Managed Care Essay

4350 Words18 Pages
HelloThis set has 241 terms Original Alphabetical Chapters 7 through 11   growth in outpatient settings 1. changes in reimbursement 2. development of technology 3. utilization controls (managed care) 4. social factors   changes in reimbursement: growth in outpatient settings few payment restrictions in outpatient services (surgeries, chemotherapy, dialysis, paid as fee-for-service 1. medicare: PPS reimbursement based on DRGs 2. managed care: capitation   development of new technology: growth in outpatient settings less invasive procedures enable quicker recuperation from surgery. patients often do not need to be hospitalized for routine surgery   managed care: growth in outpatient settings restrictions on utilization,…show more content…
Describe the services provided through home health care. Home health is consistent with the philosophy of maintaining people in the least restrictive environment possible. Most people would prefer to live and receive health services at home than be institutionalized. Home health services typically include nursing care, such as changing dressings, monitoring medications, and providing help with bathing; short-term rehabilitation, such as physical therapy, occupational therapy, and speech therapy; homemaker services, such as meal preparation, shopping, transportation, and some specific household chores; and durable medical equipment, such as hospital beds, oxygen tanks, walkers, and wheelchairs. Certain specialized high-technology home therapies that were once available only in hospitals are now delivered in the home. These specialized services include intravenous antibiotics, oncology therapy, hemodialysis, parenteral and enteral nutrition, and ventilator care.   What are the conditions of eligibility for receiving home health services under Medicare? Patients are eligible to receive home health services under Medicare if they meet three basic conditions: 1. The patient is homebound. 2. The patient is under the care of a physician who will establish a home health plan. 3. The patient needs physical therapy, occupational therapy, speech therapy, or intermittent skilled nursing care. …show more content…
hospital system/health system covers a large geographic area with a variety of facilities such as satellite hospitals, physician clinics, rehab centers, long-term care facilities, home health care   evolution of hospitals: stage one; institutions of social welfare almshouses, pesthouses, public institutions, charity function   evolution of hospitals: stage two; distinct institutions of care for the sick distinct from almshouses; sometimes an extension of government institutions; funding of voluntary hospitals became predominant, board of trustees   evolution of hospitals: stage three; institutions of medical practice science and technology, hospital services, operational efficiency   evolution of hospitals: stage four; institutions of medical training and research hospital experience became necessary for all physicians, affiliations between medical schools and teaching hospitals, research   evolution of hospitals: stage five; consolidated systems consolidation necessitated by reimbursement changes that led to declines in utilization, hospitals diversified their services into nonacute areas   hospital expansion: reasons for growth advances in medical science, development of specialized technology, advances in medical education, development in professional nursing, growth of health insurance, role of
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