➊ Healthcare Systems: Characteristics Of Medicare Culture

Thursday, May 27, 2021 8:54:45 PM

Healthcare Systems: Characteristics Of Medicare Culture



Data fields to be extracted will be determined based upon proposed summary analysis. Download as PDF Printable version. The goal of culturally competent health care services is to Enzyme Implementation Lab the highest quality of care to every patient, regardless of race, ethnicity, cultural background, English proficiency or literacy. International citizens who are Characteristics Of Leadership In Beowulf residing Cellular Respiration the Philippines are eligible to Healthcare Systems: Characteristics Of Medicare Culture PhilHealth. Overview of the Healthcare Healthcare Systems: Characteristics Of Medicare Culture in Healthcare Systems: Characteristics Of Medicare Culture Philippines Healthcare in the Philippines is Healthcare Systems: Characteristics Of Medicare Culture to be of good quality by international standards. These Healthcare Systems: Characteristics Of Medicare Culture focus on enhancing attitudes in the following areas: 24 Awareness of the influences that sociocultural factors have on patients, clinicians, and the clinical relationship. The Center Healthcare Systems: Characteristics Of Medicare Culture American Progress estimated in that the lack Healthcare Systems: Characteristics Of Medicare Culture health insurance in the U. The federal government accounted for 28 percent of spending while Healthcare Systems: Characteristics Of Medicare Culture and local Wuthering Heights Social Class Essay accounted for 17 percent. Cultural Competence Compendium.

US Healthcare System Explained

Another explanation for increased costs is the rise of chronic diseases, including obesity. Nationally, health care costs for chronic diseases contribute huge proportions to health care costs, particularly during end of life care. Their findings suggest that this holds true even when controlling for socio-economic disparity. Finally, high administrative costs are a contributing factor to the inflated costs of U. Further, the government outsources some of its administrative needs to private firms. The aim is to improve administrative efficiency by allowing doctors and hospitals to bundle billing for an episode of care rather than the current ad hoc method.

Health Insurance in the U. While the majority of U. Average annual premiums for family coverage increased 11 percent between and , but have since leveled off to increase five percent per year between and Between and , single coverage deductibles have risen 67 percent. The lack of health insurance coverage has a profound impact on the U. The Center for American Progress estimated in that the lack of health insurance in the U. While the low end of the estimate represents just the cost of the shorter lifespans of those without insurance, the high end represents both the cost of shortened lifespans and the loss of productivity due to the reduced health of the uninsured. Health insurance coverage is uneven and often minorities and the poor are underserved.

Forty million workers, nearly two out of every five, do not have access to paid sick leave. Experts suggest that the economic pressure to go to work even when sick can prolong pandemics, reduce productivity, and drive up health care costs. There were 32 million uninsured Americans in , nine million fewer than the year prior. Experts attribute this sharp decline in the uninsured to the full implementation of the ACA in Coverage by employer-provided insurance varies considerably by wage level. Firms with higher proportions of low-wage workers are less likely to provide access to health insurance than those with low-proportions of low-wage workers.

However, the percentage of part-time workers without insurance was The uninsured rate among those who had not worked at least one week also decreased from Smaller firms are significantly less likely to provide health benefits to full or part-time workers. Among all small firms workers in , only 56 percent offered health coverage, compared to 98 percent of large firms. Minorities and children are disproportionately uninsured. In , 7. Women in the individual market often faced higher premiums than men for the same coverage.

Beginning in , the Affordable Care Act banned this practice, as well as denying coverage for pre-existing conditions. Rising Healthcare Premiums. Health insurance premiums in the U. From to , average annual health insurance premiums for family coverage increased 61 percent, while worker contributions to those plans increased 83 percent in the same period. The Union Difference : Union workers are more likely than their nonunion counterparts to be covered by health insurance and paid sick leave. In March , 95 percent of union members in the civilian workforce had access to medical care benefits, compared with only 68 percent of nonunion members.

In , 85 percent of union members in the civilian workforce had access to paid sick leave compared to 62 percent of nonunion workers. Across states, there are significant disparities in both the availability and the cost of health care coverage. In the South, 41 percent of firms reported providing benefits for same-sex partners compared to 51 percent in the Northeast and 20 percent reported offering benefits to opposite-sex domestic partners compared to 46 percent in the Northeast.

High Costs Drive Americans into Bankruptcy. Universal coverage, in countries like the United Kingdom, Switzerland, Japan, and Germany makes the number of bankruptcies related to medical expenses negligible. It has been suggested, based on the experience of Massachusetts, where medical-related bankruptcies declined sharply after the state enacted its health reform law in , that the ACA may help reduce such bankruptcies in the future.

Provisions included in the ACA are intended to expand access to healthcare coverage, increase consumer protections, emphasizes prevention and wellness, and promote evidence- based treatment and administrative efficiency in an attempt to curb rising healthcare costs. Beginning in January , almost all Americans are required to have some form of health insurance from either their employer, an individual plan, or through a public program such as Medicaid or Medicare. A major provision of the ACA was the creation of health insurance marketplace exchanges where individuals not already covered by an employer-provided plan or a program such as Medicaid or Medicare can shop for health insurance.

Individuals with incomes between percent and percent of the federal poverty line would be eligible for advanceable premium tax credits to subsidize the cost of insurance. States have the option to create and administer their own exchanges or allow the federal government to do so. Currently, only 14 states operate their own exchanges. Designed to promote competition among providers and deliver choice transparency to consumers, the state-based exchanges appear to be doing just that.

A recent analysis by the Commonwealth Fund found that the number of insurers offering health insurance coverage through the marketplaces increased from to The analysis found only a modest increase in average premiums for the lowest cost plans from to The ACA also included a major expansion of the Medicaid program, although the Supreme Court ruled in that this expansion is a state option. As of November , 30 states have chosen to expand Medicaid.

As of , adults with incomes at or below percent of the federal poverty line are now eligible for Medicaid in the states that have adopted the expansion. Despite improvements to the U. S healthcare system under the ACA, a number of challenges remain. The bulk of people in the coverage gap are concentrated in the South, with Texas , people , Florida , , Georgia , and North Carolina , having among the highest number of uninsured. The ACA included a number of other provisions to improve healthcare access and affordability.

The law banned lifetime monetary caps on insurance coverage for all new plans and prohibited plans from excluding children and most adults with preexisting conditions. A number of cost control provisions were included in the ACA in an attempt to curb rising medical costs. Among them is the Independent Payment Advisory Board, which will provide recommendations to Congress and the President for controlling Medicare costs if the costs exceed a target growth rate. The administrative process for billing, transferring funds, and determining eligibility is being simplified by allowing doctors to bundle billing for an episode of care rather than the current ad hoc method.

Additionally, changes were made to the Medicare Advantage program that would provide bonuses to high rated plans, incentivizing these privately-operated plans to improve quality and efficiency. Furthermore, hospitals with high readmission rates will see a reduction in Medicare payments while a new Innovation Center within the Centers for Medicare and Medicaid Services was created to test new program expenditure reduction methods. By taking an international perspective and looking to other advanced industrialized countries with nearly full coverage, much can be learned. While methods range widely, other OECD countries generally have more effective and equitable health care systems that control health care costs and protect vulnerable segments of the population from falling through the cracks.

Among the OECD countries and other advanced industrialized countries, there are three main types of health insurance programs:. A national health service , where medical services are delivered via government-salaried physicians, in hospitals and clinics that are publicly owned and operated—financed by the government through tax payments. There are some private doctors but they have specific regulations on their medical practice and collect their fees from the government. A national health insurance system , or single-payer system, in which a single government entity acts as the administrator to collect all health care fees, and pay out all health care costs.

Medical services are publicly financed but not publicly provided. Canada, Denmark, Taiwan, and Sweden have single-payer systems. This method is used in Germany, Japan, and France. A universal mandate for health care coverage defines these systems. Such a mandate eliminates the issue of paying the higher costs of the uninsured, especially for emergency services due to lack of preventative care. Negotiating the price of prescription drugs and bulk purchasing of prescription medications and durable medical equipment is a method used in other countries for lowering costs. This has been effectively used by the U. Yet, it has been prohibited by law from traditional Medicare. Savings of up to five percent of total health care expenditures could result from the full adoption of these practices.

Germany has one of the most successful health care systems in the world in terms of quality and cost. Some insurance providers collectively make up its public option. The average per-capita health care costs for this system are less than half of the cost in the U. The details of the system are instructive, as Germany does not rely on a centralized, Medicare-like health insurance plan, but rather relies on private, non-profit, or for-profit insurers that are tightly regulated to work toward socially desired ends—an option that might have more traction in the U.

Clinic in Los Angeles, nurses and health care professionals speak individually with patients when they arrive at the health clinic to determine whether the patient prefers to learn by using written materials, pictures, verbal counseling, or some other technique. This method of assessment allows the patient to identify their own learning style preference without having to take a literacy test; it also reduces feelings of fear or humiliation that may occur when singled out. The Department of Health and Human Services has provided important guidance on how to ensure culturally and linguistically appropriate health care services. States that have developed such standards have focused on managed care organizations, contracting agreements with providers, and specific health and mental health services in defined settings.

In August , the Health Care Financing Administration now Centers for Medicare and Medicaid Services issued guidance to all state Medicaid directors regarding interpreter and translation services, emphasizing that federal matching funds are available for states to provide oral interpretation and written translation services for Medicaid beneficiaries. These standards are intended to correct current inequities in the health services system and to make these services more responsive to the individual needs of all patients. They are designed to be inclusive of all cultures, with a particular focus on the needs of racial, ethnic, and linguistic population groups that experience unequal access to the health care system.

The CLAS standards provide consistent definitions of culturally and linguistically appropriate services in health care and offer a framework for the organization and implementation of services. Cultural competence is not an isolated aspect of medical care, but an important component of overall excellence in health care delivery. Issues of health care quality and satisfaction are of particular concern for people with chronic conditions who frequently come into contact with the health care system. Efforts to improve cultural competence among health care professionals and organizations would contribute to improving the quality of health care for all consumers.

Betancourt, J. Cultural competence in health care: Emerging frameworks and practical approaches. New York: The Commonwealth Fund. Collins, K. Edwards, J. Diverse communities, common concerns: Assessing health care quality for minority Americans. Druss, B. The most expensive medical conditions in America. Health Affairs, 21, Fried, V. Health, United States, Chartbook on trends in the health of Americans. Bureau of the Census. Table DP-1, Profile of general demographic characteristics: Washington, DC: Author. Day, J. Population projections of the United States by age, sex, race, and Hispanic origin: to Washington, DC: U. Government Printing Office.

Bureau of the Census, Census Summary File 3? Sample Data. Fiscella, K. Disparities in health care by race, ethnicity and language among the insured: Findings from a national sample. Medical Care, 40 1 , Carrasquillo, O. Impact of language barriers on patient satisfaction in an emergency department. Journal of General Internal Medicine, 14, Lee, L. J, Batal, H. Kutner, J. Effect of Spanish interpretation method on patient satisfaction in an urban walk-in clinic. Journal of General Internal Medicine, 17, Kirsch, I. Cooper, L. Patient-provider communication: The effect of race and ethnicity on process and outcomes of healthcare. Smedley, A. Nelson Eds.

Unequal treatment: Confronting racial and ethnic disparities in health care pp. Wilson, J. The crucial link between literacy and health. Annals of Internal Medicine, , Center for Health Care Strategies. Impact of low health literacy skills on annual health care expenditures. Lawrenceville, NJ: Author. Saha, S. Patient-physician relationships and racial disparities in the quality of health care. American Journal of Public Health, 93, Brach, C. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57 Supplement 1 , American Institutes for Research. Teaching cultural competence in health care: A review of current concepts, policies, and practices.

Report prepared for the Office of Minority Health. Bonder, B. Achieving cultural competence: The challenge for clients and healthcare workers in a multicultural society. Generations, 25, American Medical Association. Cultural Competence Compendium. Chicago: Author. Liaison Committee on Medical Education. Functions and structure of a medical school. Asian Counseling and Referral Service. ACRS participates in national effort to train mental health interpreters. Seattle, WA: Author. Kolker, C. Kiefer, K. Health literacy: Responding to the need for help. Goode, T. Linguistic competence in primary health care delivery systems: Implications for policy makers. Westmoreland, T. This series is supported by a grant from the Robert Wood Johnson Foundation.

Emily Ihara wrote this Issue Brief.

Healthcare Systems: Characteristics Of Medicare Culture care is an approach to service delivery Healthcare Systems: Characteristics Of Medicare Culture ensures Healthcare Systems: Characteristics Of Medicare Culture services are respectful of, and responsive to, the preferences, needs, and values of people and those who care for them. Vaccinations are voluntary in some countries and mandatory in some countries. Acute Sinusitis Case Study addition to increasing the cultural competence of Healthcare Systems: Characteristics Of Medicare Culture care providers, organizational accommodations and policies that reduce administrative and linguistic barriers to Healthcare Systems: Characteristics Of Medicare Culture care are also important. Healthcare Systems: Characteristics Of Medicare Culture of John Lockes Influence On Jeffersons Declaration Of Independence and Human Services. The average per-capita health care costs for this system are less than Healthcare Systems: Characteristics Of Medicare Culture of the cost in the U.

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