Health Care eBooks
Administrative Healthcare Data: A Guide to Its Origin, Content, and Application Using SAS.
Publication Date: 2014-10-01
Provides a concise yet complete foundational knowledge of the business of healthcare.Administrative Healthcare Data: A Guide to Its Origin, Content, and Application Using SAS explains the source and content of administrative healthcare data, which is the product of financial reimbursement for healthcare services. The book integrates the business knowledge of healthcare data with practical and pertinent case studies as shown in SAS Enterprise Guide. The book's blend of SAS programming and industry knowledge is unique. It illustrates concepts of administrative healthcare data with actual healthcare case studies. All applications are created with SAS Enterprise Guide or Base SAS and can be taken straight from the book and put to use immediately. Central topics addressed include key players in the healthcare industry and the roles they play; claim submission mechanisms used by different providers; medical claim content, both pre- and post-adjudication. Written for healthcare analysts regardless of their level of proficiency with SAS Enterprise Guide, SAS programming, or healthcare industry knowledge, Administrative Healthcare Data is a must-read for analysts new to the industry and a great review for experienced healthcare analysts. This book is part of the SAS Press program.
Appreciative Healthcare Practice : A Guide to Compassionate, Person-centred Care.
Publication Date: 2015
Written by a leading healthcare academic and an accredited international business coach, this book takes a new approach to one of the most crucial issues in healthcare – how to care for patients appreciatively, responsively and compassionately. In the light of the findings of the Francis Report (2013), and at a time when healthcare services are under enormous pressure, there is a clear and urgent need for such a book. Despite the challenges of ill health, the authors demonstrate that the opportunity is there for any healthcare practitioner to draw out what the patient needs and desires, in line with the patient's own values, purposes and beliefs. This approach seeks to alleviate suffering and allows the patient to be more empowered and motivated to change, discovering choice and possibility in times of adversity. In this way, the practitioner can help the patient increase their own resilience and resourcefulness. At the same time, the practitioner discovers their own ability to self-care and self-manage. Aimed at healthcare students and practitioners at all levels, Appreciative Healthcare Practice will provide a valuable and supportive learning resource for a wide range of individuals involved in caring..
Changing the U. S. Health Care System: Key Issues in Health Services Policy and Management (4)
Publication Date: 2013-11-04
The Fourth Edition of Changing the U.S. Health Care System addresses the key topics in health care policy and management, presenting evidence-based views of current issues. Each chapter is written by an expert in the field who integrates evidence to explain the current condition and presents support for needed change. The book examines all the levers in the setting and implementation of health policy, and includes extensive coverage of impact of the Affordable Care Act, particularly on Medicare, Medicaid, and large and small group insurance markets. Also new to this edition is expanded coverage of nursing, disease management, mental health, women's health, children's health, and care for the homeless.
Clinical Governance: Improving The Quality Of Healthcare For Patients And Service Users.
Publication Date: 2014-01-01
This is an accessible and practical guide to clinical governance in healthcare, designed to help practitioners and students deliver better care to patients..
Cultural Sensibility in Healthcare: A Personal & Professional Guidebook.
Publication Date: 2015-06-01
The healthcare workforce and landscape continues to evolve with the ongoing education systems forming in foreign countries and immigration and foreign employment continuing to grow in the United States. Every heath care provider and patient is challenged with cultural competency and acceptance on a daily basis. Often times our own prejudices and beliefs have great potential to interfere with effective health care interactions when what is truly important is providing the best patient care possible. There is much discussion around cultural sensitivity and cultural expertise, but now the discussion has shifted to cultural sensibility, which is a deliberate behavior that proactively provides an enriched provider consumer/patient interaction, where the health care provider acknowledges cultural issues and situations through thoughtful reasoning, responsiveness, and discreet (attentive, considerate, and observant) interactions. In this highly practical and informative handbook, author Sally Ellis Fletcher offers healthcare providers a process that encourages them to first consider their own attitudes, biases, beliefs, and prejudices through self-reflection. Cultural Sensibility in Healthcare challenges readers to examine cultural issues beyond just theory and to instead explore culture as it affects your professional role thus creating culturally sensibility health care encounters..
Going Universal: How Twenty-Four Countries are Implementing Universal Health Coverage from the Bottom Up
Publication Date: 2015-09-01
This book is about 24 developing countries that have embarked on the journey towards universal health coverage (UHC) following a bottom-up approach, with a special focus on the poor and vulnerable, through a systematic data collection that provides practical insights to policymakers and practitioners. Each of the UHC programs analyzed in this book is seeking to overcome the legacy of inequality by tackling both a "financing gap ? and a "provision gap ?: the financing gap (or lower per capita spending on the poor) by spending additional resources in a pro-poor way; the provision gap (or underperformance of service delivery for the poor) by expanding supply and changing incentives in a variety of ways. The prevailing view seems to indicate that UHC require not just more money, but also a focus on changing the rules of the game for spending health system resources. The book does not attempt to identify best practices, but rather aims to help policy makers understand the options they face, and help develop a new operational research agenda. The main chapters are focused on providing a granular understanding of policy design, while the appendixes offer a systematic review of the literature attempting to evaluate UHC program impact on access to services, on financial protection, and on health outcomes."
Publication Date: 2011-07-15
Focusing on topics of special concern to students, this series makes complex issues less intimidating and more accessible; each book presents 10 to 14 readings from a variety of perspectives that allow readers to better understand the topic.; ; Students must often make informed decisions about serious issues that will affect the course of their lives. Focusing on topics of special concern to students, the Issues That Concern You series helps make these complex issues less intimidating and more a
Integrating Research and Practice: Health System Leaders Working Toward High-Value Care: Workshop Summary.
Publication Date: 2015-04-04
Health care has been called one of the most complex sectors of the U.S. economy. Driven largely by robust innovation in treatments and interventions, this complexity has created an increased need for evidence about what works best for whom in order to inform decisions that lead to safe, efficient, effective, and affordable care. As health care becomes more digital, clinical datasets are becoming larger and more numerous. By realizing the potential of knowledge generation that is more closely integrated with the practice of care, it should be possible not only to produce more usable evidence to inform decisions, but also to increase the efficiency and decrease the costs of doing clinical research. Patient-Centered Clinical Research Network, or PCORnet, is a nation-wide patient-centered clinical research network intended to form a resource of clinical, administrative, and patient data that can be used to carry out observational and interventional research studies and enhance the use of clinical data to advance the learning health care system. The primary goal of the first phase of PCORnet will be to establish the data infrastructure necessary to do such research. In April and June 2014 the Institute of Medicine's Roundtable on Value and Science-Driven Health Care convened two workshops aimed at accelerating progress toward real-time knowledge generation through the seamless integration of clinical practice and research, one of the fundamental concepts of a continuously learning health system, centered on the development of the PCORnet. The first workshop brought together health care system leaders, both administrative and clinical, and researchers to consider issues and strategic priorities for building a successful and durable clinical research network and facilitate progress toward a continuously learning health care system more broadly, including issues related to science, technology, ethics, business, regulatory oversight, sustainability, and governance. The second workshop focused on implementation approaches. Health system CEOs convened to consider strategic priorities and explore approaches to implementation. These workshops will inform the decisions of field leaders moving forward, including PCORI, the PCORnet steering committee, and PCORnet grantees. "Integrating Research and Practice" is the summary of the presentations and discussions of the workshops.
Introduction to Health Care Services: Foundations and Challenges
Publication Date: 2014-12-11
A comprehensive guide to the structure, synergy, and challenges in U.S. health care delivery Introduction to Health Care Services: Foundations and Challenges offers new insights into the most important sectors of the United States' health care industry and the many challenges the future holds. Designed to provide a comprehensive and up-to-date understanding of the system, this textbook covers the many facets of health care delivery and details the interaction of health, environments, organizations, populations, and the health professions. Written by authors with decades of experience teaching and working in health care administration and management, the book examines the current state and changing face of health care delivery in the United States. Each chapter includes learning objectives and discussion questions that help guide and engage deeper consideration of the issues at hand, providing a comprehensive approach for students. Cases studies demonstrating innovations in the delivery of health care services are also presented. Health care administration requires a thorough understanding of the multiple systems that define and shape the delivery of health care in the United States. At the same time, it is important for students to gain an appreciation of the dilemma confronting policy makers, providers, and patients in the struggle to balance cost, quality, and access. Introduction to Health Care Services: Foundations and Challenges is an in-depth examination of the major health care issues and policy changes that have had an impact on the U.S. health care delivery system. Includes information on U.S. health care delivery, from care to cost, and the forces of change Focuses on major industry players, including providers, insurers, and facilities Highlights challenges facing health care delivery in the future, including physician shortages, quality care, and the chronic disease epidemic The U.S. health care system is undergoing major reform, and the effects will ripple across every sector of the industry. Introduction to Health Care Services: Foundations and Challenges gives students a complete introduction to understanding the issues and ramifications.
Introduction to Health Policy
Publication Date: 2013-07-29
With the evolution of healthcare policies and their subsequent integration into healthcare systems, this book will introduce your students to health policy making, critical health policy issues, health policy research/evaluation methods, and international perspectives on health policy. Shi takes a unique perspective by integrating all these topics into this a one-of-a-kind book. Real-world cases and examples reinforce the theories and concepts throughout the book and address all healthcare settings, including public health, managed care, ambulatory care, extended care, and the hospital setting..
Mentorship in Healthcare, 2nd ed
Publication Date: 2015
In healthcare settings, the term ‘mentorship'is normally used to describe the supervision of a pre-registration student by a qualified practitioner. Mentorship can be very formal or relatively informal. It can also be practised differently in particular locations, settings and healthcare professions. This clear, concise book transcends professional and geographical boundaries in order to focus on the essential characteristics of effective mentorship. It will therefore be useful to a very wide range of healthcare professionals who are involved in mentoring and assessing junior colleagues. The book examines learning theories, teaching and communication skills and assessment methods. It also contains helpful advice on dealing with overseas students and students with special needs. Activities encourage reflection, and quotations and tables enable readers to absorb the content and relate theory to practice. In this second edition, the text has been made even clearer and the authors have added further detail on learning theories such as social constructivism. Most importantly, they have added an Afterword written in the light of reports on the Mid Staffordshire NHS Foundation Trust Public Inquiry. This final section places new emphasis on the mentor's role in helping to ensure that patients receive safe and effective care, which is provided with compassion as well as practical skill. Contents include: Introduction Professional development Teaching and learning Optimising learning in the clinical environment Skills for mentorship Assessment Challenging situations Assessing care and compassion.
Promising Care: How We Can Rescue Health Care by Improving It (1)
Publication Date: 2013-11-18
Promising Care: How We Can Rescue Health Care by Improving It collects 16 speeches given over a period of 10 years by Donald M. Berwick, an internationally acclaimed champion of health care improvement throughout the course of his long and storied career as a physician, health care educator and policy expert, leader of the Institute for Healthcare Improvement (IHI), and administrator of the Centers for Medicare & Medicaid Services. These landmark speeches (including all of Berwick's speeches delivered at IHI's annual National Forum on Quality Improvement in Health Care from 2003 to 2012) clearly show why our medical systems don't reliably contribute to our overall health. As a remedy he offers a vision for making our systems better - safer, more effective, more efficient, and more humane. Each of Berwick's compelling speeches is preceded by a brief commentary by a prominent figure in health care, policy, or politics who has a unique connection to that particular speech. Contributors include such notables as Tom Daschle, Paul Batalden, and Lord Nigel Crisp. Their commentaries reflect on how it felt to hear the speech in the context in which it was delivered, and assess its relevance in today's health care environment. The introduction is by Maureen Bisognano, CEO of Institute for Healthcare Improvement, and author of Pursuing the Triple Aim. Praise for previous books by Don Berwick Curing Health Care: "The book is an easy and affirming read for anyone who is familiar with and has used the TQM teachings of Dr. Joseph M. Juran and Dr. W. Edwards Deming and would be a simple and informative introduction to the concepts for anyone who has been hearing about TQM but has no idea what it is all about and wants to know more." -Permanent Fixes (blog) "Donald Berwick is the most clearly heard evangelist of applying industrial methods of continuous quality improvement in health care." -Annals of Internal Medicine Escape Fire: "With an effective blend of common sense, real-life stories, persuasive metaphors, and out-of-the-box thinking, Dr. Berwick's presentations make for fascinating reading for anyone interested in improving America's $1.7 trillion health care system." -Piper Report "Anyone interested in change in the healthcare system would enjoy this book. In degree programs, the various speeches would be useful for discussion in a health policy readings course." -The Annals of Pharmacotherapy
Purchasing Medical Innovation : The Right Technology, for the Right Patient, at the Right Price (1)
Publication Date: 2015-03-12
Innovation in medical technology generates a remarkable supply of new drugs, devices, and diagnostics that improve health, reduce risks, and extend life. But these technologies are too often used on the wrong patient, in the wrong setting, or at an unaffordable price. The only way to moderate the growth in health care costs without undermining the dynamic of medical innovation is to improve the process of assessing, pricing, prescribing, and using new technologies. Purchasing Medical Innovation analyzes the contemporary revolution in the purchasing of health care technology, with a focus on the roles of the Food and Drug Administration (FDA), Medicare and private health insurers, physicians and hospitals, and consumers themselves. The FDA is more thoroughly assessing product performance under real-world conditions as well as in laboratory settings, accelerating the path to market for breakthroughs while imposing use controls on risky products. Insurers are improving their criteria for coverage and designing payment methods that reward efficiency in the selection of new treatments. Hospitals are aligning adoption of complex supplies and equipment more closely with physicians' preferences for the best treatment for their patients. Consumers are becoming more engaged and financially accountable for their health care choices. This book describes both the strengths and deficiencies of the current system of purchasing and highlights opportunities for buyers, sellers, and users to help improve the value of medical technology: better outcomes at lower cost.
Rationing Is Not a Four-Letter Word: Setting Limits on Healthcare.
Publication Date: 2014-07-03
Most people would agree that the healthcare system in the United States is a mess. Healthcare accounts for a larger percentage of gross domestic product in the United States than in any other industrialized nation, but health outcomes do not reflect this enormous investment. In this book, Philip Rosoff offers a provocative proposal for providing quality healthcare to all Americans and controlling the out-of-control costs that threaten the economy. He argues that rationing -- often associated in the public's mind with such negatives as unplugging ventilators, death panels, and socialized medicine -- is not a dirty word. A comprehensive, centralized, and fair system of rationing is the best way to distribute the benefits of modern medicine equitably while achieving significant cost savings. Rosoff points out that certain forms of rationing already exist when resources are scarce and demand high: the organ transplant system, for example, and the distribution of drugs during a shortage. He argues that if we incorporate certain key features from these systems, healthcare rationing would be fair -- and acceptable politically. Rosoff considers such topics as fairness, decisions about which benefits should be subject to rationing, and whether to compensate those who are denied scarce resources. Finally, he offers a detailed discussion of what an effective and equitable healthcare rationing system would look like.
The Doctor Crisis : How Physicians Can, and Must, Lead the Way to Better Health Care
Publication Date: 2014-05-06
Calming fears, alleviating suffering, enhancing and saving lives?this is what motivates doctors virtually every single day. When the structure and culture in which physicians work are well aligned, being a doctor is a most rewarding job. But something has gone wrong in the physician world, and it is urgent that we fix it. Fundamental flaws in the US health care system make it more difficult and less rewarding than ever to be a doctor. The convergence of a complex amalgam of forces prevents primary care and specialty physicians from doing what they most want to do: Put their patients first at every step in the care process every time. Barriers include regulation, bureaucracy, the liability burden, reduced reimbursements, and much more. Physicians must accept the responsibility for guiding our nation toward a better health care delivery system, but the pathway forward?amidst jarring changes in our health care system?is not always clear. In "The Doctor Crisis," Dr. Jack Cochran, executive director of The Permanente Federation, and author Charles Kenney show how we can improve health care on a grassroots level, regardless of political policy disputes, by improving conditions for physicians and asking them to take on broader accountability; by calling on physicians to be effective leaders as well as excellent clinicians. The authors clarify the necessary steps required to enable physicians to focus on patient care and offer concrete ideas for establishing systems that place patientsOCO needs above all else. Cochran and Kenney make a compelling case that fixing the doctor crisis is a prerequisite to achieving access to quality and affordable health care throughout the United States."
The End of Employer-Provided Health Insurance: Why It's Good for You and Your Company (1)
Publication Date: 2014-11-06
How to save 20 to 60 percent on health insurance! The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. This book is written to ensure that you, your family, and your company get your fair share of the trillions of dollars the U.S. government will spend subsidizing individual health insurance plans between now and 2025. You will learn how to navigate the Affordable Care Act to save money without sacrificing coverage, and how to choose the plan that offers exactly what you, your family and your company need. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. The purpose of The End of Employer-Provided Health Insurance is to show you how to profit from this paradigm shift while helping you, your family, and your employees get better and safer health insurance at lower cost. It will help you save thousands of dollars per person each year and protect you from the greatest threat to your financial future-our nation's broken employer-provided health insurance system. We are at the beginning of a paradigm shift in the way businesses offer employee health benefits and the way Americans get health insurance-a shift from an employer-driven defined benefit model to an individual-driven defined contribution model. This parallels a similar shift in employer-provided retirement benefits that took place two to three decades ago from defined benefit to defined contribution retirement plans. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans. Using the techniques outlined in this book, you and your employer will save money on health insurance by migrating from employer-provided health insurance coverage to employer-funded individual plans at a total cost that is 20 percent to 60 percent lower for the same coverage. That's $4,000 to $12,000 in savings per year for a family of four for the same hospitals, same doctors, and same prescriptions.
The Future of Home Health Care: Workshop Summary.
Publication Date: 2015-09-04
Individuals with disabilities, chronic conditions, and functional impairments need a range of services and supports to keep living independently. However, there often is not a strong link between medical care provided in the home and the necessary social services and supports for independent living. Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall. On September 30 and October 1, 2014, the Institute of Medicine and the National Research Council convened a public workshop on the future of home health care. The workshop brought together a spectrum of public and private stakeholders and thought leaders to improve understanding of the current role of Medicare home health care in supporting aging in place and in helping high-risk, chronically ill, and disabled Americans receive health care in their communities. Through presentations and discussion, participants explored the evolving role of Medicare home health care in caring for Americans in the future, including how to integrate Medicare home health care into new models for the delivery of care and the future health care marketplace. The workshop also considered the key policy reforms and investments in workforces, technologies, and research needed to leverage the value of home health care to support older Americans, and research priorities that can help clarify the value of home health care. This summary captures important points raised by the individual speakers and workshop participants.
The Health Care System, 2015
Publication Date: 2015-06-02
Examines the state of the nation's health care system, the education and training of health care providers, and the various types of health care institutions. The ever increasing cost of health care, prevalence of insurance, mental health care, and a comparison of health care throughout the world are also covered.
The Healthiest City: Milwaukee and the Politics of Health Reform
Publication Date: 1996-05-15
Between 1850 and 1900, Milwaukee's rapid population growth also gave rise to high death rates, infectious diseases, crowded housing, filthy streets, inadequate water supplies, and incredible stench. The Healthiest City shows how a coalition of reform groups brought about community education and municipal action to achieve for Milwaukee the title of "the healthiest city" by the 1930s. This highly praised book reminds us that cutting funds and regulations for preserving public health results in inconvenience, illness, and even death. "A major work. . . . Leavitt focuses on three illustrative issues--smallpox, garbage, and milk, representing the larger areas of infectious disease, sanitation, and food control."--Norman Gevitz, Journal of the American Medical Association "Leavitt's research provides additional evidence . . . that improvements in sanitation, living conditions, and diet contributed more to the overall decline in mortality rates than advances in medical practice. . . . A solid contribution to the history of urban reform politics and public health."--Jo Ann Carrigan, Journal of American History
The Third Lie: Why Government Programs Don't Work—and a Blueprint for Change
Publication Date: 2011-10-31
OC I am from the government and I am here to help youOCO is one of the three biggest lies, or so the old joke goes. Richard J. Gelles, dean of social policy at University of Pennsylvania, explains why government programs designed to cure social ills donOCOt work in sector after sectorOC and never could work. He demonstrates how each creates its own bureaucracy to monitor participation in the program, an entrenched administrative apparatus whose needs supersede those for whom the program was designed. Against this, he contrasts universal programs such as the GI Bill, Social Security, and Medicare, the most successful, sustained government programs ever established. GellesOCOs provocative, controversial proposal for a universal entitlement to replace a raft of lumbering social programs should be read by all in social services, policy studies, and government.
Universal Health Care
Publication Date: 2011-06-17
Provides model essays on a current controversial issue guiding students in writing a five-paragraph essay, including persuasive, descriptive, expository and cause-and-effect essays. Includes guided reading and discussion questions to help students understand the essays themselves and target persuasive techniques authors use to compose convincing arguments. This volume covers the issue of universal health care.
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Affordable Care Act eBooks
A Better Choice: Healthcare Solutions for America.
Publication Date: 2015-04-01
Despite having surmounted numerous obstacles, the Affordable Care Act--also commonly known as "Obamacare"--remains highly controversial and faces ongoing legal and political challenges. The law's staunchest critics want to repeal and replace the entire law, while even its supporters acknowledge that serious changes are needed. The question is: replace it with what? In A Better Choice: Healthcare Solutions for America, economist and John C. Goodman answers the question clearly and concisely. For anyone who wants to better understand Obamacare's most serious problems and learn about some of the boldest prescriptions designed to remedy them, Goodman's book is a must-read.
Affordable Care Act: Analyses of Emergent Issues and Topics.
Publication Date: 2014-01-01
The degree to which foreign nationals (non-citizens/aliens) should have access to certain benefits as a result of their presence in the United States, as well as the responsibilities of such persons given their legal status (eg: immigrants, non-immigrants, unauthorised aliens), often figures into policy discussions in Congress. These issues become particularly salient when Congress considers legislation to establish new immigration statuses or to create or modify benefit or entitlement programs. This book discusses the Affordable Care Act (ACA), and the emergent issues and topics that arise. It discusses the treatment of non-citizens under the act, as well as individual mandates under the ACA; the delays, extensions, and other actions taken by administration in implementing the ACA; and implications for the ACA.
Affordable Care Act: Developments and Considerations.
Publication Date: 2014-01-01
Congress is deeply divided over implementation of the Patient Protection and Affordable Care Act (ACA). Since the ACA's enactment, lawmakers opposed to specific provisions in the ACA, or to the entire law, have debated implementation of the law on numerous occasions and considered multiple bills to repeal, defund, delay, or otherwise amend the law. Topics discussed in this compilation include the legislative actions to repeal, defund, or delay the Affordable Care Act; health insurance exchanges under the patient protection and ACA; health insurance premium credits in the patient protection and ACA; physician supply; annual fees on health insurers; and medial loss ratio requirements under the patient protection and ACA. (Imprint: Nova)
Health Insurance Within the Affordable Care Act: Select Elements.
Publication Date: 2013-01-01
In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act (ACA). ACA increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. It also expands Medicaid coverage. The costs to the federal government of expanding health insurance and Medicaid coverage are projected to be offset by increased taxes and revenues and reduced spending on Medicare and other federal health programs. This book provides an overview of major ACA provisions, implementation and oversight activities.
How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?
Publication Date: 2014-04-01
This report identifies potential mechanisms through which the Affordable Care Act (ACA) might affect liability claim costs and develops rough estimates of the size and direction of expected impacts as of 2016. Overall, effects of the ACA appear likely to be small relative to aggregate auto, workersOCO compensation, and medical malpractice insurer payouts, but some states and insurance lines may experience cost changes as high as 5 percent or more."
Libraries and the Affordable Care Act : Helping the Community Understand Health-care Options
Publication Date: 2015-01-01
Medicaid Expansion under the Affordable Care Act: Overview and Missed Opportunities.
Publication Date: 2014-01-01
Historically, Medicaid eligibility has generally been limited to certain low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities; however, as of 1 January 2014, states have the option to extend Medicaid coverage to most nonelderly, low-income individuals. The Patient Protection and Affordable Care Act established 133% of the federal poverty level (FPL) as the new mandatory minimum Medicaid income eligibility level for most nonelderly individuals. This book provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the book describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrolment and expenditure estimates for the ACA Medicaid expansion are provided. The book reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.Historically, Medicaid eligibility has generally been limited to certain low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities; however, as of January 1, 2014, states have the option to extend Medicaid coverage to most nonelderly, low-income individuals. The Patient Protection and Affordable Care Act established 133% of the federal poverty level (FPL) as the new mandatory minimum Medicaid income eligibility level for most non-elderly individuals. This book provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the book describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. The book reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
Population Health Implications of the Affordable Care Act: Workshop Summary
Publication Date: 2014-04-20
"Population Health Implications of the Affordable Care Act" is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement. Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health. "Population Health Implications of the Affordable Care Act" looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the "doctor's" office. Improving the health of the population - whether in a community or in the nation as a whole - requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action.
Private Health Insurance and the Affordable Care Act: Provisions and Reforms
Publication Date: 2013-01-01
Private health insurance (PHI) is the predominate form of health insurance coverage in the United States. The Patient Protection and Affordable Care Act, as amended, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges (marketplaces) to provide certain individuals and small employers access to private insurance, among other provisions. This book explains in further detail these private health insurance market reforms in the ACA and discusses the economic issues of the ACA.
The Affordable Care ACT
Publication Date: 2013-04-15
Responsibility for the current inequitable and costly health system is widely shared among all players. This book by a Professor of Medicine with 30 years of teaching and clinical experience analyzes the situation and proposes a solution that, just like the problem, will rely on all parties in a bid to endow America with an equitable and affordable universal health system.
The Impacts of the Affordable Care Act on Preparedness Resources and Programs
Publication Date: 2014-09-27
Many of the elements of the Affordable Care Act (ACA) went into effect in 2014, and with the establishment of many new rules and regulations, there will continue to be significant changes to the United States health care system. It is not clear what impact these changes will have on medical and public health preparedness programs around the country. Although there has been tremendous progress since 2005 and Hurricane Katrina, there is still a long way to go to ensure the health security of the Country. There is a commonly held notion that preparedness is separate and distinct from everyday operations, and that it only affects emergency departments. But time and time again, catastrophic events challenge the entire health care system, from acute care and emergency medical services down to the public health and community clinic level, and the lack of preparedness of one part of the system places preventable stress on other components. The implementation of the ACA provides the opportunity to consider how to incorporate preparedness into all aspects of the health care system. "The Impacts of the Affordable Care Act on Preparedness Resources and Programs" is the summary of a workshop convened by the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events in November 2013 to discuss how changes to the health system as a result of the ACA might impact medical and public health preparedness programs across the nation. This report discusses challenges and benefits of the Affordable Care Act to disaster preparedness and response efforts around the country and considers how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities.
The Reinvention of American Health Care: How the Affordable Care Act will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System
Publication Date: 2014-03-04
The definitive story of American health care today--its causes, consequences, and confusions In March 2010, the Affordable Care Act was signed into law. It was the most extensive reform of America’s health care system since at least the creation of Medicare in 1965, and maybe ever. The ACA was controversial and highly political, and the law faced legal challenges reaching all the way to the Supreme Court; it even precipitated a government shutdown. It was a signature piece of legislation for President Obama’s first term, and also a ball and chain for his second. Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania who also served as a special adviser to the White House on health care reform, has written a brilliant diagnostic explanation of why health care in America has become such a divisive social issue, how money and medicine have their own--quite distinct--American story, and why reform has bedeviled presidents of the left and right for more than one hundred years. Emanuel also explains exactly how the ACA reforms are reshaping the health care system now. He forecasts the future, identifying six mega trends in health that will determine the market for health care to 2020 and beyond. His predictions are bold, provocative, and uniquely well-informed. Health care--one of America’s largest employment sectors, with an economy the size of the GDP of France--has never had a more comprehensive or authoritative interpreter.