Health Care Payment Systems

Health Care Payment Systems Miguel Boquer   Introduction Healthcare spending has been on the rise over the years and is even more so affected by the continually evolving healthcare payment and insurance systems. To put it into perspective, national healthcare spending has grown from 5.3 percent in 2014 to 5.8 percent in 2015 reaching an astonishing reached $3.2 trillion or $9,990 per individual (Wilson, 2016). In 2016, healthcare expenditures were expected to reach $3.35 trillion averaging $10,345 per individual (Alonso-Zaldivar, 2016). Payment and insurance systems through employers, insurance providers, and government agencies are providing for ways of controlling factors driving healthcare costs. Payment Systems Payment systems have continued to evolve into many various forms over time such as fee-for-service, pay-for-coordination, comprehensive care, pay-for-performance, bundled payment or episode-of-care, upside shared savings programs (Medicare and Medicaid (CMS) or Commercial), downside shared savings programs (CMS or Commercial), partial or full capitation, and global budget (McKesson, 2017). The most popular and original way of payment for health care services being utilized today is the fee-for-service payment system. This system allows for each separate service that is provided to be paid for at a set amount (Miller, 2009). From what I gathered through my research is that as the population ages, healthcare costs rise, and technology advances, the fee-for-service isnt always the most efficient method of payment. A combination of payment systems is more preferable when working with the different sources of payers such as self-payment, insurance providers, or Medicaid/Medicare. Episode- of-care and comprehensive care would be a great combination reason being that some of the aging population or those with more serious conditions can utilize episode-of-care, whereas the comprehensive payment system will cover the population that contain conditions that require more frequent or repetitive care for chronic conditions such as diabetes. For instance, comprehensive care payment would be made to the physician practice or health system to deal with the patients who possess presumptive underlying health conditions. Then, the episode-of-care payment would be made to a hospital if a specific patient requires surgery or any other costly treatment (Miller, 2009). Payers The Affordable Care Act (ACA) is comprised of numerous regulations that focus on the organization of healthcare like how it is delivered and then paid for. The fee-for-service system that has been the most dominant payment system is inefficient and costly to patients and payers, which is why the regulations provided the ACA must be imposed on the flaws of the US health system. As the US economy strengthens, medical prices continue to increase rapidly, and the population ages, Medicare and Medicaid are projected to grow at a quicker rate than private insurance providers (Alonso-Zaldivar, 2016). In the sense of utilizing multiple payers, healthcare providers can transform the way they deliver health care to all of its patients if enabled by the changes in payment systems as long as the payers throughout the community are required to change their payment systems as well in related ways. Additionally if the right payment is set, the health care providers will be able to deliver quality c are to the patients as needed (Yong, Saunders, Olsen, 2010). HIT and Payment Systems Health Information Technology (HIT) is contributing towards effective changes in the way payment systems are operating. HIT continues to be a vital component of directing the health care payers toward automated workflows, while improving the management of medical claims. Data can better managed through the use of HIT innovations such as the transferring of health information within and in-and-out of a health plan, which is substantially important (Patrick, 2016). New, innovative healthcare technology is allowing for the combination of managed care and any additional technology that is used in managing patient care within the patients health plan along with determining the claim payments. The large amount of data that becomes available as a result through that combination can be incorporated with various types of data such as pharmacy or health assessment resulting in a pool of data readily available to access as needed. Conclusion The various healthcare payment systems are being used to cover, coordinate, and manage the costs of care for patients are copiously complex. Only through the improvements of the payment systems have payers been able to effectively control the aspects of healthcare costs. Aging population and the increasing presence of chronic illnesses are calling for improvements to the processes of payment systems such as the implementation of multiple payment systems. The advances of Health Information Technology will be able to allow for the smooth collaboration and integration of multiple payment systems in the efforts of improving the quality of patient care. References: Alonso-Zaldivar, R. (2016). $10,345 per person: U.S. health care spending reaches new peak. Retrieved from http://www.pbs.org/newshour/rundown/new-peak-us-health-care-spending-10345-per-person/. McKesson. (2017). What Payment Models Exist. Retrieved from http://www.mckesson.com/population-health-management/resources/what-payment-models-exist/. Miller, H.D. (2009). From volume to value: better ways to pay for health care. Health Affairs (Millwood); 28(5):1418-28. Retrieved from http://content.healthaffairs.org/content/28/5/1418.full. Patrick, J. (2016). Is Health Information Technology Imperative for Payers? Retrieved from http://healthpayerintelligence.com/news/is-health-information-technology-imperative-for-payers. Wilson, K. B. (2016). Health Care Costs 101: ACA Spurs Modest Growth. Retrieved from http://www.chcf.org/publications/2016/12/health-care-costs-101. Yong, P.L., Saunders, R.S., and Olsen, L.A. (2010). The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Institute of Medicine (US) Roundtable on Evidence-Based Medicine. Washington (DC): National Academies Press (US); Payment and Payer-Based Strategies; 11. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK53906/.

Sophocles Antigone :: essays research papers

This paper is an essay on Antigone. The story Antigone is a great Greek tragedy. Sophocles, an ancient Greek playwright, is the author of the story. It is a great story. It is known throughout the world. This essay is going to trace the character of Antigone through the beginning, middle, and end of the story. Antigone is a very strong willed character. In the very first scene of the book Antigone is talking to her sister (Ismene) about how their two brothers (Eteocles and Polyneices) killed each other fighting over the thrown. Antigone is enraged over the fact that Creon (Antigone’s uncle and the new king) has buried Eteocles with military honors but has left Polyneices to rot. Creon has declared that any person who buries Polyneices will be killed, but Antigone doesn’t care. Antigone is driven to bury her brother and she wants her sister’s help. â€Å"Ismene, I am going to bury him. Will you come?†(pg.750 line 30). Ismene is too afraid of Creon to help Antigone. Antigone is determined to bury her brother at any cost, and unlike her sister, she is not afraid of Creon. â€Å"Creon is not strong enough to stand in my way,†(pg.750 line 35). Not even the threat of death is enough to make Antigone afraid of Creon. At this point in the book she is stubborn and self-righteous. Antigone then goes out at night and buries Polyneices. That makes Creon very mad, so he unburies Poylneices and posts guard around the body. The next day a whirlwind kicks up around the guards and Antigone starts to bury Polyneices again. Unfortunately the whirlwind died before Antigone could finish burying him, so she is captured and brought to Creon. Antigone boldly admits to burying her brohter despite the fact that she could be killed. Creon tries to convince her that what she did is wrong by pointing out that Eteocles is her brother and Polyneices is a traitor for attacking the city. Despite the fact that her brother, Polyneices, attacked the city, Antigone still loves her brothers equally. â€Å"His own brother, traitor or not, are equal in blood,† (pg.766 line 110). Antigone enrages Creon by refusing to admit Polyneices fault. Ismene tries to take the blame with Antigone but Antigone refuses her help. â€Å"Yes, save yourself, I shall not envy you. There are those who will praise you, I will have honor too,† (pg.

Decision modeling and analysis Essay

Case Problem1: Production Strategy: Here, there is a production management in the Better Fitness, Inc. (BFI) which manufactures two types of machines (BodyPlus100 and BodyPlus200). The detailed math has been done in the report as per the statistics given for its production of the two varieties of the machines. The raw material costs in each section consisting in the manufacture of the specific machine (either BodyPlus100 or BodyPlus200). The labor costs are also given which sums up the production cost of the machine so as to calculate the total cost for its manufacture. The net profits are calculated and recommended that the manufacture of one BodyPlus100 machine provides more profit than that is produced in the manufacture of one BodyPlus200 machine. As the net profit made per hour in the manufacture of one BodyPlus100 is $24.73 and where as, the net profit made per hour in the manufacture of one BodyPlus200 is $19.83 Case Problem2: Solutions Plus: In this case issue, the company Solutions Plus is an industrial chemicals company that produces specialized cleaning fluids and solvents for a wide variety of applications. The main issue is that this company has been invited to forward a bid to supply Great North American railroad with a cleaning fluid for locomotives. The main case is to deal with the math related to the production cost and the shipping from two different places (Cincinnati and Oakland, California). The Solution Plus itself cannot produce and deliver the entire amount of required gallons of the cleaning agent and considering the larger distances to ship these cleaning agents, the shipping charges are also included as the expenditure for manufacturing the cleaning agent. The bid has is sent after deciding that the entire production from Cincinnati and Oakland, California shorts the exact requirement of the cleaning agents from eleven (11) different locations in America.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Since the requirement is not exactly met, the supply of the cleaning agents to Pendleton is made short of 17,615 gallons. The reason only Pendleton is made short of its required deal because, the shipping costs are more to the place from Cincinnati. Also, specified that only 500,000 gallons of cleaning agent can be supplied from Cincinnati and only 50,000 gallons can be sent to any location from Oakland, California. The bid is for a contract of two years. So the shipping costs may vary after one year as the fuel rates might fluctuate. So the Director of marketing of Solution Plus has to bid now fore sighting the fluctuations in the fuel price. Hence, due to the restriction of the total number of gallons supplied from Cincinnati, we could only supply 972,937 gallons of the locomotives cleaning agent to the 11 different locations where the exact requirement is 990,522 gallons of the cleaning agent. When the bid is made for $1,821,214.39 for one year, then the net profit that is made in one year is $237,749.72

Language And Social Skills Children And Young People Essays

Language And Social Skills Children And Young People Essays Language And Social Skills Children And Young People Essay Language And Social Skills Children And Young People Essay Play is the most of import portion of the kids development. Play allows the kids to heighten their physical development, psychosocial development and cognitive development. Most parents see sketchs with their kids as a manner to assist their kid learn. I have watched many kids s telecasting plans like blue s hints, the spell show, and Dora the adventurer, to understand how these telecasting plans help in kids and babe s development. I chose the Dora the adventurer sketch show to heighten my understanding about the kid development. Dora the adventurer is an alive kids s telecasting show. Dora the adventurer show programmed to prosecute kindergartner activities in a play-along, computer-style escapade. Dora the adventurer is an illustration of physical development. Physical development focuses on the physical growing and the development of both gross motor accomplishments ( e.g. Walking, leaping ) and all right motor accomplishments ( e.g. Finger motions, oculus coordination ) control over the organic structure. Dora the adventurer on-screen character speaking with the kid encourages the kid to take portion, label objects, vocals and dance actions allow for motions with control and coordination. Dora the adventurer animated besides influences the cognitive development theory, cognitive theory is a alteration and stableness in mental ability such as acquisition, thought, and memory. The Dora the Explorer allows the kids to believe of a manner to acquire out and to acquire to their finish, so this helps kids deriving cognition and solvingA jobs in day-to-day life, which enhances their memory capableness. Television provides the kids with a valuable tool at place for great acquisition. Another theory is influences psychosocial development by Erik Erikson to acquire through the thought of personality. Watching and larning from on screen shows allow kids to derive cognition of societal acquisition ; this enhances their self-esteem, larning ab out the civilization and society and teaches them how to interact with people. Cartoons besides use looks that allow kids to copy and use in day-to-day life. Learning new looks from drama allows kids how and when to demo the emotions. These allow the kids to promote self-awareness about the universe around them. The drama is really indispensable for kid development. Reading books to immature kids is the best manner to advance linguistic communication development and linguistic communication accomplishments like speech production, reading, and listening. Book reading is good for a kid s development to derive imaginativeness. Reading books to kids at place can promote their reading accomplishments. Books should hold something like forms, short narratives, images, bright colourss that kids will happen interesting, gratifying, and merriment. This will assist develop a sense of reader grasp. When kids have books in their place, they are more likely to sit down and read them. Parents can and should promote an grasp for reading ( Elrod, n.d ) . When reading a book to kids the reader needs to maintain few things in head for best consequences. The books you choose for the kids need to be short and simple, attractive, use appropriate linguistic communication, speak clearly, easy, and utilize the look, as some kids learn verbally and some non- verbally. Re ading books to kids that influence the societal acquisition theory by Albert s bandura. In societal larning theory Albert Bandura ( 1977 ) provinces behavior is learned from the environment through the procedure of experimental acquisition. Children observe the people around them acting in assorted ways ( McLeod, 2011 ) . Children learn many different ways ; some learn rapidly by visibly, for illustration, books that got colourss, image, and forms with it and some learn verbally, for example- copying the look and words. Using assorted techniques to heighten linguistic communication development, melodies of the voice and acquiring them to turn the page that influences the theory of positive support. If imitated behaviours and effect are fulfilling so the kid is likely to execute behaviours. If parents are promoting and giving them positive feedback, so the behaviour is likely to reiterate as it provides the kid with strengths. Simply utilizing the booking reading tools at place hel ps them learn. Childs are really sensitive. We need to manage them with attention. So far, the information I have gained through the instruction of drama and linguistic communication development of babes, and kids provided me with a greater apprehension that could act upon my hereafter pattern as a wellness professional. Skills that I have gained from the cognition of reading books to kids are to make an environment that allows kids to understand their personality, which will assist kids to be more synergistic. As a wellness professional, I build a warm and unfastened environment for kids to experience secure. In order to accomplish my nursing pattern, I need to utilize or set the techniques in my pattern, and they are distractions, communicating, and instruction. Have a conversation with kids for example- about their front-runner show, inquiring inquiries with slow gait and leting them to reply and educating them for being healthy. This will heighten their apprehension while mine. The usage of dis traction techniques in my pattern can enable me to finish a hard undertaking with kids like taking medical specialty ; I can acquire the kid to move like a ace hero and be strong and inquiring them to stand directly like a strong soldier. These accomplishments can assist me to construct a trust and a relationship when I am working or managing childs. Constructing a relationship creates an environment where kids experience unafraid take hazards. In my decision, drama is a precious portion of childhood that offers kids of import developmental benefits and parents the chance to prosecute to the full with their kids . Thus Influences kids and babes physical development, cognitive development and psychosocial development. Play allows kids to larn new things and to understand the universe around them. Reading books is another of import facet to heighten their development. Reading books to kids will assist kids derive linguistic communication accomplishments. I have gained many accomplishments that can be relevant or may act upon my nursing pattern as a wellness professional.The cognition of kids and babes about their drama and book reading. I learned many techniques that will do my nursing pattern easier when I have to measure kids and babes. Distractions, pass oning techniques are helpful in nursing pattern. Communicating with kids about their favourite shows and inquiring them inquiries. Therefore, all cognition I have gotten of the drama and book helpful.

A Guide to Ghost Month in China

A Guide to Ghost Month in China The 7th lunar month in the traditional Chinese calendar is called Ghost Month. It is said that on the first day of the month, the Gates of Hell are sprung open to allow ghosts and spirits access to the world of the living. The spirits spend the month visiting their families, feasting, and looking for victims.  There are three important days during Ghost Month, which this article will delve into. Honoring the Dead On the first day of the month, ancestors are honored with offerings of food, incense, and ghost money- paper money which is burned so the spirits can use it. These offerings are done at makeshift altars set up on sidewalks outside the house. Almost as important as honoring your ancestors, offerings to ghosts without families must be made so that they will not cause you any harm. Ghost month is the most dangerous time of the year, and malevolent spirits are on the lookout to capture souls. This makes ghost month a bad time to do activities such as evening strolls, traveling, moving house, or starting a new business. Many people avoid swimming during ghost month since there are many spirits in the water which can try to drown you. Ghost Festival The 15th day of the month is Ghost Festival, sometimes called Hungry Ghost Festival. The Mandarin Chinese name of this festival is ä ¸ ­Ã¥â€¦Æ'ç ¯â‚¬ (traditional form), or ä ¸ ­Ã¥â€¦Æ'节 (simplified form), which is pronounced zhÃ… ng yun jià ©. This is the day when the spirits are in high gear. It’s important to give them a sumptuous feast, to please them and to bring luck to the family. Taoists and Buddhists perform ceremonies on this day to ease the sufferings of the deceased. Closing Gates The last day of the month is when the Gates of Hell close  up again. The chants of Taoist priests inform the spirits that it’s time to return, and as they are confined once again to the underworld, they let out an unearthly wail of lament. Vocabulary for Ghost Month If you happen to be in China during Ghost Month, it could be fun to learn these vocabulary words! While terms like ghost money or ghost month are only applicable to Ghost Month, other words like feast or offerings can be used in casual conversation. English Pinyin Traditional Characters Simplified Characters altar shn tn ghost gu vampire jing sh ghost money zh qin incense xing ghost month gu yu feast gng pn offerings j bi

Inclusive education Essay Example | Topics and Well Written Essays - 2500 words

Inclusive education - Essay Example It refers to an attitude, believe and value system. So in this case, once this system has been adopted by a school, then it should drive all the decisions and actions by those people who have adopted it. It is a belief that schools embrace and educate all students and not just selecting those students who can be fit in that school. It is believed that all children are unique in their different ways and they have different talents. It is through inclusive learning that children are in a position to get good education and also attain the best practices in school. This can be well illustrated by cooperative learning. In this case, you find that students are in a position to learn with each other, and offer the necessary assistance to each other where possible. It is through this cooperation that students can be in a position to do well in most of their activities. Inclusive learning also reflects multi intelligence, multi level instructions, good learning and also teaching styles where children are exposed to competent teachers who express their teaching skills fully and they are also exposed to differentiated curriculum. (Armstrong, Barton and Armstrong, 2000) With inclusive schooling, it emphasizes on various issues. First it ensures that students get equal educational opportunities. It is through this that students will be in a position to have access to the various educational programs hence leading to their success in school.... It is through inclusive schooling that the necessary resources will be provided and these resources are usually provided to ensure that students are in a position to learn well. Third there is respecting differences whereby students in this case will be in a position to respect differences which might arise. (Bender, 2002) Inclusive schooling is said to teach mutual respect where students are in a position to respect each other, responsibility in the sense that these children will be in a position to demonstrate responsibility by obeying commands and taking charge of their responsibilities, they will also learn to be generous to others and last they will learn to be independent. (Dei, Zine, and James-Wilson, 2002) Therefore the rationale behind inclusive schooling can be summarized as intending to ensure that all children regardless of the differences the may exist between them are put under the same class environment in order to take advantage of their diversity and help them to learn well. In this regard it is also expected to lower the cost of education to the parent and to the government since students will be able to use the same resources and amenities rather than providing each student with their own resources. It is an approach that is expected to make the education process smooth for the teachers, parents and the students. It aims at eliminating any discrimination and achieving equality for all in education. Values, policies and strategies of inclusive education One of the most important emphasis of the inclusive education is the way in which it advocates for changes and modification in the content, the approach structures, policies and strategic of the education system. The model is enabled by a value system which ensures that there is child

Multinational Enterprises In Asian Development Case Study

Multinational Enterprises In Asian Development - Case Study Example The research will review the trends and expansionist strategies employed by multinational enterprises from these nations and evaluate how they managed to attain successes on the global level. Japanese Businesses The Japanese European Trade Organisation (JETRO) studied a number of things about the expansion if Japanese businesses into Europe (Sachwald, 1995). They identified five main motives for the expansion of Japanese businesses into Europe. First of all, Japanese businesses seeking to expand into Europe for production reasons. Geographically, Japan has not been a very rich island in terms of natural resources. As such, their expansionist drives into foreign nations included the desire to acquire much needed raw materials. Thus, the establishment of foreign companies enabled them to establish production systems with their technology and capital and produce at points close to the customers that they previously exported to. Secondly, the cost of energy and electricity has been tradi tionally high. Japanese expansionist ideology was to make use of cheap electricity and energy costs. Again, Japan has always been an overpopulated island. Due to that, land costs are generally higher. The expansion into foreign lands enabled Japanese businesses to economize and save significantly on rent. Other costs like pollution and transport costs were significantly lower in other parts of the world. Thus, Japanese businesses expanded to foreign lands to take advantage of these production-related advantages. Secondly, Japanese businesses moved to different parts of the world in order to develop new markets. In the 1970s, Japanese businesses had exported large volumes of products to people in different parts of the world.