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At least 433 records · Page 24Linked to original sources
PubMed1998

Medicare+Choice creates opportunities for PSOs.

The Medicare + Choice program, a feature of the Balanced Budget Act of 1997, has far-reaching implications for healthcare providers, and for provider-sponsored organizations (PSOs), in particular. Under Medicare + Choice, PSOs will be able to contract with Medicare if they meet certain conditions. Most significantly, the PSO must be established, operated, and majority-owned by healthcare providers that directly furnish a substantial portion of the covered services. PSOs and other participants in the Medicare + Choice program will receive aggregate annual payments based on geographic location and demographic characteristics of enrollees. Medicare + Choice provider participants should understand the details of how these payments will be calculated. For instance, geographically based payments will gradually be modified to reflect a more uniform payment rate nationally. In addition, participants in Medicare + Choice will need to meet state solvency requirements or apply to HCFA for a three-year waiver of those requirements to participate in the program. The best time to form a PSO may be in the next three years, before HCFA's authority to grant such waivers expires.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

Medicare program; definition of provider-sponsored organization and related requirements--HCFA. Interim final rule with comment period.

The Balanced Budget Act of 1997 establishes a new Medicare + Choice program that significantly expands the health care options available to Medicare beneficiaries. Under this program, eligible individuals may elect to receive Medicare benefits through enrollment in one of an array of private health plans that contract with HCFA. Among the new options available to Medicare beneficiaries is enrollment in a provider-sponsored organization (PSO). This interim final rule with comment period defines the term "provider-sponsored organization" for purposes of the Medicare program and establishes requirements related to meeting this definition. We believe that setting forth the definition of a PSO and the related requirements will facilitate the submission of applications to participate in the Medicare program as a PSO.

Aged↗
PubMedDate not supplied

Advancing community health through community health partnerships.

Improving a community's health is a key goal of health services organizations. Effectively pursuing that goal requires health services organizations to create partnerships with other organizations to help identify community health needs and to create and carry out programs that bring together community members and needed health services. Drawing on community systems concepts and a recent study of community health partnership efforts in three cities, this article provides a framework for such partnerships. Types of partnerships described include: Community action partnerships, in which the partnership forms to address a specific problem or pursue a specific opportunity. Community organization partnerships, in which a set of organizations in a similar service sector agree to collaborate for mutually agreed upon goals; and Community development partnerships, in which a partnership attempts to increase participation by people and organizations in collaborative activities that advance the community on multiple fronts or that contribute to community assets and services in multiple areas. The article also describes how the pressures to create large integrated delivery systems can affect creation of partnerships to improve community health. Increasingly, healthcare leaders are being held accountable for the health of communities they serve. When creating partnerships for community health and carrying out health-improvement activities, leaders should be aware of and respond to four key dimensions of accountability: political accountability, commercial accountability, clinical/patient accountability, and community accountability.

Catchment Area, Health↗
PubMed1998

Medicare Program; establishment of the Medicare+Choice Program--HCFA. Interim final rule with comment period.

The Balanced Budget Act of 1997 (BBA) establishes a new Medicare+Choice (M+C) program that significantly expands the health care options available to Medicare beneficiaries. Under this program, eligible individuals may elect to receive Medicare benefits through enrollment in one of an array of private health plan choices beyond the original Medicare program or the plans now available through managed care organizations under section 1876 of the Social Security Act. Among the alternatives that will be available to Medicare beneficiaries are M+C coordinated care plans (including plans offered by health maintenance organizations, preferred provider organizations, and provider-sponsored organizations), M+C "MSA" plans, that is, a combination of a high deductible M+C health insurance plan and a contribution to an M+C medical savings account (MSA), and M+C private fee-for-service plans. The introduction of the M+C program will have a profound effect on Medicare beneficiaries and on the health plans and providers that furnish care. The new provisions of the Medicare statute, set forth as Part C of title XVIII of the Social Security Act, address a wide range of areas, including eligibility and enrollment, benefits and beneficiary protections, quality assurance, participating providers, payments to M+C organizations, premiums, appeals and grievances, and contracting rules. This interim final rule explains and implements these provisions. In addition, we are soliciting letters of intent from organizations that intend to offer M+C MSA plans to Medicare beneficiaries and/or to serve as M+C MSA trustees.

Aged↗
PubMedDate not supplied

Community benefits are key. A common link for effective integration.

As the Michigan Health & Hospital Association leads the nation in the commitment to build healthy communities, other organizations are becoming involved in many different kinds of community initiatives with confusion and even conflict resulting. With community concepts assuming a central role in local health care reform, differing methodologies present major challenges in demonstrating benefits to target communities.

Community Health Planning↗
PubMed1999

Citizenship ethics: a call to action.

Ethics is the philosophical study of mortality--the study of goodness, moral values, and right action. Citizenship ethics is the part of public ethics that is concerned with the right action of citizens in the public arena. This article defines citizenship ethics and examines the ethics of individual citizens or groups as it relates to opportunities for healthcare professionals in their respective communities. The spirit of volunteerism among three professionals is highlighted as they make a positive contribution to their communities, and an appeal is made to healthcare professionals to seek their own opportunities to make a positive impact on their communities.

Community Networks↗
PubMed1986

Hospice program development: the nurse as a change agent.

A theory is an explanation of the interrelation among facts, concepts, or propositions. A number of theories are used in the process of hospice program assessment, including nursing process, change systems, and role theory. Collaboration between systems is crucial to the development of a smooth-running, effective hospital-community network. As a result of the theories utilized, the tools and skills needed to effect change, the driving and restraining forces that need to be identified, and the need to focus on a specific goal have been described. Although the theories utilized in this hospice study will not predict the outcome of the project, they have provided us with structure that enables us to guide our action and organize our approach to program analysis.

Hospices↗
PubMed1999

[Strategic challenges of the Internet to the laboratory informatics].

The rapid and general spread of the internet brings a lot of trials for its applications to our fields also. They include delivery of various information using the home page or e-mail, online consultation systems, quality control systems through the internet and more. So far, the security issues have been well managed with skillful administration of software and hardware. A part of them have been achieved the outstanding merits of the internet, but mostly more devices or investigation will be required to realize their intrinsic great virtue. The revolutionary progress of the network will never stop, rather will be accelerated more and more, and at last will lead us to the new era, in which all people in the world can communicate with each other at all times through the network, that may be named as the hyper-network community. So we all must considerate how to adapt our academic and medical field to the new era, rather than how to apply the internet in our field.

Clinical Laboratory Information Systems↗
PubMed2000

Louisiana Parish Health Profiles 1999: using information to drive local action.

The Parish Health Profiles 1999, published by the Department of Health and Hospitals Office of Public Health (OPH), are intended to be a source of parish-level health information to be used for community-level planning. The third edition of the Profiles uses a broader definition of health to understand the quality of life of communities. The included information represents not only health status, but also other aspects of quality of life, such as the status of local education, economy, environment, and crime and safety. The process of collecting this information yielded two additional results: strengthened relationships amongst information-providing agencies across the state and an orientation and subsequent comprehensive chapter of information on action and resources. In addition, the publication is designed to be reader friendly, with a strong emphasis on the use of the Parish Health Profiles to aid in understanding data. The Office of Public Health recognizes that the Parish Health Profiles will continue to evolve to meet the needs of their audience. In order to ensure continuous quality improvement through future editions, the Profiles are supported by an 18-month, multi-level evaluation process, ensuring consumer and user input and comment at different levels.

Community Networks↗
PubMedDate not supplied

Focus groups and vulnerable populations. Insight into client strengths and needs in complex community health care environments.

Focus groups are a useful qualitative research technique to assist in interpreting quantitative community assessment data. Data obtained from focus groups can provide sociological and psychological insights into the perceptions of population subgroups and suggest answers to the "why" questions raised by descriptive data about such issues as teen pregnancy, poverty, immunization levels, or lifestyle-related morbidity and mortality. Application of these insights can lead to the better use of community strengths and the creation of community-specific responses to barriers to health care. Focus groups work well for involving hard-to-reach members of a community in program development, planning, and evaluation. They may be more effective than face-to-face interviews and questionnaires because people often have not thought about how they feel and tend not to form opinions in isolation (1). The information sought through the use of focus groups is not randomly distributed in the population. Thus, groups are not randomly selected, and data are not gathered with the intent to generalize to all populations.

Adult↗