Medical Insurance Essays (Examples)
Study Document
US Healthcare Reimbursement And Insurance Issues
HealthCare insurance and Reimbursement
medical insurance Products and Services
Health and medical insurance represent an insurance coverage form that disburses operation and clinical treatment expenditure incurred by those insured. Such insurance may either reimburse insured individuals for the money they put into treatment for injuries or disease or may directly pay care practitioners. It … corporate structures in different nations, high-income nations currently witness an almost undisputed dedication to guaranteeing universal healthcare access to their citizens. Globally, healthcare insurance coverage attempts at improving health service utilization as well as safeguarding families against destitution due to out-of-pocket expenses (Ho, 2015).
Managed healthcare insurance plans represent a substitute for conventional healthcare plans, such as paid service plans. Over the last few decades, such schemes have grown into … substitute for conventional healthcare plans, such as paid service plans. Over the last few decades, such schemes have grown into a widely-chosen health insurance……
References
References
Araujo, M. (2020). Health and medical insurance differences: HMO, PPO, POS, EPO. Retrieved from https://www.thebalance.com/health-and-medical-insurance-2645378
Bertram, M. Y., Lauer, J. A., De Joncheere, K. D., Edejer, T., Hutubessy, R., Kieny, M. P., & Hill, S. R. (2016). Cost-effectiveness thresholds: pros and cons. Bull World Health Organ, 94, 925–930. http://dx.doi.org/10.2471/BLT.15.164418926
Dey, P., & Bach, P. B. (2019). The 6 functions of health insurance. The JAMA Forum, 321(13), 1242-1243. DOI:10.1001/jama.2019.2320
Ho, A. (2015). Health insurance. Encyclopedia of Global Bioethics. Retrieved from https://www.researchgate.net/publication/298022702_Health_Insurance
IMedPub. (2020). Health insurance. Retrieved from https://www.imedpub.com/scholarly/health-insurance-journals-articles-ppts-list.php
Maruthappu, M., Hasan, A., & Zeltner, T. (2016). Enablers and barriers in implementing integrated care. Health System & Reform, 1(4), 250-256. https://doi.org/10.1080/23288604.2015.1077301
Sekhri, N. (2000). Managed care: The US experience. Bulletin of the World Health Organization, 78(6), 830-844. Retrieved from https://www.who.int/bulletin/archives/78(6)830.pdf
Strata Decision Technology. (2020). Healthcare and hospital capital budget. Retrieved from https://www.stratadecision.com/healthcare-and-hospital-capital-budget/
Study Document
Examining The Different Types Of Original Medicare Coverage
… 65 have the ability to enroll in Medicare part A and Medicare part B. Medicare Part A is what is known as “hospital insurance”, and “helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay). Part A … a skilled nursing care unit, you are covered for meals, semi-private room, skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medications, medical social services, medical supplies and equipment used in the facility, ambulance transportation, dietary counseling, and swing bed services. In long-term care hospitals, there is some coverage … health services, Part A covers a fairly extensive range of services, including part-time skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services and part-time home health aide services. It is important to understand the limitations of this care, because it does not cover … the limitations……
References
References
Medicare.gov (2020) Website, various pages. Medicare.gov. Retrieved April 10, 2020 from https://www.medicare.gov
Social Security Administration. (no date). Website, various pages. SSA.gov. Retrieved April 10, 2020 from https://www.ssa.gov
Study Document
Design And Implementation Of Collaborative Care Model
… care professionals should be able to address the increasing obesity rates within the community. A majority of the community members do not have medical insurance and they work odd jobs. Others do not have jobs at all. People living in public housing account for the majority of patients … the community health center. Without any other option of health care access, they have to rely on the health center for all their medical needs. The lack of proper care might be discouraging but since they do not have any other option, they have to contend with … the area perennially prone to continued social injustices and lack of proper health facilities. Reduced income has made many people to not seek medical help even from the health center for fear of being charged to access care. The nurses who work in the community health center … do not closely understand……
References
References
LaBelle, C. T., Han, S. C., Bergeron, A., & Samet, J. H. (2016). Office-based opioid treatment with buprenorphine (OBOT-B): statewide implementation of the Massachusetts collaborative care model in community health centers. Journal of substance abuse treatment, 60, 6-13.
Overbeck, G., Kousgaard, M. B., & Davidsen, A. S. (2018). The work and challenges of care managers in the implementation of collaborative care: A qualitative study. Journal of psychiatric and mental health nursing, 25(3), 167-175.
Sanchez, K. (2017). Collaborative care in real-world settings: barriers and opportunities for sustainability. Patient preference and adherence, 11, 71.
Smith, S. N., Almirall, D., Prenovost, K., Liebrecht, C., Kyle, J., Eisenberg, D., . . . Kilbourne, A. M. (2019). Change in Patient Outcomes After Augmenting a Low-level Implementation Strategy in Community Practices That are Slow to Adopt a Collaborative Chronic Care Model: A Cluster Randomized Implementation Trial. Medical Care.
Unützer, J., Harbin, H., Schoenbaum, M., & Druss, B. (2013). The collaborative care model: An approach for integrating physical and mental health care in Medicaid health homes. HEALTH HOME, Information Resource Center, 1-13.
Study Document
Clinical Informatics
… the law figures into this issue with respect to HIPAA, privacy/confidentiality and security issues; and how patient safety, the nursing role and electronic medical records are impacted.
Clinical Informatics Concepts in the 21st Century
Controlling the flow of information to promote efficiency, security, and safety is the … to obtain information; it is also about how to appraise information and assess its value. Keeping complete records for the purpose of electronic medical records (EMR) databases is also part of the concept because of need for continuity of care, which necessarily depends upon continuity of information … is why EMR must be securely maintained—and that can be a challenge, as numerous data breaches over the years have shown.
The Health insurance Portability and Accountability Act (HIPAA) of 1996 was implemented to regulate health care facilities with respect to how they handle health information, and HIPAA ……
References
References
Cho, O. M., Kim, H., Lee, Y. W., & Cho, I. (2016). Clinical alarms in intensive care units: Perceived obstacles of alarm management and alarm fatigue in nurses. Healthcare informatics research, 22(1), 46-53.
Effken, J., Weaver, C., Cochran, K., Androwich, I., & O’Brien, A. (2016). Toward a central repository for sharing nursing informatics’ best practices. CIN: Computers, Informatics, Nursing, 34(6), 245-246.
Elsayed, W. A., Hussein, F. M., & Othman, W. N. (2017). Relation between nursing informatics competency and nurses’ attitude toward evidence-based practice among qualified nurses at Mansoura Oncology Center. International Journal of Nursing Didactics, 7(6), 26-33.
Drolet, B. C., Marwaha, J. S., Hyatt, B., Blazar, P. E., & Lifchez, S. D. (2017). Electronic communication of protected health information: privacy, security, and HIPAA compliance. The Journal of hand surgery, 42(6), 411-416.
Haupeltshofer, A., Egerer, V., & Seeling, S. (2020). Promoting health literacy: What potential does nursing informatics offer to support older adults in the use of technology? A scoping review. Health Informatics Journal, 1460458220933417.
Kharbanda, E. O., Asche, S. E., Sinaiko, A. R., Ekstrom, H. L., Nordin, J. D., Sherwood, N. E., & O’Connor, P. (2018). Clinical decision support for recognition and management of hypertension: a randomized trial. Pediatrics, 141(2).
Khezri, H., & Abdekhoda, M. (2019). Assessing nurses’ informatics competency and identifying its related factors. Journal of Research in Nursing, 24(7), 529-538.
Kleib, M., & Nagle, L. (2018). Factors associated with Canadian nurses\\\\\\\\\\\\' informatics competency. CIN: Computers, Informatics, Nursing, 36(8), 406-415.
Study Document
COVID 19 In South Africa Nigeria And Swaziland
...Medical insurance Literature Review on Coping Through The Use Of Informal Institutions during COVID 19 in South Africa, Nigeria, and Swaziland
The institutional theory deals with the outlines, regulations, standards, and procedures that are formulated in the institutions as commanding instructions for social behavior. This theory gives an understanding of how institutions are shaped, and the societal norms and frameworks are informed to all people of an organization. Communication is the sole indicator of how organizations are formulated with the help of formal rules and regulations, as that would reflect how they are conversed across all levels of the firm and in what way people are obeying them. This would ultimately build an organizational culture for coping with social and political issues. The informal institutions are socially shared instructions, typically unwritten, that are formed, transferred and imposed outside the official boundaries (Torniainen & Sasstamoinen, 2007), for example, giving tips to the food……
References
References
Coelho, A. (2019). The role of informal institutions in the enforcement of rules and how to improve corporate and public governance in Brazil: Studies based on a set of corporate governance cases involving state-owned companies (Working Paper). Retrieved from SSRN website https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3434037
Dacin, M.T., Goodstein, J. & Scott, W.R. (2002). Institutional theory and institutional change: Introduction to the special research forum. Academy of Management Journal, 45(1), 45- 47. DOI: 10.2307/3069284
Escandon-Barbosa, D.M., Urbano, D., Hurtado-Ayala, A., Paramo, J.S. & Dominguez, A.Z. (2019). Formal institutions, informal institutions, and entrepreneurial activity: A comparative relationship between rural and urban areas in Colombia. Journal of Urban Management, 8(3), 458-471. https://doi.org/10.1016/j.jum.2019.06.002
Estrin, S. & Prevezer, M. (2010). The role of informal institutions in corporate governance: Brazil, Russia, India, and China compared. Asia Pacific Journal of Management, 28, 41- 67. https://doi.org/10.1007/s10490-010-9229-1
Kaufmann, W., Hooghiemstra, R. & Feeney, M.K. (2018). Formal institutions, informal institutions, and red tape: A comparative study. Public Administration, 96(2), 386-403. https://doi.org/10.1111/padm.12397
Meluch, A.L. (2016, August). Understanding the organizational and institutional origins of social support in a cancer support center. (Unpublished doctoral dissertation). Retrieved from https://etd.ohiolink.edu/!etd.send_file?accession=kent1466944822&disposition=inline
Torniainen, T.J. & Sasstamoinen, O.J. (2007). Formal and informal institutions and their hierarchy in the regulation of the forest lease in Russia. Forestry: An International Journal of Forest Research, 80(5), 489-501. https://doi.org/10.1093/forestry/cpm033
Study Document
Application Of Quality And Safety Concepts
… the globe continue to stick to a pen-and-paper system, including those in developed nations such as America. This is an obstacle on the medical science path as well as gives rise to regression due to the waste caused by it. Besides patients paying the price through adverse … be highly dangerous if the patient requires complex or emergency treatment.
Hence, this paper holds that the sole means of addressing the above-mentioned medical problems is through the utilization of more, advanced technology for delivering an all-inclusive healthcare experience to allow diverse entities participating in the healthcare … more, advanced technology for delivering an all-inclusive healthcare experience to allow diverse entities participating in the healthcare process (namely physicians, patients, and healthcare insurance and scheme providers) to exchange patient data in a secure and timely manner.
Brief literature review
Federico and Alotaibi (2017) state that ever … technology articles and associated nomological……
References
Bibliography
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Med J, 38(12), 1173–1180.
Amit, M. (2019, January 28). 5 Problems Which Healthcare Technology Can Solve for a Healthier World. Retrieved from Net Solutions: https://www.netsolutions.com/insights/5-healthcare-problems-which-digital-technologies-can-solve-for-a-fit-and-healthy-world/
DeSanctis, G., & Poole, M. S. (1994). Capturing the Complexity in Advanced Technology Use: Adaptive Structuration Theory. Organization Science, 5(2), 121-147.
Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health Information Technology in Healthcare Quality and Patient Safety: Literature Review. JMIR Med Inform, 6(2).
Halamka, J., Mandl, K., & Tang, P. (2008). Early Experiences with Personal Health Records. Journal of the American Medical Informatics Association, 15(1), 1-7.
IOM. (1999). To Err is Human: Building a Safer Health System. National Academy of Sciences.
Singh, H., & Sittig, D. (2016). Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Quality & Safety, 25, 226-232.
Weigel, F., Hall, D. J., & Landrum, W. H. (2009). Human/Technology Adaptation Fit Theory for Healthcare. SAIS 2009 Proceedings.
Study Document
Optimizing Health Information Systems
… in implementing a health information system (HIS) that meets current Health Information Technology for Economic and Clinical Health (HITECH) Act and the Health insurance Portability and Accountability Act (HIPAA) Security and Privacy regulatory requirements. To this end, a discussion and analysis of health information systems, a description ……
References
References
Abouzhar, C. & Boerma, T. (2009, August). Health information systems: The foundations of public health. Bulletin of the World Health Organization, 83(8), 578-583.
Cresswell, K. & Aziz, S. (2013, May). Organizational issues in the implementation and adoption of health information technology innovations: An interpretative review. International Journal of Medical Informatics, 87(5), 73-86.
Drazen, E. L. (2006, February). Maximizing the benefits of health care information systems. Journal of Medical Systems, 10(1), 51-56.
Kruse, C. S. & Smith, D. (2017, July). Security techniques for the electronic health records. Journal of Medical Systems, 41(8), 127.
Kumar, V. (2011). Impact of health information systems on organizational health communication and behavior. The Internet Journal of Allied Health Sciences and Practice, 9(2), 37-44.
McGrail, K. M. & Black, C. (2009, August). Access to data in health information systems. Bulletin of the World Health Organization, 83(8), 563-569.
Murphy, M. L. (2019, March). Mastering accounting for business combinations: Mergers and acquisitions present challenges that finance can overcome by staying involved with the deal and preparing in advance of the closing. Journal of Accountancy, 227(3), 24-27.
NAHQ code of ethics for healthcare quality. (2019). National Association for Healthcare Quality. Retrieved from https://nahq.org/about/code-of-ethics .
Study Document
Electronic Health Records EHR
… of EHRs can be relied upon to increment drastically in the coming months and years. Meaningful use criteria direct how qualified suppliers and medical clinics must utilize EHRs innovation, while accreditation measures indicate what abilities that EHR must have so as to help significant use (Murphy & ……
References
References
Gagnon, D., Simonyan, E.K., Ghandour, G., Godin, M., Labrecque, M., Ouimet, M.R. (2016). Factors influencing electronic health record adoption by physicians: A multilevel analysis, Int J Inform Manage, 36, pp. 258-270.
Hasanain, H. (2014). Cooper Solutions to overcome technical and social barriers to electronic health records implementation in Saudi public and private hospitals, J Health Inform Dev Ctries, pp. 46-63.
Kierkegaard, P. (2019). Electronic health record: Wiring Europe\\\\'s healthcare: Computer Law & Security Review. 27 (5): 503–515.
Murphys, E.V., & Yale, J. (2014). Clinical decision support: effectiveness in improving quality processes and clinical outcomes and factors that may influence success. Biol Med; 87, pp. 187–97.
Study Document
Telemedicine And Its Impact On Patient Care
… for minimally invasive treatments, and better monitoring of vital signs and other signs. Moreover, technology is now also being used to consult with medical experts from all over the world remotely. This has led to improved healthcare and has enhanced patent experience.
Furthermore, many mobile applications have … be through reviewing a journal article titled Telemedicine Follow-up After Bariatric Surgery.
Background
For over thirty years, health services researchers, clinicians, and other medical experts have been studying how computers and other advanced telecommunication technologies have been used to enhance health care. One of the most important … a distance between them. In addition to being a way in which health care is delivered, Telemedicine is also a way in which medical experts can share knowledge and experience without having to meet each other. While Telemedicine may sound like a very modern concept or phenomenon, …
In the year 1906, the……
References
References
Meyers, A. J., Pontarelli, E., Dutta, S. K., Grinberg, G., & Yenumula, P. R. (2018). Telemedicine Follow-up After Bariatric Surgery. Surgery for Obesity and Related Diseases, 14(11), S168.
Tiago, M. T. B., Tiago, F., Amaral, F. E. B., & Silva, S. (2016). Healthy 3.0: Healthcare digital dimensions. In Reshaping medical practice and care with health information systems (pp. 287-322). IGI Global.
Conklin, T. P. (2002). Health care in the United States: An evolving system. Michigan Family Review, 7(1).
Board on Health Care Services; Institute of Medicine. (2012). \\\\\\\\\\\\"3The Evolution of Telehealth: Where Have We Been and Where Are We Going?\\\\\\\\\\\\" in The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary. National Academies Press, Washington (DC).
Sada, A., Asaad, M., Reidt, W. S., Kellogg, T. A., Kendrick, M. L., McKenzie, T. J., & Habermann, E. B. (2019). Are In-Person Post-operative Clinic Visits Necessary to Detect Complications Among Bariatric Surgery Patients?. Obesity Surgery, 1-4.
Krupka, D. C., Sandberg, W. S., & Weeks, W. B. (2012). The impact on hospitals of reducing surgical complications suggests many will need shared savings programs with payers. Health Affairs, 31(11), 2571-2578.
Fasano, P. (2013). Transforming health care: The financial impact of technology, electronic tools, and data mining. John Wiley & Sons.
Burch, S., Gray, D., & Sharp, J. (2017). The power and potential of telehealth what health systems should know: proposed legislation in Congress offers the promise that the nation\\\\\\\\\\\\'s healthcare policy will support the expansion of telehealth, allowing hospitals and health systems to fully realize the benefits of this important emerging approach to care. Healthcare Financial Management, 71(2), 46-50.
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