Health Insurance Matrix Essay - 2138 Words

University of Phoenix Material Health Insurance Matrix Origin: When was the model first used? What kind of payment system is used, such as prospective, retrospective, or concurrent? Who pays for care? What is the access structure, such as gatekeeper, open-access, and so forth? How does the model affect patients? Include pros and cons. How does the model affect providers? Include pros and cons. Indemnity In 1932 the American Medical Association (AMA) adopted a strong position against prepaid group practices, favoring instead indemnity-type insurance that protects the policyholder from expenses by reimbursement (Jones Bartlett, 2007). As one of the first health policies in the U.S., indemnity plans are considered†¦show more content†¦Potential for higher payment amounts at time of service. Alternatively, there is a potential for greater debt amounts. Larger debts will make it necessary for health care providers to be more aggressive for collections. Providers will also encounter increased staff costs in order to follow-up with patients in advance of treatment, as well as in subsequent collection efforts (Fifth Third Bank, 2008). Point-of-service HealthPartners of Minneapolis pioneered point-of-service (POS) plans in 1961, but the concept took 25 years to get off the starting blocks (Dimmit, B., 1996). In 1986 CIGNA Healthcare launched Flexcare, the first POS plan. By 1995 forty percent of employers with at least 200 employees offered POS plans. Providers within a point-of-service network are usually paid a capitated fee. The fee is fixed and does not alter regardless of services rendered. POS plans operate using a prospective payment system. Insurance companies reimburse providers an agreed amount that is decided before a patient receives services. Patients are responsible for paying a co-payment when visiting a doctor. After the patient is seen, the provider submits claim forms to the insurer for the services rendered. Once the claims are processed the insurer will reimburse the provider (Austin Wetle, 2012). If a patient goes out-of-network, they are required to pay the provider in full. Afterwards the patient can submit a claim for reimbursement. Point-of-service insurance plansShow MoreRelatedHealth Insurance Matrix3133 Words   |  13 PagesMaterial Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care workerRead Morehealth insurance matrix HCS/235 Essay637 Words   |  3 PagesMaterial Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care workerRead More HCS 235 Week 2 Completed Health insurance matrix1163 Words   |  5 PagesMaterial Health Insurance Matrix As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care workerRead MoreHistorical Context Matrix Essay1588 Words   |  7 PagesUniversity of Phoenix Material Historical Context Matrix As you learn about health care delivery in the United States, it is important to understand the history of health care delivery to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that working knowledge. Fill in the following matrix. Each box should contain responses between 50 and 100 words. |Historical Context |Historical background?|Where is the care |WhoRead MoreHCS/212 Health Services and Systems Matrix Essay1227 Words   |  5 Pagesï » ¿University of Phoenix Material Health Services and Systems Matrix Choose at least seven services or systems from the following list: Hospice care World Health Organization (WHO) Public health Rehabilitation center Department of Health and Human Services (DHHS) Medicare Centers for Medicare and Medicaid Services (CMS Center for Disease Control (CDC) Health Maintenance Organization (HMO) Occupational Safety and Health Administration (OSHA) Joint Commission on Accreditation of HealthcareRead MoreManage Care and How It Has Affected and Changed Health Care Essay1161 Words   |  5 PagesCare and How It Has Affected and Changed Health Care Manage Care and how it has affected and changed Health Care â€Å"Managed care embodies an effort by employers, the insurance industry, and some elements of the medical profession to establish priorities and decide who gets what from the health care system.† (JAMA.2001; pg. 285:2622-2628). Manage Care is part of the Health Care system since 1973 is known as the system that finances and delivers health care to individuals enrolled under theirRead MoreFinancing The Failing U.s. Healthcare System1515 Words   |  7 Pagesservice, fee-for-service. Variable payment reimbursement removes the burden of risk from the health care providers because they needn’t worry about the costs of their services exceeding the fixed amounts they receive. The amount a consumer is forced to pay determines to what degree they are incentivized to utilize healthcare services from providers. Little to no out-of-pocket costs and a high level of insurance coverage act as an incentive for a consumer to seek medical services while a consumer withRead MoreEssay about MATRIX GRID hcs 455 week 2 2464 Words   |  10 Pagesï » ¿University of Phoenix Material Health Care Reform Matrix With your learning team, complete the Health Care Reform matrix below. Listed in this matrix are some of the topics addressed by the Patient Protection and Affordable Care Act policy. You are required to describe the issue, in your own words, and list 2-3 points about each topic under each heading in the matrix. Describe the issue: Key concerns regarding the issue: How is this issue addressed in the current health care environment? How will thisRead MoreReadiness for Future Health Needs at Banner Health1249 Words   |  5 Pagesï » ¿Readiness for Future Health Needs at Banner Health Name Grand Canyon University Michael Jones NRS- 451V Date Readiness for Future Health Needs at Banner Health Banner Health celebrates its fifteen year anniversary this year (2014). Samaritan Health System merged with Lutheran Health System September 1st, 1999. Lutheran Health System began in 1938 across Western and Mid-Western states. Samaritan Health System dates back to 1911 that covered California and Arizona, primarilyRead MoreThe Shift Of The Affordable Care Act ( Aca )1100 Words   |  5 Pagesof different payment and reimbursement options, health insurance programs, and the establishment of the Affordable Care Act (ACA). Between May 2009 and April 2012, one of the initial PCMH pilot programs was conducted in Colorado, appropriately named The Colorado Multipayer Patient-Centered Medical Home Pilot. More than 100,000 patients within sixteen internal medicine practices participated in the experimental PCMH model, using six different health plans (Harbrecht Latts, 2012). When the pilot

Wide Sargasso Se The Intersection Of English And British...

Jean Rhys’s novel Wide Sargasso Sea centers on the intersection of English and British colonial cultures through the union of Rochester and Antoinette Cosway. Rochester represents patriarchal and imperialist Victorian values, which Mary Lou Emery suggests thrive in part on â€Å"distinctions between...legitimate and illegitimate sexuality, madness and reason, primitive and civilized behavior, [and] fiction and fact† (428). Antoinette threatens these supposedly objective distinctions in her emotional (â€Å"‘Afraid of what?’...‘Of nothing, of everything!’† (Rhys 45)) and intellectual (â€Å"‘Not slaves. Something must have happened a long time ago. Nobody remembers now.’† (Rhys 39)) uncertainty, which reflect the ambivalence of colonial, specifically black, culture towards English reason and fact. Antoinette’s most glaring dualities, however, appear in her subversion of racial and sexual conventions, and Rochest er ultimately perceives her as mad because these ambiguous identities confuse the essentialist binary systems that patriarchal and imperialist ideologies derive from, and with them his understanding of reality. The most obvious binary in Wide Sargasso Sea is the black/white racial binary. Imperialism holds race to be one-dimensional and static, and distinguishes only between two racial groups: white English colonists and black former slaves. This simplistic racial dichotomy cannot account for the multi-faceted reality of race in the West Indies, however, and is problematized when

Women in an Inferior position in China Free Essays

The view of women in china may have changed over the years but they all have lived in a male dominated world. The past has been like many cultures, in the legal and cultural suppression of women. The culture of china’s past has placed women as a far inferior position to men. We will write a custom essay sample on Women in an Inferior position in China or any similar topic only for you Order Now In this environment gaining power and rights was extremely difficult. Despite this there are stories of important and powerful women in china’s history. This is different than many cultures of the world where the suppression of women’s rights was total through their history. The culture has become more open to women’s rights over the years, allowing for more power and more control for them as they years went on. Education has slowly been allowed along with greater human rights. Modern women are allowed to travel, be educated, marry and be the sole wife. They commonly participate in politics, as well as all other fields of work. Women of modern times in china have greater possibilities and fewer limitations, but things are not perfect, there is still a social bias lingering from past inequality. The women of china’s past lived in an intensely male dominated world. Men dominated china both in law and in culture. Legally women were in servitude to men in the forms of marriage polygamy was common practice for men. For the most part women did not ever participate in the governing of the country. There were Dynasties that were less conservative, women were allowed more power at times. This is evidenced by the rule of Empress Wu. She rose to power from the status of concubine to rule china. This was more exceptional rather than the rule. When the Sung dynasty took over, men dominated again. Any ability of women to gain political power was taken away. It is in the culture that the real domination can be seen. Without this the legal repression would not have happened. Many practices reinforced the view that women were inferior. From basic philosophy, Yin and Yang, equated, darkness to women and light to men. The beliefs of Confucianism said that women weren’t meant to do outdoor work, thus construing them as weak and inferior. The idea of having them not do outdoor work was reinforced by the practice of foot binding. Again started in the Sung dynasty, this practice along with the other preferences on the appearance of women objectified them and put barriers on what women could do or be. Women were seen as property, as seen by the practice of concubines and polygamy those of high status had many women and having many sons was an even higher symbol of status. Despite these legal and cultural blocks on women, the domination was not total. There were many female figures that were looked up to and honored, both legendary and real women. At times the culture changed enough to allow women to participate in politics, and more rights were given to them. Powerful women of the past were looked up to and revered. The Queen Mother of the West was mixed with legend and history, but she was worship at times by men. Other legends indicate that women could be respected. Although Disney has probably distorted it a bit, the legend of Mulan even by being passed down shows a respect for women. Not only legends were respected. There were several times in the past that women have risen to power Empress Zhen (AD 182) was fought over and had power through her beauty and high status. Other women had even more power, Empress Wu, actually had power, and ruled china for a time. The culture of china’s past has surpressed women, through it’s culture and laws, with brief periods of cultural change, in which women gained rights and respect were brief and followed by periods which they were again taken away. These limitations on women, were reinforced by the isolation that china had, continuing into the twentieth century this isolation prevented women from leaving if they could not stand their situation. Despite the few legendary women the opportunities for advancement or power for women were few and difficult. Things have changed in recent times. Women are gaining power and rights in modern times. There are international groups protecting their rights as well. The first good example of this is in the ways of marriage. Arranged marriages, and those for money are no longer the norm. They are allowed to maintain their own names with marriage. Without this they are did not have as much of a separate identity. Also in modern times, women have gained the rights of inheritance from their families, equal to that of their brothers. Other aspects of women in marriage have changed. They are not as expected to bear children, and the culture is changing to give them a voice in this decision. In the areas of employment, there are opportunities as well. Women now make up 38 percent of the total workforce. In most major parts of the work force women play a part. Women even play a part in politics, representing a major part of their official government. These women are not legendary, or exceptional. It is just accepted and considered normal. Women have made advances in the field of education as well. Illiteracy among women has fallen as well and education is accepted. Women are allowed in universities and even given funding to continue education. These opportunities, encouraged by many international organizations are also backed by Chinese law. The law states: 1.Equal rights for men and women. The Constitution stipulates that â€Å"Women enjoy equal rights with men in all spheres of life, political, economic, cultural and social, including family life†; 2.Protection of special rights and interests of women; and 3.Banning of any discrimination, maltreatment and persecution directed at women. In addition Other laws have been enacted concerning their rights. These explicitly state aspects of life that women are equal to men. For example equal, equal votes, and rights to political power, freedom, and protection. These laws being stated are the only thing that I can see evidencing that there are not equal opportunities for women. The fact that they have to be stated so explicitly probably indicates a problem. It is difficult to find out what the cultural views of women are from the outside, but it appears that they have all the major opportunities that men do and that their power is increasing. One thing that has really changed is in the area of the world. There is the opportunity to leave the country and go to another culture. Granted the rest of the world is still mostly male dominated in culture, but the opportunity to emigrate is still there. The only lingering restrictions are from tradition. Lingering views of women as being inferior are probably the only thing that could keep them back now. These things can be seen through the increasingly seldom seen practices of mail order brides and foot binding. In addition, I came across a large industry of pornography featuring Chinese women when searching for information. These things limit the respect that women have in society. The opportunities for women have grow through history. Starting from the possessive view of women, giving them no rights, and giving men utter control, has changed in recent history to the to allow women more power, rights and education. Women have had their limits striped away, partly with law and partly through changing culture. The physical limitations have gone as well. The opportunities for travel have grown as well, the world is more open, and the ability to find a place more accepting exists. With fewer limitations, opportunities for women are increasing. How to cite Women in an Inferior position in China, Papers

Culture and Health-Free-Samples for Students-Myassignmenthelp.com

Question: Write a Culture and Health Reflective Assignment. Answer: During my study in nursing I was been very significant about my experience and awareness about the aboriginal peoples. Also, my personal outlooks have been affected significantly in the span of this semester. This unit played a pivotal role in enhancing my cognition and awareness on indigenous population of Australia, and their historical backgrounds. There also has been quite a change in my response towards this unit from how I initially expected it, and have repeatedly triggered my emotions. Learning about the plight of the children in these indigenous communities was really horrific and heart touching. This is the place where adoption becomes possibly the most important factor, I believe. In the past, the people from these indigenous or native communities were required to give up their customs and culture in order to amalgamate with the western culture and way of life, hoping that they would be able to acclimatize. In 1951 this was even adopted as an official government strategy. I was truly shocked to learn about the fate of those youngsters who were taken by social service workers. The children were made to live with white people as slaves and often would face sexual assault, instead of being put in better families providing emotional support. The families of these Aboriginal children would also be lied to with misinformation about the jobs their children are involved in, not knowing that the kids would end up being slaves to well to do Caucasian families. These made me realize that I have been consistently fed wrong information about the history of the country I belong to (Camer on et al., 2014). The frameworks used for the analysis of the culture are known as knowing framework. It has 4 components knowing how, knowing what, knowing why and knowing one. Indigenous Australian culture is both very rich and diverse, and the Australian Aborigines, having a history of more than 50,000 years are one of the oldest and the most established of the known tribes in existence. Their success of survival can be contributed to their ability to evolve to adjust to changes over time. Their legacy is kept alive by the transfer of knowledge, insights, exhibitions and customs to the young members of the community. The essential prosperity of the Aboriginal individuals is their territory, its condition that managed by the general population and culture, loaded with profound prosperity (Smith et al., 2015). Native individuals were seeker assembles who rummaged for uncultivated plant and wild creatures. The customary eating regimen was high in starches, proteins and supplements and low in fat and sugars. The present day Aboriginal eating routine are vigorously westernized and have a tendency to be high in fat and sugar yet low in starch, fibre and fats (Garcia et al., 2016). Acquiring the change in the state of wellbeing of indigenous peoples was considered a matter of reputation for the Australian government. Difference in the state of prosperity between the local and non local population was barred for a long time. The United Nations considered this as a source of strain on the Human Rights of these groups. The speculation of communal elements assist to see that prosperity of people and confirmation of awkwardness is done by different social parts, consistently. Additionally, human right laws makes it necessary for each benefit to be interconnected and affecting the scope of a particular law, and impacting the adaptability of few other laws. Therefore, because of the agreed importance, a discussion of human rights can help in identifying the potential consequences of prosperity in lieu of the undertakings and the course of action of the governing bodies in the local communities (Ramraj et al., 2016). Some applicable sources of disparity among the wellbeing of the indigenous and native Australians includes the non participation and the lack of similar openness towards improving the level of well being and the essential care, compared to the non- native population of Australia. It is seen that the Australian Native and Indigenous populace, are not open to the idea of attaining an equal chance to be similar to the non native population. Regarding the matter of strong family ties, amid my last situation, there was a native patient who was regularly gone by such expansive gatherings of individuals that it would overpower medical attendants who trusted it was ruining conveyance of care (Santoro Kennedy, 2016). While I valued their help and solidarity, I too felt like they were hindering consideration, until I later learnt from the patient that as a general rule, the general population going to were normally not close family but rather group individuals, out of social obligation. To enhance my nursing practice, I plan to recognize the indigenous Australians estimation of group ties, now that I have more knowledge on their group character. The rate of advancement was perceived as inadequate, in the past couple of decades, to diminish the awkward differences among the Australian local and the indigenous. As an example, an incorporation along whole deal estimations such as the future estimate. Although developmental measures were made in improve the prosperity status of the Australian Indigenous and local communities, they were never at par with the hasty capture in prosperity seen in the comprehensive population. The mortality risks due to cardiovascular diseases and dysfunctions have reduced by 30% since 1991 within the comprehensive group (Eades, 2015). Type II diabetes is right now perceived as a critical medical issue for Indigenous Australians everywhere and particularly for those living in remote ranges, with the occurrence being three times progressively that of non-Indigenous Australians. While type II diabetes is connected to hereditary vulnerability, its improvement is fixing to poor way of life decisions like unfortunate sustenance and physical disability (Parker Milroy, 2014). Detachment of solid substances, for example, products of the soil in remote ranges, adds to utilization of handled nourishments high in sugar, salt and fats, expanding odds of type II diabetes, heart maladies and weight. Additionally, administration and treatment of type II diabetes can be troublesome in remote ranges because of detachment of wellbeing administrations. To address this medical problem for Indigenous patients, I would construct compatibility by really exhibiting a comprehension of their social foundation, by enquiring their individual advantages on issues, for example, family contribution in basic leadership. I would likewise concoct methods of teaching them on solid ways of life and administration of the condition. The experience of indigenous and local people concerning divergence within the condition of prosperity seems to be connected to the vital issue of partition. In the past the indigenous and local communities of Australia did not get the same opportunities of being as healthy and fir as the non-indigenous population. This was mostly owing to the inability of involve the proper organizational standards and a lack of transparency of the organizations involved in improving their prosperity (Lowell et al., 2015). This resulted in incorrect course of action in regards to the establishment and fundamental care of prosperity within the indigenous and local population of Australia. These aberrations were considered both as inefficient and avoidable. This legacy was tended to absolution, and a basic test for these people to receive maximum benefit from their right to prosperity. On each significant pointer, the indigenous populace of Australia is known for encountering a few financial inconveniences. According to National Census of 2001, normal total pay of families of the Australian native and indigenous populace was distinguished as $ 364 weekly, which is 62 for each penny earned by non-native populace at $ 585 weekly. According to a similar statistics, the amount of joblessness among indigenous populace was 20 for every penny, which is three times higher than the amount for the non-native populace of Australia (Newman et al., 2015). Relationship was shown by different investigations between the monetary and social condition of people and their overall wellbeing. Without a doubt, neediness is generally identified with impoverished level of wellbeing. A lack of proficiency and instruction are profoundly related with the impoverished status of wellbeing, and it affects the extent of people to utilize the framework of wellbeing and its maintenance. Poor level of wage brings about the diminishment of access towards prescriptions and administrations of medicinal services. Once-over lodging and stuffed regions are exceedingly identified with destitution and bring about contributing towards transmittable ailments being spread over (Lemelin, Koster Youroukos, 2015). These looks into have likewise depicted that poorer people additionally confront issue of less monetary help alongside the absence of a few other shape to control fitting level of prosperity. This has brought about the commitment of an immense weight on the unfortunate worry where long introduction on requests of brain research in which the odds of governing the occasion can be seen as confined and its conceivable outcomes about getting any compensation are few. Endless anxiety can impact the safe framework, metabolic capacities and circulatory framework by various hormonal ways and is identified with various medical problems because of circulatory sicknesses, aggressive behaviour at home, emotional well-being issues and a few different types of brokenness with the group (Baydala, Ruttan Starkes, 2015). Native and Torres Strait Islander individuals' wellbeing drawback should be considered in the more extensive setting of social inconvenience, imbalance and prohibition, political underestimation and the verifiable streams of imperialism. With a specific end goal to discover procedures for wellbeing administrations for the Indigenous Australian need to assess recorded, social, social and political factors so as to comprehend the wellbeing disservice looked by Aboriginal people groups in contemporary society. This improves our insight into unequal wellbeing results amongst Aboriginal and non - Aboriginal individuals by concentrating on the effects of social structures and social fittingness of human services administrations (Hill et al., 2014). While the reporters of indigenous populace have been featuring the medical advantages identified with society and culture in regards to availability to properties and lands, numerous conceivable effects of wellbeing can add opportunities to incorporate enhanced training/workout and eating regimen. It can also likewise contribute to reconnect the Australian native and indigenous populace, with the conventional bases of economy. And aligned with such a reality, one can reason that by providing assistance to the conventional culture which incorporates administrative framework and standard law practices, will favour enhancing the status of soundness of people living inside the secluded territories. Introducing developments in the condition of health among these aboriginal communities has been treated as a long lasting matter for the government of Australia. The difference seen in the state of health between the non aboriginal and the aboriginal populations throughout Australia can be considered as unacceptable since a very long time. The inequalities experienced by these aboriginal and indigenous populations are mostly related to the basic and systematic issue of discrimination. In the past decades, the aboriginal and indigenous population neither received nor could enjoy equal opportunities of healthy living as much the non-indigenous populations did in Australia. Studies done by several researches also show a correlation between the health condition of the native aboriginal population with the social and economic status of the individuals. Evidently, poor health is related to poverty, and economic instability (Greenwood et al., 2015). Similarly, low literacy levels and educat ional standards are also very much related to the impoverished health status, and can negatively affect the ability of individuals accessing health related information and infrastructure. References Baydala, L., Ruttan, L., Starkes, J. (2015). Community-based participatory research with Aboriginal children and their communities: Research principles, practice and the social determinants of health.First Peoples Child Family Review,10(2), 82-94. Cameron, B. L., Plazas, M. D. P. C., Salas, A. S., Bearskin, R. L. B., Hungler, K. (2014). Understanding inequalities in access to health care services for Aboriginal people: a call for nursing action. Advances in Nursing Science, 37(3), E1-E16. Eades, S. (2015). Recent Research Addressing Health Inequalities among Australias Aboriginal and Torres Strait Islander peoples. International Journal of Epidemiology, 44(suppl 1), i33-i33. Francis, R., Bekera, B. (2014). A metric and frameworks for resilience analysis of engineered and infrastructure systems.Reliability Engineering System Safety,121, 90-103. Garcia, M. H., Rodriguez, L., Ballesta, T., Bellido, G., Medrano, C., Sevillano, I., ... De La Red, H. (2016). EV459Aboriginal and Torres Strait Islander. Not just a matter of cultural diversity. European Psychiatry, 33, S495. Greenwood, M., De Leeuw, S., Lindsay, N. M., Reading, C. (Eds.). (2015). Determinants of Indigenous Peoples' Health. Canadian Scholars Press. Hill, A., Nailon, D., Getenet, S., McCrea, N., Emery, S., Dyment, J., Davis, J. M. (2014). Exploring how adults who work with young children conceptualise sustainability and describe their practice initiatives. Australasian Journal of Early Childhood, 39(3), 14. Lemelin, R. H., Koster, R., Youroukos, N. (2015). Tangible and intangible indicators of successful aboriginal tourism initiatives: A case study of two successful aboriginal tourism lodges in Northern Canada.Tourism management,47, 318-328. Lowell, A., Kildea, S., Liddle, M., Cox, B., Paterson, B. (2015). Supporting aboriginal knowledge and practice in health care: lessons from a qualitative evaluation of the strong women, strong babies, strong culture program. BMC pregnancy and childbirth, 15(1), 19. Newman, L., Baum, F., Javanparast, S., O'Rourke, K., Carlon, L. (2015). Addressing social determinants of health inequities through settings: a rapid review.Health Promotion International,30(suppl_2), ii126-ii143. Parker, R., Milroy, H. (2014). Aboriginal and Torres Strait Islander mental health: an overview.Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice,2, 25-38. Ramraj, C., Shahidi, F. V., Darity, W., Kawachi, I., Zuberi, D., Siddiqi, A. (2016). Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada. Social Science Medicine, 161, 19-26. Santoro, N., Kennedy, A. (2016). How is cultural diversity positioned in teacher professional standards? an international analysis. Asia-Pacific Journal of Teacher Education, 44(3), 208-223. Smith, J. D., Springer, S., Togno, J., Martin, M., Murphy, B., Wolfe, C. (2015). Developing a cultural immersion approach to teaching Aboriginal and Torres Strait Islander health and culture.LIME Good Practice Case Studies Volume 3, 39.