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Related Concept Videos

Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Standards of Care I01:22

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
Introduction To Health Care Delivery System01:18

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Obedience01:08

Obedience

According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation, obedience...
Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Accountability and Responsibility of a Nurse II01:09

Accountability and Responsibility of a Nurse II

Professional accountability in nursing is a multifaceted concept that encompasses professional ethics, legal standards, and employment expectations. This framework ensures that nurses maintain and elevate the quality of care while upholding the values of their profession. It compels them to treat patients, families, and colleagues with respect, compassion, and integrity.
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide comfort...

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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
19:57

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

Affordability in a mandated environment.

Jill M Yegian1, Grace Wang

  • 1American Institutes for Research, San Mateo, CA, USA. jyegian@iha.org

The American Journal of Managed Care
|July 13, 2013
PubMed
Summary
This summary is machine-generated.

Hawaii's mandated employer-based coverage led to lower uninsured rates and premiums, but did not slow healthcare cost growth. Addressing cost growth is key for sustainable health insurance affordability.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Public Health Policy

Background:

  • Hawaii has nearly 40 years of experience with mandated employer-based health coverage.
  • The state's healthcare landscape offers insights as the Affordable Care Act (ACA) implementation progresses.

Purpose of the Study:

  • To analyze Hawaii's healthcare cost experience under mandated employer-based coverage.
  • To identify implications for other states facing ACA implementation and rising healthcare costs.

Main Methods:

  • A case analysis approach was employed.
  • Literature review on Hawaii's healthcare costs.
  • Analysis of state-level and national data (MEPS, Hawaii Dept. of Commerce).
  • 14 interviews with 12 diverse healthcare stakeholder organizations.

Main Results:

  • Hawaii exhibits lower uninsured rates and employer-based premiums compared to national averages.
  • A concentrated insurance market, with a dominant carrier acting as a single payer, contributed to cost efficiencies and negotiating power.
  • Despite lower premiums, the rate of healthcare cost growth in Hawaii remains a concern, prompting focus on payer-provider incentive alignment.

Conclusions:

  • Mandated health coverage alone does not curb rising healthcare costs or solve affordability issues.
  • Sustainable expansion of health coverage requires proactive strategies to address healthcare cost growth.