Through competition the companies are able to lower premiums, making them affordable to the majority of the citizens. Healthcare exchanges have completely changed the outpatient concept. promote preventive health care to all US residents. It helps to prevent diseases before they could require emergency room care (Hall & Lord, 2014).
Full Answer
Can we improve outpatient outpatient services?
Conclusions There are a number of promising interventions which may improve the effectiveness and efficiency of outpatient services, including making it easier for primary care clinicians and specialists to discuss patients by email or phone.
Should we move from outpatient clinics to shared care?
There are studies which show net savings by moving from outpatient clinics to a shared care model, but such savings are not universal and may depend on the nature of the shared care arrangement.28,30 Professional behaviour change to reduce rates of referral from primary to secondary care
Does transfer of services from secondary to primary care reduce outpatient referrals?
The 183 studies published since 2005, taken with the findings of the previous review, suggest that transfer of services from secondary to primary care and strategies aimed at changing referral behaviour of primary care clinicians can be effective in reducing outpatient referrals and in increasing the appropriateness of referrals.
How can GPS reduce the number of patients seen in outpatient clinics?
Studies where GPs can obtain specialist advice by phone or email suggest there is substantial opportunity to reduce the number of patients who are seen in outpatient clinics. Only two studies report on costs, but both report an overall cost saving from the intervention, as a result of reductions in secondary care costs.
What is the purpose of a healthcare exchange?
Health Care Exchanges function as online, web based health insurance marketplaces where employees and individuals can directly compare various competing health insurance plans and select the plan that best fits their coverage needs and family budget.
What are exchanges in healthcare?
Exchanges are virtual marketplaces in which consumers and small business owners and employees can shop for and purchase private health insurance coverage and, where applicable, be connected to public health insurance programs (e.g., Medicaid).
What are the primary goals of health insurance exchanges?
The Patient Protection and Affordable Care Act (ACA) has 3 main objectives: (1) to reform the private insurance market—especially for individuals and small-group purchasers, (2) to expand Medicaid to the working poor with income up to 133% of the federal poverty level, and (3) to change the way that medical decisions ...
How will the Affordable Care Act affect the use of health care services?
Impact on Utilization Will Be Nominal Our analysis indicates that the ACA is expected to result in roughly 20.3 million additional primary care visits nationally, with people newly insured through the marketplaces accounting for more than a third of these visits, or about 3.8 percent above base (Table A).
What is the purpose of the health insurance exchanges that have been created under the Patient Protection and Affordable Care Act?
Exchanges are meant to simplify and ease health insurance purchasing by creating a one-stop shopping market for insurance products that qualify for federal tax subsidies and that meet federal and state standards and, thus, are certified as “qualified health benefit plans.” Under the Act, Exchanges are empowered to ...
What's the difference between on exchange and off exchange?
If you buy your health insurance through the health insurance exchange in your state (on your own, or with the help of a broker or enrollment counselor), it is considered an "on-exchange" plan. If you buy it directly from the insurance company (on your own, or with the help of a broker), it's off-exchange.
Which of the following best defines a health insurance exchange?
A health insurance exchange is an online marketplace where consumers can compare and buy individual health insurance plans.
What is healthcare reform and why do we need it?
One of the goals of the Affordable Care Act is to improve the quality and safety of health care. In that way, health care reform means better care for everyone. Other provisions of the Affordable Care Act help people get health insurance who couldn't before. They also help make coverage more affordable.
What are the most important elements of the Affordable Care Act in relation to community and public health?
Key Federal Provisions Provisions included in the ACA are intended to expand access to insurance, increase consumer protections, emphasize prevention and wellness, improve quality and system performance, expand the health workforce, and curb rising health care costs.
In what ways has the Affordable Care Act improved our health care system in terms of access?
The ACA has helped address this issue in the following ways.Treating all individuals and families equally in gaining access to coverage.Promoting wellness by generally requiring insurers to cover preventive care at no additional cost.Preventing discrimination based on pre-existing health conditions.More items...
Which of the following is a change implemented under the Affordable Care Act?
These reforms include access to coverage for young adults, a ban on preexisting condition exclusions, the coverage of a minimum set of essential health benefits, and a ban on lifetime limits for health care coverage, among other critical consumer protections.
How does the ACA improve the quality of health care?
The ACA has reduced the number of uninsured people to historically low levels and helped more people access health care services, especially low-income people and people of color.
Explain how healthcare exchanges change the concept of outpatient treatment
Explain how healthcare exchanges change the concept of outpatient treatment. Many clinical information systems now embed practice guidelines and clinical pathways into their electronic medical record systems. Discuss some of the advantages and disadvantages of this. Describe demand management and how it can increase consumer involvement in care.
Regulatory Environment
Explain how healthcare exchanges change the concept of outpatient treatment. Many clinical information systems now embed practice guidelines and clinical pathways into their electronic medical record systems. Discuss some of the advantages and disadvantages of this. Describe demand management and how it can increase consumer involvement in care.
How can outpatient care improve efficiency?
There are a number of promising interventions which may improve the effectiveness and efficiency of outpatient services, including making it easier for primary care clinicians and specialists to discuss patients by email or phone. There remain substantial gaps in the evidence, particularly on cost-effectiveness, and new interventions should continue to be evaluated as they are implemented more widely. A move for specialists to work in the community is unlikely to be cost-effective without enhancing primary care clinicians’ skills through education or joint consultations with complex patients.
How can transfer of services from secondary to primary care be effective?
The 183 studies published since 2005, taken with the findings of the previous review, suggest that transfer of services from secondary to primary care and strategies aimed at changing referral behaviour of primary care clinicians can be effective in reducing outpatient referrals and in increasing the appropriateness of referrals. Availability of specialist advice to primary care practitioners by email or phone and use of store-and-forward telemedicine also show potential for reducing outpatient referrals and hence reducing costs. There was little evidence of a beneficial effect of relocation of specialists to primary care, or joint primary/secondary care management of patients on outpatient referrals. Across all intervention categories there was little evidence available on cost-effectiveness.
What can variation in patterns of referral from primary care lead to?
Variation in patterns of referral from primary care can lead to inappropriate overuse or underuse of specialist resources. Our aim was to review the literature on strategies involving primary care that are designed to improve the effectiveness and efficiency of outpatient services.
What is relocation in healthcare?
Relocation: Shifting the venue of specialist care from outpatient clinics to primary care without changing the people who deliver the service.
When was the scoping review published?
A scoping review to update a review published in 2006. We conducted a systematic literature search and qualitative evidence synthesis of studies across five intervention domains: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary care practitioners and specialists; interventions to change the referral behaviour of primary care practitioners and interventions to change patient behaviour.
How effective are collaborative models of mental health care?
Collaborative models of mental health care are likely to be effective across a wide spectrum of disorders. Community mental health teams are likely to be most effective when there are regular opportunities for face to face contact between mental health workers and the primary care practice team.
What is the transfer of responsibility to clinical commissioning groups?
One initiative in England in 2012 was the transfer of responsibility to clinical commissioning groups (CCGs). This required GPs working as part of CCGs to balance their responsibility to their patients with a responsibility to manage NHS budgets. More recently, a number of new models of care, intended to provide more integrated care as well as increasing efficiency have been encouraged.4Similar initiatives are ongoing in other countries.5
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