Preview

Healthcare Delivery Case Study

Good Essays
Open Document
Open Document
650 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Healthcare Delivery Case Study
Healthcare Delivery
The state insurance options include both Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). In 2015, the total enrollment in Colorado’s forty-four HMOs was 839,754 (Kaiser Family Foundation, 2016). In December 2015, the total enrollment for Medicaid and CHP+ combined was 1,315,144 (Kaiser Family Foundation, 2016). The CHP+ focuses on providing quality care in preventative services, acute services, and services for chronic illness (Kempe, Beaty, Englund, Roark, Hester, & Steiner 2000). The PPACA mandate requires that all individuals be enrolled in some type of insurance plan or face penalties. Despite expanding access to healthcare insurance, access is now inadequate because healthcare resources
…show more content…
The act was enacted in response to the asymmetry of the services offered in the rural and urban areas in Colorado (Lampe, Atherly, VanRaemdonck, Matthews & Marshall). This act allowed all residents in Colorado equal access to healthcare services. Since Colorado’s geography includes both rural and urban areas, it is necessary to provide this type of access. Only 13% of Colorado’s residents reported having difficulties accessing primary care services (Kaiser Family Foundation, 2016). This is significant because that it describes the lack of a medical home for some individuals. Twenty-four percent of individuals indicated that they did not have a designated primary care provider (Kaiser Family Foundation, 2016). It is necessary for individuals to have access to a primary care physician because it is of the emphasis on a primary care physician being the gatekeeper in the United States. This is noteworthy because the United States has a lower percentage of individuals not having access to a primary care physician at 22% (Kaiser Family Foundation, 2016). Colorado is attempting to resolve the issue of accessibility, while controlling the costs associated with healthcare …show more content…
In 2011, there was structural change in Colorado’s Clinica Family Health Services organization to promote better health outcomes and cost-effective measures. The organization began restructuring its operations by highlighting the need for greater patient access, continuity of care, and provider teamwork to improve efficiency in the delivery of care (Feder, 2011). The focus of both the United States and Colorado is on preventative services, which cost less than specialty services to provide. By providing better access to care, Colorado expects to help residents control their conditions and reduce the need for expensive, and potentially avoidable,

You May Also Find These Documents Helpful

  • Powerful Essays

    Cassie Thorne of Mackinaw Administrators Insurance Company referred this file for medical case management. Instructions were given to meet with Timothy Blackmore and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery.…

    • 666 Words
    • 3 Pages
    Powerful Essays
  • Satisfactory Essays

    NU333 Complete Physical Assessment Jarvis: Physical Examination and Health Assessment, 6th Edition Complete Physical Examination Form COMPLETE PHYSICAL EXAMINATION Date __8/31/2013______________ Patient __Jane Doe_________________________ Age __33_ Sex _F__ Occupation Healthcare worker Client Representative/Interpreter: __none__ Examiner _Emanuel Singleton RN________ General Survey of Patient 1. Appears stated age: Yes_____________________________________ 2. Level of consciousness: Alert and oriented x 3 (person, place and time)…

    • 772 Words
    • 4 Pages
    Satisfactory Essays
  • Good Essays

    Preferred provider organizations (PPOs) are a private plan which is the most popular, followed by health maintenance organizations (HMOs). PPOs sometimes pay participating providers based on a discount from their physician fee schedules which is called a discounted fee-for-service. With a PPO the patient pays annual premiums and often a deductible. The patient has two choices with the first being offered a low deductible with a higher premium and the second being a high deductible with a low premium and they always pay a copayment at the time medical services are rendered. Consumer-driven health plans (CDHPs) combine two components with the first being a high-deductible…

    • 738 Words
    • 3 Pages
    Good Essays
  • Better Essays

    The current grave state of the economy has had a significant impact on health care across The United States. Massive budget cuts, reduced services, and limited access to care significantly have affected Medicaid patients. Hennepin County Clinic (HCC), a facility that provides health care to Medicaid patients, is dealing with an additional 15% budget cut that will force management to make decisions about which services must be changed or eliminated while still meeting the basic needs of the clients.…

    • 1397 Words
    • 6 Pages
    Better Essays
  • Better Essays

    Brown voiced receiving Hepatitis B vaccination and Influenza vaccination at his dialysis clinic; he also recalls getting tetanus shots years ago for dog bite.…

    • 3394 Words
    • 14 Pages
    Better Essays
  • Good Essays

    In chapter 5 we have reviewed major elements of ambulatory (outpatient) care and discussed changes supported by the Patient Protection and Affordable Care Act (ACA) and American Reinvestment and Recovery Act. Ambulatory care encompasses a diverse and growing sector of the healthcare delivery system. Ambulatory surgery is a continuously expanding component of ambulatory care, as new technology allows an increasing number of procedures to be performed safely and efficiently outside of the hospital. In addition to new diagnostic and treatment tools available in outpatient setting, financial mandates also have driven services into the ambulatory arena. This new development pushed more hospitals to shift procedures and services amenable to outpatient delivery from more expensive inpatient environment to less expensive. For profit, free standing facilities providing primary, specialty, and surgical services have been increased (Sultz & Young, 2014, p163-199).…

    • 499 Words
    • 2 Pages
    Good Essays
  • Good Essays

    There are many factors fused together that affect the health of communities and individuals. Whether individuals are healthy or not, is determined by their environment and circumstances. These factors include where we live, the condition of our genetics, environment, our education and income level, and our relationships with family and friends all have considerable impacts on health, considered that the more widely known factors such as availability and use of health care services often have less of an influence( World Health Organization (2010).…

    • 408 Words
    • 2 Pages
    Good Essays
  • Better Essays

    HSA 510 Healthcare Market

    • 2119 Words
    • 6 Pages

    The Affordable Care Act (ACA) went into full effect, ushering in health insurance reforms and new health coverage options that are impacting Americans across the country. Ohio is experiencing changes to its health care delivery system as the state expands Medicaid, targets the uninsured with a federal health insurance marketplace, streamlines health and human services programs, and implements new health care delivery payment systems (PR Newswire US, 2013). In collaboration with CMS, Ohio extended coordinated care to its dual eligible population through an…

    • 2119 Words
    • 6 Pages
    Better Essays
  • Better Essays

    All Americans regardless of their economic standing in the community deserve access to essential and quality preventative, and primary healthcare. Those Americans who currently fall under the “publicly insured” category (Medicaid), and the medically uninsured, are at similar risk for delayed or non-existent required medical care. Establishing a free, 24 hour accessible Shelby County Primary Care Clinic would eliminate patient medical care delay, and result in large scale overall savings in projected annual medical care costs. (So You Want to Start a Health Center?, 2011)…

    • 854 Words
    • 4 Pages
    Better Essays
  • Powerful Essays

    Pros And Cons Of The PPACA

    • 1023 Words
    • 5 Pages

    Under the PPACA, primary care will have the responsibility of increasing same-day access with the expectation of reducing emergency room visits and hospitalizations. Although, the PPACA attempted to address this challenge with a stimulus package which guaranteed to train additional primary doctors the burden would be too great. As it has been noted by 2030 the country will experience an estimated shortage of physicians between 40,800 to 104,900; and primary care’s deficient is approximated to be between 8,700 and 43,100 (Mann, 2017). Fewer Insurance…

    • 1023 Words
    • 5 Pages
    Powerful Essays
  • Good Essays

    The design of the health care delivery system has created a variety of obstacles to those seeking care. Strategies are needed to address such impediments. Improving the primary care system and access to it by conducting community assessments to determine gaps in services and engaging stakeholders in the process of access improvement. It is also important to focus on equalizing access to care by improving the quality of existing…

    • 982 Words
    • 4 Pages
    Good Essays
  • Good Essays

    US health care expenditures have been rising quickly over the past few years; it has risen more than the national financial system. Nonetheless a number of citizens in the US still lack appropriate health care. If the truth be told, health care expenditures are going to continue to increase; in addition numerous individuals will possibly have to make difficult choices pertaining to their health care. Our health system has grave problems that require reform, through reforming, there is optimism that there will be an increase in affordable health care and high-quality of care for America. Medicaid, Medicare and private sector insurances are all going through trials and tribulations because of spending. Obama Cares purpose is to put consumers back in charge of their health care and aid in driving down the cost of spending in health care. The reform will also strive to put forward a delivery system that operates better for all involved thereby decreasing organizational burdens and assisting in the collaboration towards improved care. If the reform is successful, it will lead to measureable improvements in care outcomes, and in the health of the American general public overall.…

    • 769 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Healthcare Introduction

    • 2706 Words
    • 11 Pages

    Healthcare in United States has been a topic of discussion for many generations. Improving the quality and quantity of life is why healthcare delivery has evolved from the traditional family doctor providing the majority of the care to a team of healthcare professionals across a continuum of care. In the past, health care was designed to focus on the major health problems like epidemics. In addition, technology to handle the predominant health problems was virtually nonexistent. Individuals were left on their own resources to pay for doctor’s services. Furthermore, people were actively involved in giving care to their families (Williams & Torrens, 2008).…

    • 2706 Words
    • 11 Pages
    Powerful Essays
  • Good Essays

    In the past, managed care in the United States took the form of voluntary programs. Such programs date from about 1850, when managed care was provided chiefly by cooperative mutual benefit and fraternal beneficiary associations. Limited coverage by commercial companies was also introduced during that period, and subsequently many plans were established by industries and labor unions.…

    • 901 Words
    • 4 Pages
    Good Essays
  • Powerful Essays

    Healthcare Insurance Issues

    • 2493 Words
    • 10 Pages

    Healthcare today is a big issue for a lot of individuals, and families. Because it’s not affordable and some plans are lacking the necessary coverage people need these days. There are many ways to make healthcare more affordable, adequate, efficient, and patient-centered. That being said there are also various healthcare plans that are suited for many different people such as HMO’s, PPO’s, POS’s, Medicaid, and Medicare. This is why government should develop a reform plan that focus on all of the above issues and much more.…

    • 2493 Words
    • 10 Pages
    Powerful Essays