more content…
This was adapted in 1978. It has been formed as a result of efforts of a number of countries which was combined or unified to form the ICHI. It focuses on the present conformance criteria in the health sector and is the most dynamic element among these three categories (Who.int, 2010).
Management Action Plan for Healthcare Reform
Impacts
• The fast-approaching deadlines to comply with the Patient Protection and Affordable Care Act (ACA) force state agencies to narrow the scope and functionality of public health insurance exchanges (HIXs).
• The federal and state exchanges will go live with limited operational capabilities, resulting in manual work-around processes.
• Public exchanges will eventually orient toward the commercial health insurance market and away from human services agencies.
Recommendations
• Conduct a realistic assessment of exchange and Medicaid eligibility system project plans.
• Identify and triage gaps that pose the greatest risk to delivering first-class consumer service during the open enrolment period.
• Implement solutions and acquire services that provide the minimum necessary HIX 1.0
Introduction 1
Extension of public health and creation of Medicare and Medicaid 1
Pricing and reimbursement 2
Medicaid 3
Introduction
The US healthcare system is fragmented, with various stakeholders interacting to create a complex network. There is a mix of public and private players, with the government funding healthcare for certain sections of the society while the majority of the population has private health insurance sponsored by employers. However, a significant minority of the US population remains uninsured and has little access to healthcare services. The US healthcare system has several other issues such as rising healthcare costs and poor health relative to other developed nations. The country leads the …show more content…
Part-B :- supplemental medical insurance (against monthly fee) In 1997 Medicare as a whole covered 38 million people utilization of Part-A and B was 87% of enrollees. (DeButts, 1997). Title XIX of the social security act of 1965 gave rise to Medicaid as part of the federal state welfare structure to aid America’s poor population. It allowed federal funding for state run programs. In order to provide basic health service including hospitals in patients and out patients service laboratory and X-ray services and physician services.
The articles state that healthcare quality standards are an extremely important aspect of health care development in America. They state that developing quality standards help in improving the accountability as well as the responsibility of the doctors and the medical staff. Bringing in measures to motivate them by using performance based incentives is a good measure to ensure that there is adequate level of quality in service.
The first article describes the advantages of quality standards whereas the other describes the disadvantages, problems and reasons for reluctance in their acceptance. The articles stand contradictory views as the perspectives differ. Yet, they help provide an insight into Medical quality …show more content…
This was adapted in 1978. It has been formed as a result of efforts of a number of countries which was combined or unified to form the ICHI. It focuses on the present conformance criteria in the health sector and is the most dynamic element among these three categories (Who.int, 2010).
Management Action Plan for Healthcare Reform
Impacts
• The fast-approaching deadlines to comply with the Patient Protection and Affordable Care Act (ACA) force state agencies to narrow the scope and functionality of public health insurance exchanges (HIXs).
• The federal and state exchanges will go live with limited operational capabilities, resulting in manual work-around processes.
• Public exchanges will eventually orient toward the commercial health insurance market and away from human services agencies.
Recommendations
• Conduct a realistic assessment of exchange and Medicaid eligibility system project plans.
• Identify and triage gaps that pose the greatest risk to delivering first-class consumer service during the open enrolment period.
• Implement solutions and acquire services that provide the minimum necessary HIX 1.0