Mr. Brownstein gave an update on the Unified Managed Care Strategic Plan and that the Board appointed committee met with County staff and discussions continue around a joint strategic planning process. In that discussion there was an agreement that Mr. Butler and Ms. Tomcala would continue to work on a variety of issues and those discussions are going well. Also discussed was the idea of a strategic planning process and it was agreed to move forward with the idea to have a Managed Care Strategic Plan generated out of that process and has asked for volunteers to be part of the Strategic Planning group. The Board of Supervisors (BOS) had expressed interest in having discussions on Integrated Managed Care and that we would report back to BOS.…
Labor relations are defined as the activities managers engage in to ensure they have effective working relationships with the labor unions that represent their employees’ interests. These labor unions participate in collective bargaining. Collective bargaining is defined as negotiation between labor and management to resolve conflicts and disputes about issues such as working hours, wages, benefits, working conditions, and job security. The article explains that the new ruling was necessary to encourage the use of collective bargaining. And while labor unions are celebrating this decision, it has the potential to damage diverse industries throughout the entire…
8 managed care contracting terms and how they impact the way that health care is delivered in the United States Managed care contracting is a term majorly used in the United States that majorly describes techniques that are intended to reduce rather lower the costs giving and providing benefits of health with a mission to improve the care quality for specific organizations using the above-stated techniques. There exist more than 8 managed care contracting terms. However, in this case, we shall only discuss only eight managed care contracting terms. The American Association of preferred provider Organizations.…
In the industry, there are 17 companies within the S&P 500 index, including Cigna and its operating revenue had increased very consistently $17,877-$34,914 billion in last decade between 2004 and 2014. Five companies with the S&P 500 index annual revenue more than $100 billion (the largest being McKesson, a pharmaceutical distributor, with sales of about $188 billion). There was a significant boost in revenues in 2014 when the individual mandate component of the Health Care Reform law became effective. Revenues were also added shortly after the Health Care Reform law went into effect in 2010, as one component of the law allowed parents to keep their children up to the age of 26 under their health care coverage.…
William, I agree that bad faith bargaining is where the employer or union refuse to negotiate on collective bargaining. I think this wastes a lot of time when one of the parties isn’t willing to compromise on reaching an agreement. In fact, there are other ways an employer may try to bargain in bad faith. For example, an employer may try to incorporate an illegal subject of bargaining during negotiations. Although, it’s against the law, many employers still try to negotiate illegal subjects of bargaining.…
Chapter 7 went into great detail about the different types of Managed Care Plans. People want to carry health insurance to help cover them in case of a health emergency. Firms sell insurance because they are paid a set amount to assume a risk that can be managed by spreading it over a large pool of insurers. Insurance companies set premiums based on the expected payout along with other costs. Typically, health care is provided by a managed care organization (MCO) to a defined population at a fixed monthly rate.…
In the Clinton health care reform case, the primary interest groups were the Big Five, Business Roundtable, National Federation of Independent Business (NFIB), and Health Insurance Association of America (HIAA). The Big Five was the strongest supporter of the health care reform while the NFIB and HIAA were the strongest opponents of the proposal. The Business Roundtable was predictable to be favorable to the proposal; however, several members favored a newer proposal (Cooper-Gandy) which they showed more support. The HIAA represented smaller businesses and opposed health care reform because small business owners could not cover the costs of health insurance for all employees.…
Capitation arrangements pose an ethical challenge through the risk-sharing model of encouraging economic incentive via reduced utilization of services, to the financial benefit of the physician and the managed health care organization that share the risk. While some applaud the inherent incentive within the capitation risk-sharing system to increase efficiency and reduce over-utilization of resources, others suggest that there exists within a capitation system the insidious incentive to under treat patients and avoid patients with chronic or extreme…
Hertz, B. (2015). Compensation Considerations. Dermatology Times, 36(11), 80-81. The article argues on healthcare compensation caps in the U.S.…
1. Why does the Medicaid program receive a great deal of attention each year in the state of Florida? From legislators? From providers? From health plans?…
1. There are two main types of third party payers: private insures and public programs. Private payers sell insurance as a product in order to invest into health benefits, where the provider gets paid for the delivered healthcare service. Commercial insurers, Bleu Cross Blue Shield and self-insures are the main private insures in the country. BCBS is a set of independent companies that are required to follow the rules of the main nationwide association in order to be part of it.…
Shared Governance The increasingly dire scarcity of professional nurses is a threatening theme in healthcare. In retort to it, more and more establishments are turning to shared governance, a concept introduced into healthcare organizations in the 1970s (Section 1) as an evidence-based system to control the shortage’s harmful effects for example, adverse patient outcomes, high cost of agency staff, and nurses sign-on bonuses to mention a few. What is Shared Governance?…
Choosing health care can be very difficult or even overwhelming. You might have a lot of questions. Here are some tips and information for making your healthcare choices not so difficult. Some insurance options are…
There are differences in public and private collective bargaining. In particular, there are differences between the ways the agreement is caring out. For instance, collective bargaining in the private sector influences by market forces. The primary concentration is on profit. As a business owner, you want your profit was higher than the expenses.…
Simple. Unions are created to essentially give nurses more power to voice out concerns for the safety and health of their patients and themselves. Once an agreement is reached, positive results can be seen in nursing. Any nurse can talk to management about issues that they have in hopes that it can be resolved. There are sets of procedures that one can go through, known as the grievance process, which specify steps and time limits for resolution.…