It wasn’t till 1990 that California decided to enrolled Medical beneficiaries into managed care. Today, more that 50 percent of Medical beneficiaries are enroll in a managed care. California has four Medicaid Managed Care (MMC) models; County Organized Health Systems (COHS), Geographic Managed Care (GMC), and the Two-Plan Model and the Primary Care Case Management (PCCM) that enroll Medical beneficiaries on a prepaid basis. Medicaid Managed Care Enrollment Rate in the State of California Enrollment rate as of July 2010 The Medicaid managed care penetration rates, expansion enrollment by state, and the national penetration rate are composed annually by the Data and System Group (DSG) of the Centers for Medicare & Medicaid Services (CMS).
Medicaid is currently the largest source of funding for medical and health related services for people in the United States with low-income, disabilities, nursing home and community-based long-term care. Medicaid has been referred to as a safety net for the needy. As a parent of a disabled child, I have a personal interest in the Medicaid system, its history, current functioning, and future plans. The history of Medicaid dates back to the early 1960’s with Lyndon Johnson’s reform movement, coined the “Great Society”. The goal of Johnson’s reform program was to eliminate poverty and racial injustice and for all citizens to reap the benefits of prosperity.
These two definitions are not fully satisfactory because, firstly, some forms of CAM which were tested by scientists and appeared to be safe and effective and found a place in conventional medical mainstream. Secondly, CAM is not about medical intervention, which means impacts of taken drugs. The majority of CAM is based on psychology, spirituality, sociology and traditional Chinese medicine (TCM), which make trials difficult. However, despite the fact that conventional medicine is scientific based and proven by science, many people still use alternative medicine instead or as a compliment to the modern one. Research shows that the majority of the patients at an Accident and Emergency department used to refer to some forms of CAM.
Before Medicare, many Americans didn't have health insurance coverage, but since its inception the program has enrolled almost 40 million beneficiaries, who jointly fund the insurance program along with the national government (Carnegie). According to Dr. Don McCanne, a member of the Board of Directors of Physicians for a National Health Program, "Before the passage of Medicare in 1965, only 52% of persons age 65 and over had hospital insurance and less than 15% had adequate health insurance" (McCanne). The Medicare program has improved access to healthcare and improved the quality of life for millions of elderly members, and has provided insurance for millions of persons with disabilities. By reducing the burden of large medical bills, Medicare also has improved the economic status of the elderly. As Dorothy Price points out "Over its 33 year history, Medicare has channeled billions of dollars into the health care system, helping to foster enormous improvements in health care technology and medical education" (Carnegie).
KP is made up of three distinct groups of body: the Kaiser Health Plan; Kaiser Hospitals; and Permanente Medical Groups. As of 2014, Kaiser Permanente are in eight states and the District of Columbia, and is one of the largest healthcare organizations in the United States. According to the fast fact from its own web site, “Kaiser Permanente has 9.6 million health plan members, 174,415 employees, 17,425 physicians, 38 medical centers, and 618 medical offices. For 2011, the non-profit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported a $56.4 billion in operating revenues” (Fast Facts about Kaiser
After World War II however, hospitals and clinics started popping up all over our country enrolling more than half a million people. By the 1970’s healthcare became common place and the choice of HMO, PPO etc... were formed. Employers began to see managed care as a necessity for their employees and now healthcare comes as a job benefit (Tufts Managed Care Institute, 1998). Having a health care plan through work The alternative choice to a managed healthcare is a Universal healthcare which is a government-funded program. This health care system dates back just as far as managed health care however, this has never been much of a success in the American System (Karen S. Palmer,1999).
Section 1: Introduction 1.1: Organization Summary Christ Hospital was founded in 1872 in Jersey City, NJ and is currently operated by the for-profit organization Care Point Health also known as Hudson Hospital OpCo. Christ Hospital is a community healthcare provider that exists to promote and improve health of residents of Jersey City, NJ. Christ Hospital is a 376-bed acute care facility that offers a full spectrum of services including oncology radiation center, and is staffed by over 500 physicians. As part a family of three local hospitals owned and operated by Care Point Health, Christ Hospital shares some administrative and operational functions with the Bayonne Medical Center and Hoboken University Medical Center, all located in Hudson County, NJ. Just like Christ Hospital, Bayonne Medical Center is an acute-care facility with 278-bed capacity and is known for its cardiovascular services, whereas Hoboken University Medical Center is a general medical and surgical hospital with 364 beds known for its maternity services.
Financial liability associated with illness is a huge burden which can result in lack in proper medical care. Only half of old age people had health insurance. The U.S. Federal government initiated a social Insurance Program, one of its most significant success stories called MEDICARE to meet its objectives of providing affordable healthcare. Its objectives included ( i) to create awareness about the financial risk associated with illness throughout the society , (ii) guarantee Americans aged 65 and above and younger people with disabilities proper medical access to health insurance initially, (iii) issue a MEDICARE HEALTH INSURANCE CARD to the benefiter to help them avail its benefits . Medicare policy is in vogue for over forty years and has brought tremendous changes in the society and created a better place to live in .
Limit your response to 3 pages maximum for each modular component of the SLP. The health care organization with which I am familiar and involved is Kaiser Permanente where I work as an Emergency Room Registered Nurse and later promoted to management. Kaiser Permanente was founded in 1945, is the nation’s largest not-for-profit health plan, serving 9.1 million members, with headquarters in Oakland, California. At Kaiser Permanente, physicians are responsible for medical decisions, continuously developing and refining medical practices to ensure that care is delivered in the most effective manner possible. Kaiser Permanente combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama’s health care law encourages.
Technology change and its adoption: With the technological evolution occurring more than ever before, it is important for the healthcare practices in the County to decide on where to invest. Buying equipment wouldn’t be the only cost incurred. Its training and personnel costs will also be adding up. The County must be prudent as well as serve the patients with all the