QI PLAN PART 32QI PLAN PART 310QI Plan Part 3.docx

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QI PLAN PART 3 2 QI PLAN PART 3 10 QI Plan Part 3 Name School Measuring Performance Standards HCS/588 Instructor December 22, 2014 Running head: QI PLAN PART 3 1 QI Plan Part 3 Quality Improvement (QI) plan involves a number of events when incorporated together improve the performance of the healthcare organization. It involves studies to be carried out successively and the processes to be improved to suit the needs and expectations of patients, staff and the community at large. The Health Quality of Ontario is a system that seeks to monitor the progress that healthcare organizations are making in trying to improve their services. A QI plan will provide them with information on the various steps of improvement they have taken. The QI plan’s major objective is to ensure that a formal process exists to monitor and evaluate the quality of both clinical and operational services. The QI plan provides information on the general medicine, behavioral health and oral health care services that are used to facilitate the improvement of the performance. Comment by Dr. Cynthia Hughes: Introduction should discuss the salient points to be discussed in your paper. Authority, structure, and organization An organizational structure is a formal system that incorporates the people, information and technology in the organization to attain a common goal. Ontario health care organization has a major goal of maximizing the organizations value by ensuring the mission and vision promotes quality improvement. The board of directors,executive leaders,committee for quality improvement,departmentand medical staff, middle management all have different roles to play. Leadership and the organization structure are vital aspects to be considered during the implementation process of a QI plan. In order to establish an effective QI plan the organizational culture has to change over time to adopt the new changes in the organizational goals of quality. All the protocols involved in the implementation of the QI plan should embrace their roles. The executive leadership is composed of the senior leaders and the chief medical officers. They are the highest authority in the organizational chart. Their main leadership role includes that of leading the organization towards the achievement of their goal of quality. They also provide guidance towards achieving the goals. The executive leaders should possess a level of commitment and should be available physical to ensure they lead by example hence promoting the quality improvement in the organization. The board of directors contributes to quality care in the organization. The main objective of a health care organization is to provide safety to their patients. The board of directors can meet this objective indirectly by being committed and overseeing the safety measurements being practiced in the organization on a regular basis. The organization should involve the board of directors in the implementation of the plan. Comm ...

QI PLAN PART 32QI PLAN PART 310QI Plan Part 3.docx

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amrit47
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QI PLAN PART 3 2 QI PLAN PART 3 10 QI Plan Part 3 Name School Measuring Performance Standards HCS/588 Instructor December 22, 2014 Running head: QI PLAN PART 3 1 QI Plan Part 3 Quality Improvement (QI) plan involves a number of events when incorporated together improve the performance of the healthcare organization. It involves studies to be carried out successively and the processes to be improved to suit the needs and expectations of patients, staff and the community at large. The Health Quality of Ontario is a system that seeks to monitor the progress that healthcare organizations are making in trying to improve their services. A QI plan will provide them with information on the various steps of improvement they have taken. The QI plan’s major objective is to ensure that a formal process exists to monitor and evaluate the quality of both clinical and operational services. The QI plan provides information on the general medicine, behavioral health and oral health care services that are used to facilitate the improvement of the performance. Comment by Dr. Cynthia Hughes: Introduction should discuss the salient points to be discussed in your paper. Authority, structure, and organization An organizational structure is a formal system that incorporates the people, information and technology in the organization to attain a common goal. Ontario health care organization has a major goal of maximizing the organizations value by ensuring the mission and vision promotes quality improvement. The board of directors,executive leaders,committee for quality improvement,departmentand medical staff, middle management all have different roles to play. Leadership and the organization structure are vital aspects to be considered during the implementation process of a QI plan. In order to establish an effective QI plan the organizational culture has to change over time to adopt the new changes in the organizational goals of quality. All the protocols involved in the implementation of the QI plan should embrace their roles. The executive leadership is composed of the senior leaders and the chief medical officers. They are the highest authority in the organizational chart. Their main leadership role includes that of leading the organization towards the achievement of their goal of quality. They also provide guidance towards achieving the goals. The executive leaders should possess a level of commitment and should be available physical to ensure they lead by example hence promoting the quality improvement in the organization. The board of directors contributes to quality care in the organization. The main objective of a health care organization is to provide safety to their patients. The board of directors can meet this objective indirectly by being committed and overseeing the safety measurements being practiced in the organization on a regular basis. The organization should involve the board of directors in the implementation of the plan. Comm ...

QI PLAN PART 32QI PLAN PART 310QI Plan Part 3.docx

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QI PLAN PART 3 2 QI PLAN PART 3 10 QI Plan Part 3 Name School Measuring Performance Standards HCS/588 Instructor December 22, 2014 Running head: QI PLAN PART 3 1 QI Plan Part 3 Quality Improvement (QI) plan involves a number of events when incorporated together improve the performance of the healthcare organization. It involves studies to be carried out successively and the processes to be improved to suit the needs and expectations of patients, staff and the community at large. The Health Quality of Ontario is a system that seeks to monitor the progress that healthcare organizations are making in trying to improve their services. A QI plan will provide them with information on the various steps of improvement they have
taken. The QI plan’s major objective is to ensure that a formal process exists to monitor and evaluate the quality of both clinical and operational services. The QI plan provides information on the general medicine, behavioral health and oral health care services that are used to facilitate the improvement of the performance. Comment by Dr. Cynthia Hughes: Introduction should discuss the salient points to be discussed in your paper. Authority, structure, and organization An organizational structure is a formal system that incorporates the people, information and technology in the organization to attain a common goal. Ontario health care organization has a major goal of maximizing the organizations value by ensuring the mission and vision promotes quality improvement. The board of directors,executive leaders,committee for quality improvement,departmentand medical staff, middle management all have different roles to play. Leadership and the organization structure are vital aspects to be considered during the implementation process of a QI plan. In order to establish an effective QI plan the organizational culture has to change over time to adopt the new changes in the organizational goals of quality. All the protocols involved in the implementation of the QI plan should embrace their roles. The executive leadership is composed of the senior leaders and the chief medical officers. They are the highest authority in the organizational chart. Their main leadership role includes that of leading the organization towards the achievement of their goal of quality. They also provide guidance towards achieving the goals. The executive leaders should possess a level of commitment and should be available physical to ensure they lead by example hence promoting the quality improvement in the organization. The board of directors contributes to quality care in the organization. The main objective of a health care organization is to provide safety to their patients. The board of directors can meet this objective indirectly by being committed
and overseeing the safety measurements being practiced in the organization on a regular basis. The organization should involve the board of directors in the implementation of the plan. Communication The quality improvement committee is answerable to the board of directors and is responsible for writing a report which should be presented to the board annually. The chair of the quality improvement committee should account for the certification of the approval of the QI plan. The middle management works in unison with the board of directors and the quality improvement committee to facilitate in the implementation of the QI plan. Their roles include providing all the data and information required by the committee and the board. They are required to write monitoring reports on their progress that should be presented to the board on a regular basis. The medical staff is involved in the implementation of the QI plan by suggesting areas that require improvement and strategies to achieve them. The department staff plays the role of connecting support staff and the quality improvement team. They are responsible for the communication flow between the two. During the performance improvement phase, data management plays a huge role. In this stage the data is collected, monitored, analyzed and interpreted. This is a very important step in the implementation of a QI plan because it formulates and implements areas that can be improved and monitors the progress. The evaluation of the progress made is normally done once a year. The top management evaluates the objectives to monitor the progress achieved during the implementation of the QI plan. In order to achieve an effective plan the collection of data should be more frequency than a once a year basis. An individual is tasked with the collection of data and providing it when it is required. The duties and responsibilities of this individual are outlined clearly and separated from other staff members to reduce any disruptions incurred during transitions. The individual is required to
possess the quality of responsibility. Education The leadership of the organization has the responsibility of providing structures that will support the improvement efforts, form values, enhance the education of the plan to employees, form support policies and allocate resources that will facilitate the improvement. The board has a role to play in this leadership. They are responsible for providing support, evaluating, and approving the plan every year. They are responsible to ensure the allocated resources are approved and provided for. The organization should provide training programs and technical assistance to the employees. The health care organization has imposed certain environmental standards which should be engineered to suit the QI plan. The health care environment should be developed based on national quality measurement and reporting systems. These strategies will enhance the efforts made to develop strategies in the implementation process. Annual Evaluation A QI plan is normally evaluated annually as the improvement activities of the previous year are reviewed and recommendations for the next year are made. In the annual evaluation, the QI plan is updated and the medical staff approves it. It is basically a two years plan of the clinical and service improvement attributes for improving events in the organization. In order to achieve an effective implementation plan, monitoring is recommended to be continuous with a minimum time frame of a year. When monitoring the clinical indicators, a study by the medical staff in the organization should be considered. This aids in the development of new strategies of the plan. The administrative indicators are reviewed on a departmental view. Each department formulates their own strategies and they are approved by the department managers. This should be done a regular time frame and should air the complaints of the staff. This will enable the organization to determine important areas that require improvement.
External Entities The government uses agencies such as certification agencies and the joint commission to evaluate the health care organization. This will involve the agencies assigning trained personnel to visit the organization, interview its staff, review their documents and inspect the facilities used by the organization. The experts define standards that should be met by health care organizations and they gauge them against this. The hospitals pay a fee to be reviewed. The joint commission accredits these organizations which are then viewed to meet the required specifications of Medicare. The Medicare Certification is a compulsory requirement for all health care organizations. These are mainly tailored for organization that seek to provide Medicare but not accredited. There is no fee charged for this service. The appointed state agencies are paid and trained by the health care financing administration. Challenges The improvement efforts are propelled by the leadership and the organizational culture. However, they are limited by certain limiting issues. The staff may fail to comprehend the demand that comes with the quality improvement. The organization has the mandate of aligning the general and specific goals to avoid any confusion. Another challenge encountered is that the process of data collection is time consuming and hence requires external support. The concept of providing incentives to enhance improvement works only for the short term. In the long run the organization should prioritize on encouraging change and highlighting the benefits that come with it. Despite the many short falls of implementing a QI plan, an organization still benefits from it. It enhances improvements in the quality of life of patients that require long term attention. Conclusion Quality improvement process' main goal is to improve and assure the safety, quality, and cost efficiency of a health care organization, whereas performance measurement in reality measures the progress of these goals. Performance measurement
and quality improvement processes are very different in the way that the information is handled. The consumer has a great deal of say into how an organization improves on their processes. Most consumers are more than happy to give their input and participate in an organization's quality improvement plan. Comment by Dr. Cynthia Hughes: Conclusion should summarize the major points discussed in your paper. ReferencesBeers, L. (2010). Quality Improvement. Pediatric news, 44(10), 55-55.doi:10.1016/S0031-398X(10)70482- 3Kinsman, L. (2004). Clinical pathway compliance and quality improvement. Nursing Standard, 18(18), 33-5. Retrieved from http://search.proquest.com/docview/219838395?accountid=458S ukhneet P, Andrew C, Sarah S, Aziz S. (2014). Patient Safety and Healthcare Improvement at a Glance. Retrieved from: http://books.google.com/books/about/Patient_Safety_and_Healt hcare_Improvemen.html?hl=&id=LQDeAwAAQBAJTimothy J, Eric N. (2011). Great Health Care: Making It Happen. Retrieved from:http://books.google.com/books/about/Great_Health_Care.h tml?hl=&id=-FuuG4fQU-IC Grading CriteriaQI Plan Part 3 This assignment is due in Week 5. Content 60 Percent Points Available
6 Points Earned X/6 Additional Comments: Student chose a health care organization for which to create a QI plan. Student wrote a paper that includes the following: Authority, structure, and organization Describe the authority structure of the plan’s implementation. This must describe who is responsible for implementing the plan. Include a description of each role involved in the plan: Board of directors Executive leadership Quality improvement committee Medical staff Middle management Department staff Communication Identify who the performance activity outcomes are communicated to and who does the communicating. This describes who is responsible for overseeing data collection and preparing data reports. Education Describe how staff will be educated regarding the plan. This covers how each staff member will be initially oriented to the plan and how each employee fits into the plan based on job responsibilities.
Annual evaluation Describe what elements of the plan are annually evaluated for improvement. Identify how to monitor the effect of changes implemented from the decision-making process. External entities Describe the effect of external entities—governmental agencies, accrediting bodies, and professional interest groups—on the quality and performance measure of an organization’s decision- making processes. Challenges Identify barriers that can interfere with the implementation or revision of quality measures. Determine strategies to ensure successful implementation of new quality measures. The student cited at least three sources to support his or her information. 6 Required areas were discussed in a substantive way in your paper. Please see comments. Organization/Development 20 Percent Points Available 2 Points Earned X/2 Additional Comments: · The paper is 1,050 to 1,400 words in length. · The introduction provides sufficient background on the topic
and previews major points. · The conclusion is logical, flows, and reviews the major points. 1.5 Please see comments about introduction and conclusion. Mechanics 20 Percent Points Available 2 Points Earned X/2 Additional Comments: · The paper is consistent with APA guidelines as directed by the facilitator. The paper is laid out with effective use of headings, font styles, and white space. · Rules of grammar, usage, and punctuation are followed; spelling is correct. 2 . Total Available Total Earned 10 9.5 PRINTED BY: [email protected] Printing is for personal,
private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. Bookshelf </> Essentials of Health Policy & Law, 2nd Edition Shop <http://store.vitalsource.com/> * User Info </user/edit?page=info> * Device Activations </user/edit?page=activations> * Resources </user/edit?page=resources> * Print on Demand </user/edit?page=pod> * Settings </user/edit?page=settings> * Privacy <http://bookshelf.vitalsource.com/privacy-policy> * Support <http://support.vitalsource.com> * Sign Out </signout> Book <#choose-search> * Book <https://online.vitalsource.com/search/9781284021646> * Figures <https://online.vitalsource.com/search/9781284021646/figures> * Highlights <https://online.vitalsource.com/search/9781284021646/highlight s> Search Search Loading
* Contents </books/9781284021646/toc?xhr=true>Tab currently selected * Figures </books/9781284021646/figures?xhr=true> * Highlights </books/9781284021646/highlights> Manage <#manage> * Manage Highlighters </markers> * Manage Subscriptions </subscriptions> * Printed page number: Essentials of Health Policy &amp; Law </books/9781284021646/pages/163742917> * Expand <#>Printed page number: Front Matter </books/9781284021646/pages/163742918> o Printed page number: viiPrologue </books/9781284021646/pages/163742919> o Printed page number: ixPreface </books/9781284021646/pages/163742920> o Printed page number: xiiiAcknowledgments </books/9781284021646/pages/163742921> o Printed page number: xvAbout the Authors </books/9781284021646/pages/163742922> o Printed page number: xviiContributors </books/9781284021646/pages/163742923> * Expand <#>Printed page number: Part I Setting the Stage: An Overview of Health Policy and Law </books/9781284021646/pages/163742924>
o Expand <#>Printed page number: 3CHAPTER 1 Understanding the Role of and Conceptualizing Health Policy and Law </books/9781284021646/pages/163742925> + Printed page number: 3LEARNING OBJECTIVES </books/9781284021646/pages/163742925> + Printed page number: 3INTRODUCTION </books/9781284021646/pages/163742925> + Printed page number: 4ROLE OF POLICY AND LAW IN HEALTH CARE AND PUBLIC HEALTH </books/9781284021646/pages/163742926> + Expand <#>Printed page number: 5CONCEPTUALIZING HEALTH POLICY AND LAW </books/9781284021646/pages/163742927> # Printed page number: 5BOX 1-1 Three Conceptual Frameworks for Studying Health Policy and Law </books/9781284021646/pages/163742928> # Expand <#>Printed page number: 6The Three Broad Topical Domains of Health Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Health Care Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Public Health Policy and
Law </books/9781284021646/pages/163742929> * Printed page number: 6Bioethics </books/9781284021646/pages/163742929> # Expand <#>Printed page number: 6Social, Political, and Economic Historical Context </books/9781284021646/pages/163742930> * Printed page number: 6Professional Autonomy Perspective </books/9781284021646/pages/163742930> * Printed page number: 6Social Contract Perspective </books/9781284021646/pages/163742930> * Printed page number: 7Free Market Perspective </books/9781284021646/pages/163742931> # Printed page number: 8Key Stakeholders </books/9781284021646/pages/163742932> + Printed page number: 8CONCLUSION </books/9781284021646/pages/163742932> + Printed page number: 9ENDNOTES </books/9781284021646/pages/163742934> o Expand <#>Printed page number: 11CHAPTER 2 Policy and the Policymaking Process </books/9781284021646/pages/163742935> + Printed page number: 11LEARNING OBJECTIVES
</books/9781284021646/pages/163742935> + Printed page number: 11INTRODUCTION </books/9781284021646/pages/163742935> + Expand <#>Printed page number: 12DEFINING POLICY </books/9781284021646/pages/163742936> # Printed page number: 12Identifying Public Problems </books/9781284021646/pages/163742936> # Printed page number: 12Structuring Policy Options </books/9781284021646/pages/163742937> + Expand <#>Printed page number: 13PUBLIC POLICYMAKING STRUCTURE AND PROCESS </books/9781284021646/pages/163742938> # Printed page number: 13State-Level Policymaking </books/9781284021646/pages/163742938> # Expand <#>Printed page number: 14The Federal Legislative Branch </books/9781284021646/pages/163742939> * Printed page number: 14Leadership Positions </books/9781284021646/pages/163742939> * Printed page number: 14Committees </books/9781284021646/pages/163742940> * Printed page number: 15Congressional Commissions and Staff Agencies
</books/9781284021646/pages/163742941> * Printed page number: 17How Laws Are Made </books/9781284021646/pages/163742945> * Printed page number: 18Congressional Budget and Appropriations Process11,12 </books/9781284021646/pages/163742946> * Printed page number: 19Constituents </books/9781284021646/pages/163742947> # Expand <#>Printed page number: 20The Federal Executive Branch </books/9781284021646/pages/163742948> * Expand <#>Printed page number: 20The Presidency </books/9781284021646/pages/163742949> o Printed page number: 20BOX 2-1 Office of Management and Budget (OMB) </books/9781284021646/pages/163742949> o Printed page number: 21Agenda Setting </books/9781284021646/pages/163742950> o Printed page number: 22Presidential Powers </books/9781284021646/pages/163742951> o Printed page number: 22Constituents </books/9781284021646/pages/163742951> * Expand <#>Printed page number: 23Administrative Agencies
</books/9781284021646/pages/163742952> o Printed page number: 23Agency Powers </books/9781284021646/pages/163742953> o Printed page number: 24Constituents </books/9781284021646/pages/163742954> + Expand <#>Printed page number: 24THE HEALTH BUREAUCRACY </books/9781284021646/pages/163742954> # Expand <#>Printed page number: 24The Federal Government </books/9781284021646/pages/163742954> * Printed page number: 24Department of Health and Human Services </books/9781284021646/pages/163742954> * Printed page number: 27Department of Veterans Affairs and Department of Defense </books/9781284021646/pages/163742957> # Printed page number: 27State and Local Governments </books/9781284021646/pages/163742957> + Expand <#>Printed page number: 28INTEREST GROUPS </books/9781284021646/pages/163742958> # Printed page number: 29Interest Group Powers </books/9781284021646/pages/163742959> + Printed page number: 29CONCLUSION
</books/9781284021646/pages/163742959> + Printed page number: 29REFERENCES </books/9781284021646/pages/163742959> + Printed page number: 30ENDNOTES </books/9781284021646/pages/163742960> o Expand <#>Printed page number: 31CHAPTER 3 Law and the Legal System </books/9781284021646/pages/163742961> + Printed page number: 31LEARNING OBJECTIVES </books/9781284021646/pages/163742961> + Printed page number: 32INTRODUCTION </books/9781284021646/pages/163742962> + Printed page number: 32THE ROLE OF LAW </books/9781284021646/pages/163742963> + Expand <#>Printed page number: 33THE DEFINITION AND SOURCES OF LAW </books/9781284021646/pages/163742964> # Printed page number: 33Defining ?Law? </books/9781284021646/pages/163742964> # Expand <#>Printed page number: 33Sources of Law </books/9781284021646/pages/163742964> * Printed page number: 34Constitutions </books/9781284021646/pages/163742965> * Printed page number: 35Statutes </books/9781284021646/pages/163742966>
* Printed page number: 35Administrative Regulations </books/9781284021646/pages/163742967> * Printed page number: 36Common Law </books/9781284021646/pages/163742968> + Expand <#>Printed page number: 37KEY FEATURES OF THE LEGAL SYSTEM </books/9781284021646/pages/163742969> # Printed page number: 37Separation of Powers </books/9781284021646/pages/163742969> # Printed page number: 38Federalism: Allocation of Federal and State Legal Authority </books/9781284021646/pages/163742970> # Expand <#>Printed page number: 40The Role of Courts </books/9781284021646/pages/163742972> * Printed page number: 40Enforcing Legal Rights </books/9781284021646/pages/163742973> * Printed page number: 41Reviewing the Actions of the Political Branches </books/9781284021646/pages/163742974> * Printed page number: 43Maintaining Stability in the Law </books/9781284021646/pages/163742976> +
Printed page number: 44CONCLUSION </books/9781284021646/pages/163742978> + Printed page number: 44REFERENCES </books/9781284021646/pages/163742978> + Printed page number: 44ENDNOTES </books/9781284021646/pages/163742979> o Expand <#>Printed page number: 45CHAPTER 4 Overview of the United States Healthcare System </books/9781284021646/pages/163742980> + Printed page number: 45LEARNING OBJECTIVES </books/9781284021646/pages/163742980> + Printed page number: 45INTRODUCTION </books/9781284021646/pages/163742980> + Expand <#>Printed page number: 47HEALTHCARE FINANCE </books/9781284021646/pages/163742982> # Printed page number: 47Health Insurance </books/9781284021646/pages/163742982> # Printed page number: 49Direct Services Programs </books/9781284021646/pages/163742984> + Expand <#>Printed page number: 50HEALTHCARE ACCESS </books/9781284021646/pages/163742985> # Expand <#>Printed page number: 50The Uninsured </books/9781284021646/pages/163742985>
* Expand <#>Printed page number: 50Characteristics of the Uninsured </books/9781284021646/pages/163742985> o Printed page number: 50Income Level </books/9781284021646/pages/163742985> o Printed page number: 51Employment Status </books/9781284021646/pages/163742986> o Printed page number: 51Age </books/9781284021646/pages/163742986> o Printed page number: 52Education Level </books/9781284021646/pages/163742987> o Printed page number: 52Race, Ethnicity, and Immigrant Status </books/9781284021646/pages/163742987> o Printed page number: 53Gender </books/9781284021646/pages/163742988> o Expand <#>Printed page number: 53Geography </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-1 Discussion Questions </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-2 Discussion Questions </books/9781284021646/pages/163742988> *
Printed page number: 54The Importance of Health Insurance Coverage to Health Status </books/9781284021646/pages/163742989> * Printed page number: 54Ways to Assess the Cost of Being Uninsured </books/9781284021646/pages/163742990> # Printed page number: 54The Underinsured </books/9781284021646/pages/163742990> # Printed page number: 55Insurance Coverage Limitations </books/9781284021646/pages/163742991> # Printed page number: 57Safety Net Providers </books/9781284021646/pages/163742993> # Expand <#>Printed page number: 58Workforce Issues </books/9781284021646/pages/163742995> * Printed page number: 58BOX 4-3 Discussion Questions </books/9781284021646/pages/163742995> * Printed page number: 61BOX 4-4 Discussion Questions </books/9781284021646/pages/163742998> + Expand <#>Printed page number: 62HEALTHCARE QUALITY </books/9781284021646/pages/163742999> # Printed page number: 63BOX 4-5 Discussion
Questions </books/9781284021646/pages/163743000> + Expand <#>Printed page number: 64COMPARATIVE HEALTH SYSTEMS </books/9781284021646/pages/163743002> # Printed page number: 65A National Health Insurance System: Canada </books/9781284021646/pages/163743003> # Printed page number: 67A National Health System: Great Britain </books/9781284021646/pages/163743005> # Expand <#>Printed page number: 67A Socialized Insurance System: Germany </books/9781284021646/pages/163743005> * Printed page number: 67BOX 4-6 Discussion Questions </books/9781284021646/pages/163743006> # Printed page number: 67The Importance of Health Insurance Design </books/9781284021646/pages/163743006> + Printed page number: 70CONCLUSION </books/9781284021646/pages/163743008> + Printed page number: 72REFERENCES </books/9781284021646/pages/163743009> o Expand <#>Printed page number: 73CHAPTER 5 Public Health
Institutions and Systems </books/9781284021646/pages/163743010> + Printed page number: 73LEARNING OBJECTIVES </books/9781284021646/pages/163743010> + Printed page number: 74WHAT ARE THE GOALS AND ROLES OF GOVERNMENTAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743011> + Printed page number: 75WHAT ARE THE TEN ESSENTIAL PUBLIC HEALTH SERVICES? </books/9781284021646/pages/163743012> + Expand <#>Printed page number: 77WHAT ARE THE ROLES OF LOCAL AND STATE PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743013> # Printed page number: 78BOX 5-1 Brief History of American Public Health Agencies </books/9781284021646/pages/163743014> + Printed page number: 79WHAT ARE THE ROLES OF FEDERAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743015> + Printed page number: 80WHAT ARE THE ROLES OF GLOBAL HEALTH ORGANIZATIONS AND AGENCIES? </books/9781284021646/pages/163743016> +
Printed page number: 82HOW CAN PUBLIC HEALTH AGENCIES WORK TOGETHER? </books/9781284021646/pages/163743017> + Expand <#>Printed page number: 83WHAT OTHER GOVERNMENT AGENCIES ARE INVOLVED IN HEALTH ISSUES? </books/9781284021646/pages/163743018> # Printed page number: 83BOX 5-3 SARS and the Public Health Response </books/9781284021646/pages/163743018> + Printed page number: 84WHAT ROLES DO NONGOVERNMENTAL ORGANIZATIONS PLAY IN PUBLIC HEALTH? </books/9781284021646/pages/163743019> + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH AGENCIES PARTNER WITH HEALTH CARE TO IMPROVE THE RESPONSE TO HEALTH PROBLEMS? </books/9781284021646/pages/163743020> # Printed page number: 85BOX 5-4 National Vaccine Plan </books/9781284021646/pages/163743020> + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH TAKE THE LEAD IN MOBILIZING COMMUNITY PARTNERSHIPS TO IDENTIFY AND SOLVE HEALT
</books/9781284021646/pages/163743021> # Printed page number: 85BOX 5-5 Community Oriented Primary Care (COPC) </books/9781284021646/pages/163743021> # Printed page number: 87BOX 5-6 Child Oral Health and Community Oriented Public Health (COPH) </books/9781284021646/pages/163743023> # Printed page number: 87Discussion Questions </books/9781284021646/pages/163743024> + Printed page number: 89REFERENCES </books/9781284021646/pages/163743025> + Printed page number: 89ENDNOTES </books/9781284021646/pages/163743025> + Printed page number: 89PART I ADDENDUM: Historical Contextual Timeline of Important Events in Health Policy and Law </books/9781284021646/pages/163743025> + Printed page number: 102PART I ADDENDUM REFERENCES </books/9781284021646/pages/163743037> * Expand <#>Printed page number: Part II Essential Issues in Health Policy and Law </books/9781284021646/pages/163743038> o Expand <#>Printed page number: 105CHAPTER 6
Individual Rights in Health Care and Public Health </books/9781284021646/pages/163743039> + Printed page number: 105LEARNING OBJECTIVES </books/9781284021646/pages/163743039> + Printed page number: 105BOX 6-1 Vignette </books/9781284021646/pages/163743039> + Printed page number: 106INTRODUCTION </books/9781284021646/pages/163743040> + Printed page number: 106BACKGROUND </books/9781284021646/pages/163743040> + Expand <#>Printed page number: 108INDIVIDUAL RIGHTS AND HEALTH CARE: A GLOBAL PERSPECTIVE </books/9781284021646/pages/163743043> # Printed page number: 109BOX 6-2 Discussion Question </books/9781284021646/pages/163743044> + Expand <#>Printed page number: 109INDIVIDUAL RIGHTS AND THE HEALTHCARE SYSTEM </books/9781284021646/pages/163743044> # Expand <#>Printed page number: 109Rights Under Healthcare and Health Financing Laws </books/9781284021646/pages/163743045> * Printed page number: 110Rights Under Health Care
Laws: Examination and Treatment for Emergency Medical Conditions and Women </books/9781284021646/pages/163743046> * Printed page number: 111Rights Under Healthcare Financing Laws: Medicaid </books/9781284021646/pages/163743047> * Printed page number: 111Rights Under Health Insurance Laws: The Affordable Care Act </books/9781284021646/pages/163743047> # Expand <#>Printed page number: 111Rights Related to Freedom of Choice and Freedom from Government Interference </books/9781284021646/pages/163743048> * Printed page number: 111The Right to Make Informed Healthcare Decisions </books/9781284021646/pages/163743048> * Expand <#>Printed page number: 112The Right to Personal Privacy </books/9781284021646/pages/163743049> o Printed page number: 113BOX 6-3 Discussion Questions </books/9781284021646/pages/163743050> o Printed page number: 113The Roe v. Wade Decision </books/9781284021646/pages/163743050> o Printed page number: 114The Planned
Parenthood of Southeastern Pennsylvania v. Casey Decision </books/9781284021646/pages/163743052> o Printed page number: 115The Stenberg v. Carhart Decision </books/9781284021646/pages/163743053> o Printed page number: 115Partial Birth Abortion Ban Act of 2003 </books/9781284021646/pages/163743054> o Printed page number: 116The Gonzales v. Carhart Decision </books/9781284021646/pages/163743055> # Expand <#>Printed page number: 116The Right to Be Free from Wrongful Discrimination </books/9781284021646/pages/163743056> * Printed page number: 117BOX 6-4 Discussion Question </books/9781284021646/pages/163743057> * Printed page number: 117Race/Ethnicity Discrimination </books/9781284021646/pages/163743057> * Printed page number: 118Physical and Mental Disability Discrimination </books/9781284021646/pages/163743059> * Printed page number: 119Socioeconomic Status
Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Gender Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Age Discrimination </books/9781284021646/pages/163743060> + Expand <#>Printed page number: 120INDIVIDUAL RIGHTS IN A PUBLIC HEALTH CONTEXT </books/9781284021646/pages/163743061> # Printed page number: 120Overview of Police Powers </books/9781284021646/pages/163743061> # Expand <#>Printed page number: 120The Jacobson v. Massachusetts Decision </books/9781284021646/pages/163743062> * Expand <#>Printed page number: 121The ?Negative Constitution? </books/9781284021646/pages/163743063> o Printed page number: 121BOX 6-5 Discussion Question </books/9781284021646/pages/163743063> o Printed page number: 123BOX 6-6 Discussion Questions </books/9781284021646/pages/163743067> + Printed page number: 123CONCLUSION
</books/9781284021646/pages/163743067> + Printed page number: 124REFERENCES </books/9781284021646/pages/163743068> + Printed page number: 126ENDNOTES </books/9781284021646/pages/163743069> o Expand <#>Printed page number: 127CHAPTER 7 Understanding Health Insurance </books/9781284021646/pages/163743070> + Printed page number: 127LEARNING OBJECTIVES </books/9781284021646/pages/163743070> + Expand <#>Printed page number: 127INTRODUCTION </books/9781284021646/pages/163743070> # Printed page number: 128BOX 7-1 Vignette </books/9781284021646/pages/163743071> + Expand <#>Printed page number: 129A BRIEF HISTORY OF THE RISE OF HEALTH INSURANCE IN THE UNITED STATES </books/9781284021646/pages/163743072> # Printed page number: 129BOX 7-2 Discussion Questions </books/9781284021646/pages/163743073> + Expand <#>Printed page number: 130HOW HEALTH INSURANCE OPERATES </books/9781284021646/pages/163743074> #
Expand <#>Printed page number: 130Basic Terminology </books/9781284021646/pages/163743074> * Printed page number: 131BOX 7-3 Discussion Questions </books/9781284021646/pages/163743075> # Expand <#>Printed page number: 131Uncertainty </books/9781284021646/pages/163743075> * Printed page number: 131BOX 7-4 Discussion Questions </books/9781284021646/pages/163743076> # Printed page number: 131Risk </books/9781284021646/pages/163743076> # Expand <#>Printed page number: 133Setting Premiums </books/9781284021646/pages/163743078> * Printed page number: 133BOX 7-5 Discussion Questions </books/9781284021646/pages/163743079> * Printed page number: 134BOX 7-6 Discussion Questions </books/9781284021646/pages/163743080> * Printed page number: 134BOX 7-7 Discussion Questions </books/9781284021646/pages/163743080> # Printed page number: 135Medical Underwriting </books/9781284021646/pages/163743081>
+ Expand <#>Printed page number: 136MANAGED CARE </books/9781284021646/pages/163743082> # Expand <#>Printed page number: 137Cost Containment and Utilization Tools </books/9781284021646/pages/163743083> * Printed page number: 137Provider Payment Tools </books/9781284021646/pages/163743083> # Printed page number: 137Utilization Control Tools </books/9781284021646/pages/163743084> # Expand <#>Printed page number: 139Common Managed Care Structures </books/9781284021646/pages/163743087> * Printed page number: 139BOX 7-8 Discussion Questions </books/9781284021646/pages/163743087> * Printed page number: 139Health Maintenance Organizations </books/9781284021646/pages/163743087> * Expand <#>Printed page number: 140Preferred Provider Organizations </books/9781284021646/pages/163743088> o Printed page number: 142BOX 7-9 Discussion Questions
</books/9781284021646/pages/163743090> * Printed page number: 142Point-of-Service Plans </books/9781284021646/pages/163743090> # Printed page number: 142The Future of Managed Care </books/9781284021646/pages/163743090> + Printed page number: 143CONCLUSION </books/9781284021646/pages/163743091> + Printed page number: 143REFERENCES </books/9781284021646/pages/163743091> + Printed page number: 143ENDNOTES </books/9781284021646/pages/163743091> o Expand <#>Printed page number: 145CHAPTER 8 Health Economics in a Health Policy Context </books/9781284021646/pages/163743092> + Printed page number: 145LEARNING OBJECTIVES </books/9781284021646/pages/163743092> + Expand <#>Printed page number: 145INTRODUCTION </books/9781284021646/pages/163743092> # Printed page number: 146BOX 8-1 Vignette </books/9781284021646/pages/163743094> + Expand <#>Printed page number: 146HEALTH ECONOMICS DEFINED </books/9781284021646/pages/163743094> #
Expand <#>Printed page number: 146How Economists View Decision Making </books/9781284021646/pages/163743094> * Printed page number: 147Utility Analysis </books/9781284021646/pages/163743095> * Printed page number: 148Scarce Resources </books/9781284021646/pages/163743096> # Printed page number: 148How Economists View Health Care </books/9781284021646/pages/163743097> + Expand <#>Printed page number: 148ECONOMIC BASICS: DEMAND </books/9781284021646/pages/163743097> # Expand <#>Printed page number: 148Demand Changers </books/9781284021646/pages/163743097> * Printed page number: 149BOX 8-2 Discussion Questions </books/9781284021646/pages/163743098> # Expand <#>Printed page number: 150Elasticity </books/9781284021646/pages/163743099> * Printed page number: 150Demand Elasticity </books/9781284021646/pages/163743099> * Printed page number: 151Supply Elasticity </books/9781284021646/pages/163743100> #
Printed page number: 151Health Insurance and Demand </books/9781284021646/pages/163743100> + Expand <#>Printed page number: 151ECONOMIC BASICS: SUPPLY </books/9781284021646/pages/163743101> # Printed page number: 152Costs </books/9781284021646/pages/163743102> # Printed page number: 152Supply Changers </books/9781284021646/pages/163743102> # Printed page number: 153Profit Maximization </books/9781284021646/pages/163743103> # Printed page number: 154Health Insurance and Supply </books/9781284021646/pages/163743104> + Expand <#>Printed page number: 154ECONOMIC BASICS: MARKETS </books/9781284021646/pages/163743104> # Printed page number: 154Health Insurance and Markets </books/9781284021646/pages/163743104> # Printed page number: 154Market Structure </books/9781284021646/pages/163743105> # Expand <#>Printed page number: 155Market Failure </books/9781284021646/pages/163743106> * Printed page number: 155Public Goods
</books/9781284021646/pages/163743106> * Printed page number: 156Externalities </books/9781284021646/pages/163743107> * Expand <#>Printed page number: 157Government Intervention </books/9781284021646/pages/163743108> o Printed page number: 157Government Finances or Directly Provides Public Goods. </books/9781284021646/pages/163743108> o Printed page number: 157Government Increases Taxes, Tax Deductions, or Subsidies. </books/9781284021646/pages/163743108> o Printed page number: 157Government Issues Regulatory Mandates. </books/9781284021646/pages/163743109> o Expand <#>Printed page number: 157Government Prohibitions. </books/9781284021646/pages/163743109> + Printed page number: 158BOX 8-3 Discussion Questions </books/9781284021646/pages/163743110> o Printed page number: 158Redistribution of Income. </books/9781284021646/pages/163743110> +
Printed page number: 158CONCLUSION </books/9781284021646/pages/163743110> + Printed page number: 158REFERENCES </books/9781284021646/pages/163743111> + Printed page number: 158ENDNOTES </books/9781284021646/pages/163743111> o Expand <#>Printed page number: 159CHAPTER 9 Health Reform in the United States </books/9781284021646/pages/163743112> + Printed page number: 159LEARNING OBJECTIVES </books/9781284021646/pages/163743112> + Printed page number: 159VIGNETTE </books/9781284021646/pages/163743112> + Printed page number: 160INTRODUCTION </books/9781284021646/pages/163743113> + Expand <#>Printed page number: 160DIFFICULTY OF HEALTH REFORM IN THE UNITED STATES </books/9781284021646/pages/163743113> # Printed page number: 161Culture </books/9781284021646/pages/163743114> # Printed page number: 161U.S. Political System </books/9781284021646/pages/163743114> # Printed page number: 162Interest Groups </books/9781284021646/pages/163743116> #
Printed page number: 162Path Dependency </books/9781284021646/pages/163743116> + Printed page number: 163UNSUCCESSFUL ATTEMPTS TO PASS NATIONAL HEALTH REFORM </books/9781284021646/pages/163743117> + Expand <#>Printed page number: 165WHY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT PASSED </books/9781284021646/pages/163743120> # Printed page number: 166Commitment and Leadership </books/9781284021646/pages/163743121> # Printed page number: 167Lessons from Failed Health Reform Efforts </books/9781284021646/pages/163743123> # Printed page number: 170Political Pragmatism </books/9781284021646/pages/163743126> + Expand <#>Printed page number: 170PATIENT PROTECTION AND AFFORDABLE CARE ACT </books/9781284021646/pages/163743126> # Printed page number: 170Individual Mandate </books/9781284021646/pages/163743127> # Expand <#>Printed page number: 171State Health Insurance Exchanges </books/9781284021646/pages/163743128>
* Printed page number: 171BOX 9-1 Discussion Questions </books/9781284021646/pages/163743128> # Expand <#>Printed page number: 173Premium and Cost-Sharing Subsidies </books/9781284021646/pages/163743132> * Printed page number: 173BOX 9-2 Discussion Questions </books/9781284021646/pages/163743132> # Expand <#>Printed page number: 174Employer Mandate </books/9781284021646/pages/163743134> * Printed page number: 174BOX 9-3 Discussion Questions </books/9781284021646/pages/163743136> # Printed page number: 174Changes to the Private Insurance Market </books/9781284021646/pages/163743136> # Expand <#>Printed page number: 176Financing Health Reform </books/9781284021646/pages/163743139> * Printed page number: 177BOX 9-4 Discussion Questions </books/9781284021646/pages/163743140> # Expand <#>Printed page number: 177Public Health, Workforce, Prevention, and Quality </books/9781284021646/pages/163743141>
* Printed page number: 177BOX 9-5 Discussion Questions </books/9781284021646/pages/163743141> # Printed page number: 179States and Health Reform </books/9781284021646/pages/163743142> + Printed page number: 179CONClUSION </books/9781284021646/pages/163743142> + Printed page number: 181REFERENCES </books/9781284021646/pages/163743143> + Printed page number: 182ENDNOTES </books/9781284021646/pages/163743144> o Expand <#>Printed page number: 183CHAPTER 10 Government Health Insurance Programs: Medicaid, CHIP, and Medicare </books/9781284021646/pages/163743145> + Printed page number: 183LEARNING OBJECTIVES </books/9781284021646/pages/163743145> + Expand <#>Printed page number: 184INTRODUCTION </books/9781284021646/pages/163743146> # Printed page number: 184BOX 10-1 Vignette </books/9781284021646/pages/163743146> # Printed page number: 185BOX 10-2 Discussion Questions </books/9781284021646/pages/163743148> + Expand <#>Printed page number: 185MEDICAID
</books/9781284021646/pages/163743148> # Expand <#>Printed page number: 185Program Administration </books/9781284021646/pages/163743148> * Printed page number: 186BOX 10-3 Discussion Questions </books/9781284021646/pages/163743149> # Expand <#>Printed page number: 186Eligibility </books/9781284021646/pages/163743149> * Printed page number: 186BOX 10-4 Federal Poverty Level </books/9781284021646/pages/163743150> * Printed page number: 187Eligibility Requirements </books/9781284021646/pages/163743151> * Expand <#>Printed page number: 188Medically Needy </books/9781284021646/pages/163743152> o Printed page number: 189BOX 10-5 Discussion Questions </books/9781284021646/pages/163743153> * Printed page number: 189Immigrants </books/9781284021646/pages/163743153> # Expand <#>Printed page number: 189Medicaid Eligibility Expansion Under the Affordable Care Act </books/9781284021646/pages/163743154> *
Printed page number: 189BOX 10-6 Discussion Questions </books/9781284021646/pages/163743154> * Printed page number: 190BOX 10-7 Discussion Questions </books/9781284021646/pages/163743155> # Expand <#>Printed page number: 190Benefits </books/9781284021646/pages/163743155> * Printed page number: 192BOX 10-8 DRA Benefit Options </books/9781284021646/pages/163743158> # Expand <#>Printed page number: 192Amount, Duration, and Scope, and Reasonableness Requirements </books/9781284021646/pages/163743159> * Printed page number: 192BOX 10-9 Idaho Implementation of DRA25 </books/9781284021646/pages/163743159> # Expand <#>Printed page number: 193Medicaid Spending </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-10 Discussion Questions </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-11 Discussion Questions </books/9781284021646/pages/163743160> #
Expand <#>Printed page number: 194Medicaid Financing </books/9781284021646/pages/163743162> * Printed page number: 195BOX 10-12 Discussion Questions </books/9781284021646/pages/163743163> * Printed page number: 196BOX 10-13 Discussion Questions </books/9781284021646/pages/163743164> # Expand <#>Printed page number: 196Medicaid Provider Reimbursement </books/9781284021646/pages/163743165> * Printed page number: 196Fee-for-Service Reimbursement </books/9781284021646/pages/163743165> * Expand <#>Printed page number: 196Managed Care Reimbursement </books/9781284021646/pages/163743165> o Printed page number: 197BOX 10-14 Discussion Questions </books/9781284021646/pages/163743166> o Printed page number: 197BOX 10-15 Discussion Questions </books/9781284021646/pages/163743166> #
Printed page number: 197Medicaid Waivers </books/9781284021646/pages/163743167> # Expand <#>Printed page number: 198The Future of Medicaid </books/9781284021646/pages/163743168> * Printed page number: 198BOX 10-16 Discussion Questions </books/9781284021646/pages/163743168> + Expand <#>Printed page number: 198STATE CHILDREN?S HEALTH INSURANCE PROGRAM </books/9781284021646/pages/163743168> # Printed page number: 199CHIP Structure and Financing </books/9781284021646/pages/163743169> # Expand <#>Printed page number: 199CHIP Eligibility </books/9781284021646/pages/163743170> * Printed page number: 199BOX 10-17 Discussion Questions </books/9781284021646/pages/163743170> # Expand <#>Printed page number: 200CHIP Benefits and Beneficiary Safeguards </books/9781284021646/pages/163743171> * Printed page number: 201BOX 10-18 Discussion Questions </books/9781284021646/pages/163743172>
# Printed page number: 201CHIP and Private Insurance Coverage </books/9781284021646/pages/163743172> # Printed page number: 201CHIP Waivers </books/9781284021646/pages/163743173> # Printed page number: 201The Future of CHIP </books/9781284021646/pages/163743173> + Expand <#>Printed page number: 201MEDICARE </books/9781284021646/pages/163743173> # Printed page number: 202BOX 10-19 Discussion Questions </books/9781284021646/pages/163743174> # Printed page number: 202Medicare Eligibility </books/9781284021646/pages/163743174> # Printed page number: 202Medicare Benefits </books/9781284021646/pages/163743174> # Expand <#>Printed page number: 204Medicare Spending </books/9781284021646/pages/163743177> * Printed page number: 205BOX 10-20 Discussion Questions </books/9781284021646/pages/163743178> # Printed page number: 205Medicare Financing </books/9781284021646/pages/163743178> # Expand <#>Printed page number: 207Medicare
Provider Reimbursement </books/9781284021646/pages/163743181> * Expand <#>Printed page number: 208Physician Reimbursement </books/9781284021646/pages/163743182> o Printed page number: 208BOX 10-21 Discussion Questions </books/9781284021646/pages/163743182> o Printed page number: 209BOX 10-22 Discussion Questions </books/9781284021646/pages/163743183> * Printed page number: 209Hospital Reimbursement </books/9781284021646/pages/163743183> * Printed page number: 209Medicare Advantage Reimbursement </books/9781284021646/pages/163743184> + Printed page number: 209CONCLUSION </books/9781284021646/pages/163743184> + Printed page number: 210REFERENCES </books/9781284021646/pages/163743185> + Printed page number: 212ENDNOTES </books/9781284021646/pages/163743186> o Expand <#>Printed page number: 213CHAPTER 11 Healthcare Quality
Policy and Law </books/9781284021646/pages/163743187> + Printed page number: 213LEARNING OBJECTIVES </books/9781284021646/pages/163743187> + Printed page number: 213BOX 11-1 Vignette </books/9781284021646/pages/163743187> + Printed page number: 214INTRODUCTION </books/9781284021646/pages/163743188> + Printed page number: 215QUALITY CONTROL THROUGH LICENSURE AND ACCREDITATION </books/9781284021646/pages/163743189> + Expand <#>Printed page number: 216MEDICAL ERRORS AS A PUBLIC HEALTH CONCERN </books/9781284021646/pages/163743190> # Printed page number: 216BOX 11-2 Discussion Questions </books/9781284021646/pages/163743191> + Expand <#>Printed page number: 217PROMOTING HEALTHCARE QUALITY THROUGH THE STANDARD OF CARE </books/9781284021646/pages/163743192> # Printed page number: 217The Origins of the Standard of Care </books/9781284021646/pages/163743192> # Expand <#>Printed page number: 218The Evolution
of the Standard of Care </books/9781284021646/pages/163743193> * Printed page number: 218The Professional Custom Rule </books/9781284021646/pages/163743193> * Expand <#>Printed page number: 218The Locality Rule </books/9781284021646/pages/163743194> o Printed page number: 220BOX 11-3 Discussion Questions </books/9781284021646/pages/163743196> + Expand <#>Printed page number: 220TORT LIABILITY OF HOSPITALS, INSURERS, AND MANAGED CARE ORGANIZATIONS </books/9781284021646/pages/163743196> # Expand <#>Printed page number: 220Hospital Liability </books/9781284021646/pages/163743196> * Printed page number: 220Vicarious Liability </books/9781284021646/pages/163743196> * Printed page number: 221Corporate Liability </books/9781284021646/pages/163743198> # Printed page number: 221Insurer Liability </books/9781284021646/pages/163743198> # Expand <#>Printed page number: 222Managed Care
Liability </books/9781284021646/pages/163743199> * Printed page number: 222BOX 11-4 Discussion Questions </books/9781284021646/pages/163743200> + Expand <#>Printed page number: 222FEDERAL PREEMPTION OF STATE LIABILITY LAWS UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT </books/9781284021646/pages/163743200> # Printed page number: 222Overview of ERISA </books/9781284021646/pages/163743200> # Printed page number: 224ERISA Preemption </books/9781284021646/pages/163743202> # Expand <#>Printed page number: 225The Intersection of ERISA Preemption and Managed Care Professional Medical Liability </books/9781284021646/pages/163743203> * Printed page number: 226BOX 11-5 Discussion Questions </books/9781284021646/pages/163743205> + Expand <#>Printed page number: 226MEASURING AND INCENTIVIZING HEALTHCARE QUALITYg </books/9781284021646/pages/163743205> # Printed page number: 227Quality Measure
Development </books/9781284021646/pages/163743206> # Printed page number: 228Quality Measurement </books/9781284021646/pages/163743207> # Printed page number: 228Public Reporting </books/9781284021646/pages/163743207> # Printed page number: 228Value-Based Purchasing </books/9781284021646/pages/163743207> # Printed page number: 228National Quality Strategy </books/9781284021646/pages/163743208> + Printed page number: 230CONCLUSION </books/9781284021646/pages/163743210> + Printed page number: 230REFERENCES </books/9781284021646/pages/163743210> + Printed page number: 230ENDNOTES </books/9781284021646/pages/163743211> o Expand <#>Printed page number: 231CHAPTER 12 Public Health Preparedness Policy </books/9781284021646/pages/163743212> + Printed page number: 231LEARNING OBJECTIVES </books/9781284021646/pages/163743212> + Printed page number: 231INTRODUCTION </books/9781284021646/pages/163743212> + Expand <#>Printed page number: 232DEFINING
PUBLIC HEALTH PREPAREDNESS </books/9781284021646/pages/163743213> # Expand <#>Printed page number: 233Threats to Public Health </books/9781284021646/pages/163743215> * Printed page number: 233BOX 12-1 Discussion Questions </books/9781284021646/pages/163743215> * Expand <#>Printed page number: 233Chemical, Biological, Radiological, and Nuclear Agents </books/9781284021646/pages/163743215> o Expand <#>Printed page number: 233Chemical Agents </books/9781284021646/pages/163743215> + Printed page number: 233BOX 12-2 Types of Chemical Agents </books/9781284021646/pages/163743216> o Expand <#>Printed page number: 234Biological Agents </books/9781284021646/pages/163743217> + Printed page number: 234BOX 12-3 Examples of Chemical Agents Impacting Public Health </books/9781284021646/pages/163743217> + Printed page number: 234BOX 12-4 Biological Agents in Nature
</books/9781284021646/pages/163743218> + Printed page number: 235BOX 12-5 Category A, B, and C Biological Threat Agents </books/9781284021646/pages/163743219> o Expand <#>Printed page number: 236Radiological and Nuclear Agents </books/9781284021646/pages/163743224> + Printed page number: 236BOX 12-6 Anthrax Event in Sverdlovsk </books/9781284021646/pages/163743225> * Expand <#>Printed page number: 237Naturally-Occurring Disease Threats </books/9781284021646/pages/163743226> o Printed page number: 237BOX 12-7 Chernobyl Nuclear Power Plant Accident </books/9781284021646/pages/163743226> o Printed page number: 238BOX 12-8 National Security Strategy: The Threat of Naturally Occurring Disease </books/9781284021646/pages/163743227> o Printed page number: 238BOX 12-9 Discussion Question </books/9781284021646/pages/163743228> * Expand <#>Printed page number: 238Natural Disasters </books/9781284021646/pages/163743228>
o Printed page number: 239BOX 12-10 Hurricane Katrina and the Public Health Response </books/9781284021646/pages/163743229> * Expand <#>Printed page number: 240Manmade Environmental Disasters </books/9781284021646/pages/163743230> o Printed page number: 240BOX 12-11 Discussion Questions </books/9781284021646/pages/163743230> + Expand <#>Printed page number: 240PUBLIC HEALTH PREPAREDNESS POLICY </books/9781284021646/pages/163743230> # Expand <#>Printed page number: 241Department of Health and Human Services (HHS) </books/9781284021646/pages/163743231> * Printed page number: 241Office of the Assistant Secretary for Preparedness and Response </books/9781284021646/pages/163743231> * Printed page number: 241Centers for Disease Control and Prevention </books/9781284021646/pages/163743231> * Printed page number: 241National Institutes of Health </books/9781284021646/pages/163743231> *
Printed page number: 241The Food and Drug Administration </books/9781284021646/pages/163743231> # Printed page number: 242Department of Agriculture </books/9781284021646/pages/163743232> # Printed page number: 242Department of Justice, Federal Bureau of Investigation </books/9781284021646/pages/163743232> # Printed page number: 242Department of Defense </books/9781284021646/pages/163743232> # Expand <#>Printed page number: 242Preparedness Statutes, Regulations, and Policy Guidance </books/9781284021646/pages/163743232> * Printed page number: 242Public Health Improvement Act of 2000 (Public Law 106-505) </books/9781284021646/pages/163743233> * Printed page number: 242USA PATRIOT Act of 2001 (Public Law 107-56) </books/9781284021646/pages/163743233> * Printed page number: 242Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (Public Law 107-188) </books/9781284021646/pages/163743233>
* Printed page number: 243Smallpox Emergency Personnel Protection Act of 2003 (Public Law 108-20) </books/9781284021646/pages/163743234> * Printed page number: 243The Project Bioshield Act of 2004 (Public Law 108-276) </books/9781284021646/pages/163743234> * Printed page number: 243Public Readiness and Emergency Preparedness (PREP) Act of 2005 (Division C of the Department of Defe </books/9781284021646/pages/163743234> * Expand <#>Printed page number: 243Pandemic and All-Hazards Preparedness Act of 2006 (Public Law 109-417) </books/9781284021646/pages/163743234> o Printed page number: 244BOX 12-12 Discussion Question </books/9781284021646/pages/163743235> * Printed page number: 244Implementing Recommendations of the 9/11 Commission Act of 2007 (Public Law 110-53) </books/9781284021646/pages/163743235> * Printed page number: 244Biodefense for the 21st
Century: National Security Presidential Directive 33/Homeland Security Presi </books/9781284021646/pages/163743235> * Printed page number: 244Medical Countermeasures Against Weapons of Mass Destruction: Homeland Security Presidential Directiv </books/9781284021646/pages/163743235> * Printed page number: 244Public Health and Medical Preparedness: Homeland Security Presidential Directive 21. October 2007 </books/9781284021646/pages/163743236> * Printed page number: 244Establishing Federal Capability for the Timely Provision of Medical Countermeasures Following a Biol </books/9781284021646/pages/163743236> * Printed page number: 244National Strategy for Countering Biological Threats, Presidential Policy Directive 2. November 2009 </books/9781284021646/pages/163743236> * Expand <#>Printed page number: 245National Preparedness Presidential Policy Directive 8. March 2011 </books/9781284021646/pages/163743237> o Printed page number: 246BOX 12-13 Discussion Questions </books/9781284021646/pages/163743238> +
Printed page number: 246PUBLIC HEALTH PREPAREDNESS FEDERALISM </books/9781284021646/pages/163743238> + Expand <#>Printed page number: 246CONCLUSION </books/9781284021646/pages/163743239> # Printed page number: 247BOX 12-14 Discussion Question </books/9781284021646/pages/163743240> + Printed page number: 247REFERENCES </books/9781284021646/pages/163743240> + Printed page number: 248ENDNOTES </books/9781284021646/pages/163743241> * Expand <#>Printed page number: Part III Basic Skills in Health Policy Analysis </books/9781284021646/pages/163743242> o Expand <#>Printed page number: 251CHAPTER 13 The Art of Structuring and Writing a Health Policy Analysis </books/9781284021646/pages/163743243> + Printed page number: 251LEARNING OBJECTIVES </books/9781284021646/pages/163743243> + Printed page number: 251Defining Policy Analysis </books/9781284021646/pages/163743243> + Printed page number: 251INTRODUCTION </books/9781284021646/pages/163743243> +
Expand <#>Printed page number: 252POLICY ANALYSIS OVERVIEW </books/9781284021646/pages/163743244> # Printed page number: 253Multiple Purposes </books/9781284021646/pages/163743246> + Expand <#>Printed page number: 253STRUCTURING A POLICY ANALYSIS </books/9781284021646/pages/163743246> # Expand <#>Printed page number: 254The Problem Statement </books/9781284021646/pages/163743247> * Printed page number: 255Make the Problem Statement Analytically Manageable </books/9781284021646/pages/163743248> * Printed page number: 256Do Not Include the Recommendation in Your Problem Statement </books/9781284021646/pages/163743249> # Printed page number: 256The Background Section </books/9781284021646/pages/163743250> # Expand <#>Printed page number: 257The Landscape Section </books/9781284021646/pages/163743251> * Printed page number: 257Identifying Key Stakeholders </books/9781284021646/pages/163743251> * Printed page number: 257Identifying Key Factors
</books/9781284021646/pages/163743252> * Expand <#>Printed page number: 258Writing Structure </books/9781284021646/pages/163743253> o Printed page number: 258BOX 13-1 Possible Factors to Include in a Landscape Section </books/9781284021646/pages/163743253> # Expand <#>Printed page number: 259The Options Section </books/9781284021646/pages/163743255> * Printed page number: 259Identifying Options </books/9781284021646/pages/163743255> * Expand <#>Printed page number: 260Assessing Your Options </books/9781284021646/pages/163743256> o Printed page number: 261BOX 13-2 Sample Options Criteria </books/9781284021646/pages/163743257> * Printed page number: 261Writing Structure </books/9781284021646/pages/163743257> * Printed page number: 261Side-by-Side Tables </books/9781284021646/pages/163743258> # Expand <#>Printed page number: 262The Recommendation Section </books/9781284021646/pages/163743259>
* Printed page number: 262BOX 13-3 Checklist for Writing a Policy Analysis </books/9781284021646/pages/163743259> + Printed page number: 263CONCLUSION </books/9781284021646/pages/163743260> + Printed page number: 263REFERENCES </books/9781284021646/pages/163743260> * Expand <#>Printed page number: Back Matter </books/9781284021646/pages/163743261> o Printed page number: 265Glossary </books/9781284021646/pages/163743262> o Printed page number: 271Index </books/9781284021646/pages/163743263> <#resize-toc> CHAPTER 6 Individual Rights in Health Care and Public Health Previous Page <https://online.vitalsource.com/books/9781284021646/pages/16 3743045> CHAPTER 6 Individual Rights in Health Care and Public Health <#> Next Page
<https://online.vitalsource.com/books/9781284021646/pages/16 3743047> Loading */Rights Under Health Care Laws: Examination and Treatment for Emergency Medical Conditions and Women in Labor Act/ * Because EMTALA represents the only truly universal legal right to health care in this country�the right to access emergency hospital services�it is often described as one of the building blocks of health rights. EMTALA was enacted by Congress in 1986 to prevent the practice of �patient dumping��that is, the turning away of poor or uninsured persons in need of hospital care. Patient dumping was a common strategy among private hospitals aiming to shield themselves from the potentially uncompensated costs associated with treating poor and/or uninsured patients. By refusing to treat these individuals and instead �dumping� them on public hospitals, private institutions were effectively limiting their patients to those whose treatment costs would likely be covered out-of-pocket or by insurers. Note that the no-duty principle made this type of strategy possible. EMTALA was a conscious effort on the part of elected federal
officials to chip away at the no-duty principle: By creating legally enforceable rights to emergency hospital care for all individuals regardless of their income or health insurance status, Congress created a corresponding legal /duty/ of care on the part of hospitals. At its core, EMTALA includes two related duties, which technically attach only to hospitals that participate in the Medicare program (but then again, nearly every hospital in the country participates). The first duty requires covered hospitals to provide an �appropriate� screening examination to all individuals who present at a hospital�s emergency department seeking care for an �emergency medical condition.� Under the law, an appropriate medical 109110screening is one that is nondiscriminatory and that adheres to a hospital�s established emergency care guidelines. EMTALA defines an emergency medical condition as a * medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in (i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, (ii) serious impairment to bodily functions, or (iii) serious dysfunction of any bodily organ or part; or with
respect to a pregnant woman who is having contractions, that there is inadequate time to effect a safe transfer to another hospital before delivery, or that transfer may pose a threat to the health or safety of the woman or the unborn child.^20 </books/9781284021646/content/id/ch06bib20> Page Goto the specified printed page number Print Activate the following button to retrieve the URL to cite or link to this pageCite/Link PRINTED BY: [email protected] Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. Bookshelf </> Essentials of Health Policy & Law, 2nd Edition Shop <http://store.vitalsource.com/> * User Info </user/edit?page=info> * Device Activations </user/edit?page=activations> * Resources </user/edit?page=resources> * Print on Demand </user/edit?page=pod> * Settings </user/edit?page=settings> * Privacy <http://bookshelf.vitalsource.com/privacy-policy> * Support <http://support.vitalsource.com> * Sign Out </signout>
Book <#choose-search> * Book <https://online.vitalsource.com/search/9781284021646> * Figures <https://online.vitalsource.com/search/9781284021646/figures> * Highlights <https://online.vitalsource.com/search/9781284021646/highlight s> Search Search Loading * Contents </books/9781284021646/toc?xhr=true>Tab currently selected * Figures </books/9781284021646/figures?xhr=true> * Highlights </books/9781284021646/highlights> Manage <#manage> * Manage Highlighters </markers> * Manage Subscriptions </subscriptions> * Printed page number: Essentials of Health Policy &amp; Law </books/9781284021646/pages/163742917> * Expand <#>Printed page number: Front Matter </books/9781284021646/pages/163742918> o Printed page number: viiPrologue </books/9781284021646/pages/163742919>
o Printed page number: ixPreface </books/9781284021646/pages/163742920> o Printed page number: xiiiAcknowledgments </books/9781284021646/pages/163742921> o Printed page number: xvAbout the Authors </books/9781284021646/pages/163742922> o Printed page number: xviiContributors </books/9781284021646/pages/163742923> * Expand <#>Printed page number: Part I Setting the Stage: An Overview of Health Policy and Law </books/9781284021646/pages/163742924> o Expand <#>Printed page number: 3CHAPTER 1 Understanding the Role of and Conceptualizing Health Policy and Law </books/9781284021646/pages/163742925> + Printed page number: 3LEARNING OBJECTIVES </books/9781284021646/pages/163742925> + Printed page number: 3INTRODUCTION </books/9781284021646/pages/163742925> + Printed page number: 4ROLE OF POLICY AND LAW IN HEALTH CARE AND PUBLIC HEALTH </books/9781284021646/pages/163742926> + Expand <#>Printed page number: 5CONCEPTUALIZING HEALTH
POLICY AND LAW </books/9781284021646/pages/163742927> # Printed page number: 5BOX 1-1 Three Conceptual Frameworks for Studying Health Policy and Law </books/9781284021646/pages/163742928> # Expand <#>Printed page number: 6The Three Broad Topical Domains of Health Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Health Care Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Public Health Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Bioethics </books/9781284021646/pages/163742929> # Expand <#>Printed page number: 6Social, Political, and Economic Historical Context </books/9781284021646/pages/163742930> * Printed page number: 6Professional Autonomy Perspective </books/9781284021646/pages/163742930> * Printed page number: 6Social Contract Perspective </books/9781284021646/pages/163742930> * Printed page number: 7Free Market Perspective
</books/9781284021646/pages/163742931> # Printed page number: 8Key Stakeholders </books/9781284021646/pages/163742932> + Printed page number: 8CONCLUSION </books/9781284021646/pages/163742932> + Printed page number: 9ENDNOTES </books/9781284021646/pages/163742934> o Expand <#>Printed page number: 11CHAPTER 2 Policy and the Policymaking Process </books/9781284021646/pages/163742935> + Printed page number: 11LEARNING OBJECTIVES </books/9781284021646/pages/163742935> + Printed page number: 11INTRODUCTION </books/9781284021646/pages/163742935> + Expand <#>Printed page number: 12DEFINING POLICY </books/9781284021646/pages/163742936> # Printed page number: 12Identifying Public Problems </books/9781284021646/pages/163742936> # Printed page number: 12Structuring Policy Options </books/9781284021646/pages/163742937> + Expand <#>Printed page number: 13PUBLIC POLICYMAKING STRUCTURE AND PROCESS </books/9781284021646/pages/163742938>
# Printed page number: 13State-Level Policymaking </books/9781284021646/pages/163742938> # Expand <#>Printed page number: 14The Federal Legislative Branch </books/9781284021646/pages/163742939> * Printed page number: 14Leadership Positions </books/9781284021646/pages/163742939> * Printed page number: 14Committees </books/9781284021646/pages/163742940> * Printed page number: 15Congressional Commissions and Staff Agencies </books/9781284021646/pages/163742941> * Printed page number: 17How Laws Are Made </books/9781284021646/pages/163742945> * Printed page number: 18Congressional Budget and Appropriations Process11,12 </books/9781284021646/pages/163742946> * Printed page number: 19Constituents </books/9781284021646/pages/163742947> # Expand <#>Printed page number: 20The Federal Executive Branch </books/9781284021646/pages/163742948> * Expand <#>Printed page number: 20The Presidency </books/9781284021646/pages/163742949>
o Printed page number: 20BOX 2-1 Office of Management and Budget (OMB) </books/9781284021646/pages/163742949> o Printed page number: 21Agenda Setting </books/9781284021646/pages/163742950> o Printed page number: 22Presidential Powers </books/9781284021646/pages/163742951> o Printed page number: 22Constituents </books/9781284021646/pages/163742951> * Expand <#>Printed page number: 23Administrative Agencies </books/9781284021646/pages/163742952> o Printed page number: 23Agency Powers </books/9781284021646/pages/163742953> o Printed page number: 24Constituents </books/9781284021646/pages/163742954> + Expand <#>Printed page number: 24THE HEALTH BUREAUCRACY </books/9781284021646/pages/163742954> # Expand <#>Printed page number: 24The Federal Government </books/9781284021646/pages/163742954> * Printed page number: 24Department of Health and Human Services </books/9781284021646/pages/163742954>
* Printed page number: 27Department of Veterans Affairs and Department of Defense </books/9781284021646/pages/163742957> # Printed page number: 27State and Local Governments </books/9781284021646/pages/163742957> + Expand <#>Printed page number: 28INTEREST GROUPS </books/9781284021646/pages/163742958> # Printed page number: 29Interest Group Powers </books/9781284021646/pages/163742959> + Printed page number: 29CONCLUSION </books/9781284021646/pages/163742959> + Printed page number: 29REFERENCES </books/9781284021646/pages/163742959> + Printed page number: 30ENDNOTES </books/9781284021646/pages/163742960> o Expand <#>Printed page number: 31CHAPTER 3 Law and the Legal System </books/9781284021646/pages/163742961> + Printed page number: 31LEARNING OBJECTIVES </books/9781284021646/pages/163742961> + Printed page number: 32INTRODUCTION </books/9781284021646/pages/163742962> + Printed page number: 32THE ROLE OF LAW
</books/9781284021646/pages/163742963> + Expand <#>Printed page number: 33THE DEFINITION AND SOURCES OF LAW </books/9781284021646/pages/163742964> # Printed page number: 33Defining ?Law? </books/9781284021646/pages/163742964> # Expand <#>Printed page number: 33Sources of Law </books/9781284021646/pages/163742964> * Printed page number: 34Constitutions </books/9781284021646/pages/163742965> * Printed page number: 35Statutes </books/9781284021646/pages/163742966> * Printed page number: 35Administrative Regulations </books/9781284021646/pages/163742967> * Printed page number: 36Common Law </books/9781284021646/pages/163742968> + Expand <#>Printed page number: 37KEY FEATURES OF THE LEGAL SYSTEM </books/9781284021646/pages/163742969> # Printed page number: 37Separation of Powers </books/9781284021646/pages/163742969> # Printed page number: 38Federalism: Allocation of Federal and State Legal Authority </books/9781284021646/pages/163742970>
# Expand <#>Printed page number: 40The Role of Courts </books/9781284021646/pages/163742972> * Printed page number: 40Enforcing Legal Rights </books/9781284021646/pages/163742973> * Printed page number: 41Reviewing the Actions of the Political Branches </books/9781284021646/pages/163742974> * Printed page number: 43Maintaining Stability in the Law </books/9781284021646/pages/163742976> + Printed page number: 44CONCLUSION </books/9781284021646/pages/163742978> + Printed page number: 44REFERENCES </books/9781284021646/pages/163742978> + Printed page number: 44ENDNOTES </books/9781284021646/pages/163742979> o Expand <#>Printed page number: 45CHAPTER 4 Overview of the United States Healthcare System </books/9781284021646/pages/163742980> + Printed page number: 45LEARNING OBJECTIVES </books/9781284021646/pages/163742980> + Printed page number: 45INTRODUCTION </books/9781284021646/pages/163742980>
+ Expand <#>Printed page number: 47HEALTHCARE FINANCE </books/9781284021646/pages/163742982> # Printed page number: 47Health Insurance </books/9781284021646/pages/163742982> # Printed page number: 49Direct Services Programs </books/9781284021646/pages/163742984> + Expand <#>Printed page number: 50HEALTHCARE ACCESS </books/9781284021646/pages/163742985> # Expand <#>Printed page number: 50The Uninsured </books/9781284021646/pages/163742985> * Expand <#>Printed page number: 50Characteristics of the Uninsured </books/9781284021646/pages/163742985> o Printed page number: 50Income Level </books/9781284021646/pages/163742985> o Printed page number: 51Employment Status </books/9781284021646/pages/163742986> o Printed page number: 51Age </books/9781284021646/pages/163742986> o Printed page number: 52Education Level </books/9781284021646/pages/163742987> o Printed page number: 52Race, Ethnicity, and
Immigrant Status </books/9781284021646/pages/163742987> o Printed page number: 53Gender </books/9781284021646/pages/163742988> o Expand <#>Printed page number: 53Geography </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-1 Discussion Questions </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-2 Discussion Questions </books/9781284021646/pages/163742988> * Printed page number: 54The Importance of Health Insurance Coverage to Health Status </books/9781284021646/pages/163742989> * Printed page number: 54Ways to Assess the Cost of Being Uninsured </books/9781284021646/pages/163742990> # Printed page number: 54The Underinsured </books/9781284021646/pages/163742990> # Printed page number: 55Insurance Coverage Limitations </books/9781284021646/pages/163742991> # Printed page number: 57Safety Net Providers </books/9781284021646/pages/163742993> #
Expand <#>Printed page number: 58Workforce Issues </books/9781284021646/pages/163742995> * Printed page number: 58BOX 4-3 Discussion Questions </books/9781284021646/pages/163742995> * Printed page number: 61BOX 4-4 Discussion Questions </books/9781284021646/pages/163742998> + Expand <#>Printed page number: 62HEALTHCARE QUALITY </books/9781284021646/pages/163742999> # Printed page number: 63BOX 4-5 Discussion Questions </books/9781284021646/pages/163743000> + Expand <#>Printed page number: 64COMPARATIVE HEALTH SYSTEMS </books/9781284021646/pages/163743002> # Printed page number: 65A National Health Insurance System: Canada </books/9781284021646/pages/163743003> # Printed page number: 67A National Health System: Great Britain </books/9781284021646/pages/163743005> # Expand <#>Printed page number: 67A Socialized Insurance System: Germany </books/9781284021646/pages/163743005>
* Printed page number: 67BOX 4-6 Discussion Questions </books/9781284021646/pages/163743006> # Printed page number: 67The Importance of Health Insurance Design </books/9781284021646/pages/163743006> + Printed page number: 70CONCLUSION </books/9781284021646/pages/163743008> + Printed page number: 72REFERENCES </books/9781284021646/pages/163743009> o Expand <#>Printed page number: 73CHAPTER 5 Public Health Institutions and Systems </books/9781284021646/pages/163743010> + Printed page number: 73LEARNING OBJECTIVES </books/9781284021646/pages/163743010> + Printed page number: 74WHAT ARE THE GOALS AND ROLES OF GOVERNMENTAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743011> + Printed page number: 75WHAT ARE THE TEN ESSENTIAL PUBLIC HEALTH SERVICES? </books/9781284021646/pages/163743012> + Expand <#>Printed page number: 77WHAT ARE THE ROLES OF LOCAL AND STATE PUBLIC HEALTH AGENCIES?
</books/9781284021646/pages/163743013> # Printed page number: 78BOX 5-1 Brief History of American Public Health Agencies </books/9781284021646/pages/163743014> + Printed page number: 79WHAT ARE THE ROLES OF FEDERAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743015> + Printed page number: 80WHAT ARE THE ROLES OF GLOBAL HEALTH ORGANIZATIONS AND AGENCIES? </books/9781284021646/pages/163743016> + Printed page number: 82HOW CAN PUBLIC HEALTH AGENCIES WORK TOGETHER? </books/9781284021646/pages/163743017> + Expand <#>Printed page number: 83WHAT OTHER GOVERNMENT AGENCIES ARE INVOLVED IN HEALTH ISSUES? </books/9781284021646/pages/163743018> # Printed page number: 83BOX 5-3 SARS and the Public Health Response </books/9781284021646/pages/163743018> + Printed page number: 84WHAT ROLES DO NONGOVERNMENTAL ORGANIZATIONS PLAY IN PUBLIC HEALTH? </books/9781284021646/pages/163743019>
+ Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH AGENCIES PARTNER WITH HEALTH CARE TO IMPROVE THE RESPONSE TO HEALTH PROBLEMS? </books/9781284021646/pages/163743020> # Printed page number: 85BOX 5-4 National Vaccine Plan </books/9781284021646/pages/163743020> + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH TAKE THE LEAD IN MOBILIZING COMMUNITY PARTNERSHIPS TO IDENTIFY AND SOLVE HEALT </books/9781284021646/pages/163743021> # Printed page number: 85BOX 5-5 Community Oriented Primary Care (COPC) </books/9781284021646/pages/163743021> # Printed page number: 87BOX 5-6 Child Oral Health and Community Oriented Public Health (COPH) </books/9781284021646/pages/163743023> # Printed page number: 87Discussion Questions </books/9781284021646/pages/163743024> + Printed page number: 89REFERENCES </books/9781284021646/pages/163743025> + Printed page number: 89ENDNOTES
</books/9781284021646/pages/163743025> + Printed page number: 89PART I ADDENDUM: Historical Contextual Timeline of Important Events in Health Policy and Law </books/9781284021646/pages/163743025> + Printed page number: 102PART I ADDENDUM REFERENCES </books/9781284021646/pages/163743037> * Expand <#>Printed page number: Part II Essential Issues in Health Policy and Law </books/9781284021646/pages/163743038> o Expand <#>Printed page number: 105CHAPTER 6 Individual Rights in Health Care and Public Health </books/9781284021646/pages/163743039> + Printed page number: 105LEARNING OBJECTIVES </books/9781284021646/pages/163743039> + Printed page number: 105BOX 6-1 Vignette </books/9781284021646/pages/163743039> + Printed page number: 106INTRODUCTION </books/9781284021646/pages/163743040> + Printed page number: 106BACKGROUND </books/9781284021646/pages/163743040> + Expand <#>Printed page number: 108INDIVIDUAL RIGHTS AND HEALTH CARE: A GLOBAL PERSPECTIVE
</books/9781284021646/pages/163743043> # Printed page number: 109BOX 6-2 Discussion Question </books/9781284021646/pages/163743044> + Expand <#>Printed page number: 109INDIVIDUAL RIGHTS AND THE HEALTHCARE SYSTEM </books/9781284021646/pages/163743044> # Expand <#>Printed page number: 109Rights Under Healthcare and Health Financing Laws </books/9781284021646/pages/163743045> * Printed page number: 110Rights Under Health Care Laws: Examination and Treatment for Emergency Medical Conditions and Women </books/9781284021646/pages/163743046> * Printed page number: 111Rights Under Healthcare Financing Laws: Medicaid </books/9781284021646/pages/163743047> * Printed page number: 111Rights Under Health Insurance Laws: The Affordable Care Act </books/9781284021646/pages/163743047> # Expand <#>Printed page number: 111Rights Related to Freedom of Choice and Freedom from Government Interference </books/9781284021646/pages/163743048> * Printed page number: 111The Right to Make
Informed Healthcare Decisions </books/9781284021646/pages/163743048> * Expand <#>Printed page number: 112The Right to Personal Privacy </books/9781284021646/pages/163743049> o Printed page number: 113BOX 6-3 Discussion Questions </books/9781284021646/pages/163743050> o Printed page number: 113The Roe v. Wade Decision </books/9781284021646/pages/163743050> o Printed page number: 114The Planned Parenthood of Southeastern Pennsylvania v. Casey Decision </books/9781284021646/pages/163743052> o Printed page number: 115The Stenberg v. Carhart Decision </books/9781284021646/pages/163743053> o Printed page number: 115Partial Birth Abortion Ban Act of 2003 </books/9781284021646/pages/163743054> o Printed page number: 116The Gonzales v. Carhart Decision </books/9781284021646/pages/163743055> # Expand <#>Printed page number: 116The Right to Be
Free from Wrongful Discrimination </books/9781284021646/pages/163743056> * Printed page number: 117BOX 6-4 Discussion Question </books/9781284021646/pages/163743057> * Printed page number: 117Race/Ethnicity Discrimination </books/9781284021646/pages/163743057> * Printed page number: 118Physical and Mental Disability Discrimination </books/9781284021646/pages/163743059> * Printed page number: 119Socioeconomic Status Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Gender Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Age Discrimination </books/9781284021646/pages/163743060> + Expand <#>Printed page number: 120INDIVIDUAL RIGHTS IN A PUBLIC HEALTH CONTEXT </books/9781284021646/pages/163743061> # Printed page number: 120Overview of Police Powers </books/9781284021646/pages/163743061> # Expand <#>Printed page number: 120The Jacobson v.
Massachusetts Decision </books/9781284021646/pages/163743062> * Expand <#>Printed page number: 121The ?Negative Constitution? </books/9781284021646/pages/163743063> o Printed page number: 121BOX 6-5 Discussion Question </books/9781284021646/pages/163743063> o Printed page number: 123BOX 6-6 Discussion Questions </books/9781284021646/pages/163743067> + Printed page number: 123CONCLUSION </books/9781284021646/pages/163743067> + Printed page number: 124REFERENCES </books/9781284021646/pages/163743068> + Printed page number: 126ENDNOTES </books/9781284021646/pages/163743069> o Expand <#>Printed page number: 127CHAPTER 7 Understanding Health Insurance </books/9781284021646/pages/163743070> + Printed page number: 127LEARNING OBJECTIVES </books/9781284021646/pages/163743070> + Expand <#>Printed page number: 127INTRODUCTION </books/9781284021646/pages/163743070> # Printed page number: 128BOX 7-1 Vignette
</books/9781284021646/pages/163743071> + Expand <#>Printed page number: 129A BRIEF HISTORY OF THE RISE OF HEALTH INSURANCE IN THE UNITED STATES </books/9781284021646/pages/163743072> # Printed page number: 129BOX 7-2 Discussion Questions </books/9781284021646/pages/163743073> + Expand <#>Printed page number: 130HOW HEALTH INSURANCE OPERATES </books/9781284021646/pages/163743074> # Expand <#>Printed page number: 130Basic Terminology </books/9781284021646/pages/163743074> * Printed page number: 131BOX 7-3 Discussion Questions </books/9781284021646/pages/163743075> # Expand <#>Printed page number: 131Uncertainty </books/9781284021646/pages/163743075> * Printed page number: 131BOX 7-4 Discussion Questions </books/9781284021646/pages/163743076> # Printed page number: 131Risk </books/9781284021646/pages/163743076> # Expand <#>Printed page number: 133Setting
Premiums </books/9781284021646/pages/163743078> * Printed page number: 133BOX 7-5 Discussion Questions </books/9781284021646/pages/163743079> * Printed page number: 134BOX 7-6 Discussion Questions </books/9781284021646/pages/163743080> * Printed page number: 134BOX 7-7 Discussion Questions </books/9781284021646/pages/163743080> # Printed page number: 135Medical Underwriting </books/9781284021646/pages/163743081> + Expand <#>Printed page number: 136MANAGED CARE </books/9781284021646/pages/163743082> # Expand <#>Printed page number: 137Cost Containment and Utilization Tools </books/9781284021646/pages/163743083> * Printed page number: 137Provider Payment Tools </books/9781284021646/pages/163743083> # Printed page number: 137Utilization Control Tools </books/9781284021646/pages/163743084> # Expand <#>Printed page number: 139Common Managed Care Structures
</books/9781284021646/pages/163743087> * Printed page number: 139BOX 7-8 Discussion Questions </books/9781284021646/pages/163743087> * Printed page number: 139Health Maintenance Organizations </books/9781284021646/pages/163743087> * Expand <#>Printed page number: 140Preferred Provider Organizations </books/9781284021646/pages/163743088> o Printed page number: 142BOX 7-9 Discussion Questions </books/9781284021646/pages/163743090> * Printed page number: 142Point-of-Service Plans </books/9781284021646/pages/163743090> # Printed page number: 142The Future of Managed Care </books/9781284021646/pages/163743090> + Printed page number: 143CONCLUSION </books/9781284021646/pages/163743091> + Printed page number: 143REFERENCES </books/9781284021646/pages/163743091> + Printed page number: 143ENDNOTES </books/9781284021646/pages/163743091> o Expand <#>Printed page number: 145CHAPTER 8 Health
Economics in a Health Policy Context </books/9781284021646/pages/163743092> + Printed page number: 145LEARNING OBJECTIVES </books/9781284021646/pages/163743092> + Expand <#>Printed page number: 145INTRODUCTION </books/9781284021646/pages/163743092> # Printed page number: 146BOX 8-1 Vignette </books/9781284021646/pages/163743094> + Expand <#>Printed page number: 146HEALTH ECONOMICS DEFINED </books/9781284021646/pages/163743094> # Expand <#>Printed page number: 146How Economists View Decision Making </books/9781284021646/pages/163743094> * Printed page number: 147Utility Analysis </books/9781284021646/pages/163743095> * Printed page number: 148Scarce Resources </books/9781284021646/pages/163743096> # Printed page number: 148How Economists View Health Care </books/9781284021646/pages/163743097> + Expand <#>Printed page number: 148ECONOMIC BASICS: DEMAND </books/9781284021646/pages/163743097> #
Expand <#>Printed page number: 148Demand Changers </books/9781284021646/pages/163743097> * Printed page number: 149BOX 8-2 Discussion Questions </books/9781284021646/pages/163743098> # Expand <#>Printed page number: 150Elasticity </books/9781284021646/pages/163743099> * Printed page number: 150Demand Elasticity </books/9781284021646/pages/163743099> * Printed page number: 151Supply Elasticity </books/9781284021646/pages/163743100> # Printed page number: 151Health Insurance and Demand </books/9781284021646/pages/163743100> + Expand <#>Printed page number: 151ECONOMIC BASICS: SUPPLY </books/9781284021646/pages/163743101> # Printed page number: 152Costs </books/9781284021646/pages/163743102> # Printed page number: 152Supply Changers </books/9781284021646/pages/163743102> # Printed page number: 153Profit Maximization </books/9781284021646/pages/163743103> # Printed page number: 154Health Insurance and Supply
</books/9781284021646/pages/163743104> + Expand <#>Printed page number: 154ECONOMIC BASICS: MARKETS </books/9781284021646/pages/163743104> # Printed page number: 154Health Insurance and Markets </books/9781284021646/pages/163743104> # Printed page number: 154Market Structure </books/9781284021646/pages/163743105> # Expand <#>Printed page number: 155Market Failure </books/9781284021646/pages/163743106> * Printed page number: 155Public Goods </books/9781284021646/pages/163743106> * Printed page number: 156Externalities </books/9781284021646/pages/163743107> * Expand <#>Printed page number: 157Government Intervention </books/9781284021646/pages/163743108> o Printed page number: 157Government Finances or Directly Provides Public Goods. </books/9781284021646/pages/163743108> o Printed page number: 157Government Increases Taxes, Tax Deductions, or Subsidies. </books/9781284021646/pages/163743108> o Printed page number: 157Government Issues
Regulatory Mandates. </books/9781284021646/pages/163743109> o Expand <#>Printed page number: 157Government Prohibitions. </books/9781284021646/pages/163743109> + Printed page number: 158BOX 8-3 Discussion Questions </books/9781284021646/pages/163743110> o Printed page number: 158Redistribution of Income. </books/9781284021646/pages/163743110> + Printed page number: 158CONCLUSION </books/9781284021646/pages/163743110> + Printed page number: 158REFERENCES </books/9781284021646/pages/163743111> + Printed page number: 158ENDNOTES </books/9781284021646/pages/163743111> o Expand <#>Printed page number: 159CHAPTER 9 Health Reform in the United States </books/9781284021646/pages/163743112> + Printed page number: 159LEARNING OBJECTIVES </books/9781284021646/pages/163743112> + Printed page number: 159VIGNETTE </books/9781284021646/pages/163743112> +
Printed page number: 160INTRODUCTION </books/9781284021646/pages/163743113> + Expand <#>Printed page number: 160DIFFICULTY OF HEALTH REFORM IN THE UNITED STATES </books/9781284021646/pages/163743113> # Printed page number: 161Culture </books/9781284021646/pages/163743114> # Printed page number: 161U.S. Political System </books/9781284021646/pages/163743114> # Printed page number: 162Interest Groups </books/9781284021646/pages/163743116> # Printed page number: 162Path Dependency </books/9781284021646/pages/163743116> + Printed page number: 163UNSUCCESSFUL ATTEMPTS TO PASS NATIONAL HEALTH REFORM </books/9781284021646/pages/163743117> + Expand <#>Printed page number: 165WHY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT PASSED </books/9781284021646/pages/163743120> # Printed page number: 166Commitment and Leadership </books/9781284021646/pages/163743121> # Printed page number: 167Lessons from Failed Health Reform Efforts
</books/9781284021646/pages/163743123> # Printed page number: 170Political Pragmatism </books/9781284021646/pages/163743126> + Expand <#>Printed page number: 170PATIENT PROTECTION AND AFFORDABLE CARE ACT </books/9781284021646/pages/163743126> # Printed page number: 170Individual Mandate </books/9781284021646/pages/163743127> # Expand <#>Printed page number: 171State Health Insurance Exchanges </books/9781284021646/pages/163743128> * Printed page number: 171BOX 9-1 Discussion Questions </books/9781284021646/pages/163743128> # Expand <#>Printed page number: 173Premium and Cost-Sharing Subsidies </books/9781284021646/pages/163743132> * Printed page number: 173BOX 9-2 Discussion Questions </books/9781284021646/pages/163743132> # Expand <#>Printed page number: 174Employer Mandate </books/9781284021646/pages/163743134> * Printed page number: 174BOX 9-3 Discussion Questions
</books/9781284021646/pages/163743136> # Printed page number: 174Changes to the Private Insurance Market </books/9781284021646/pages/163743136> # Expand <#>Printed page number: 176Financing Health Reform </books/9781284021646/pages/163743139> * Printed page number: 177BOX 9-4 Discussion Questions </books/9781284021646/pages/163743140> # Expand <#>Printed page number: 177Public Health, Workforce, Prevention, and Quality </books/9781284021646/pages/163743141> * Printed page number: 177BOX 9-5 Discussion Questions </books/9781284021646/pages/163743141> # Printed page number: 179States and Health Reform </books/9781284021646/pages/163743142> + Printed page number: 179CONClUSION </books/9781284021646/pages/163743142> + Printed page number: 181REFERENCES </books/9781284021646/pages/163743143> + Printed page number: 182ENDNOTES </books/9781284021646/pages/163743144> o Expand <#>Printed page number: 183CHAPTER 10 Government Health
Insurance Programs: Medicaid, CHIP, and Medicare </books/9781284021646/pages/163743145> + Printed page number: 183LEARNING OBJECTIVES </books/9781284021646/pages/163743145> + Expand <#>Printed page number: 184INTRODUCTION </books/9781284021646/pages/163743146> # Printed page number: 184BOX 10-1 Vignette </books/9781284021646/pages/163743146> # Printed page number: 185BOX 10-2 Discussion Questions </books/9781284021646/pages/163743148> + Expand <#>Printed page number: 185MEDICAID </books/9781284021646/pages/163743148> # Expand <#>Printed page number: 185Program Administration </books/9781284021646/pages/163743148> * Printed page number: 186BOX 10-3 Discussion Questions </books/9781284021646/pages/163743149> # Expand <#>Printed page number: 186Eligibility </books/9781284021646/pages/163743149> * Printed page number: 186BOX 10-4 Federal Poverty Level </books/9781284021646/pages/163743150> * Printed page number: 187Eligibility Requirements </books/9781284021646/pages/163743151>
* Expand <#>Printed page number: 188Medically Needy </books/9781284021646/pages/163743152> o Printed page number: 189BOX 10-5 Discussion Questions </books/9781284021646/pages/163743153> * Printed page number: 189Immigrants </books/9781284021646/pages/163743153> # Expand <#>Printed page number: 189Medicaid Eligibility Expansion Under the Affordable Care Act </books/9781284021646/pages/163743154> * Printed page number: 189BOX 10-6 Discussion Questions </books/9781284021646/pages/163743154> * Printed page number: 190BOX 10-7 Discussion Questions </books/9781284021646/pages/163743155> # Expand <#>Printed page number: 190Benefits </books/9781284021646/pages/163743155> * Printed page number: 192BOX 10-8 DRA Benefit Options </books/9781284021646/pages/163743158> # Expand <#>Printed page number: 192Amount, Duration, and Scope, and Reasonableness Requirements </books/9781284021646/pages/163743159>
* Printed page number: 192BOX 10-9 Idaho Implementation of DRA25 </books/9781284021646/pages/163743159> # Expand <#>Printed page number: 193Medicaid Spending </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-10 Discussion Questions </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-11 Discussion Questions </books/9781284021646/pages/163743160> # Expand <#>Printed page number: 194Medicaid Financing </books/9781284021646/pages/163743162> * Printed page number: 195BOX 10-12 Discussion Questions </books/9781284021646/pages/163743163> * Printed page number: 196BOX 10-13 Discussion Questions </books/9781284021646/pages/163743164> # Expand <#>Printed page number: 196Medicaid Provider Reimbursement </books/9781284021646/pages/163743165> * Printed page number: 196Fee-for-Service Reimbursement
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  • 1. QI PLAN PART 3 2 QI PLAN PART 3 10 QI Plan Part 3 Name School Measuring Performance Standards HCS/588 Instructor December 22, 2014 Running head: QI PLAN PART 3 1 QI Plan Part 3 Quality Improvement (QI) plan involves a number of events when incorporated together improve the performance of the healthcare organization. It involves studies to be carried out successively and the processes to be improved to suit the needs and expectations of patients, staff and the community at large. The Health Quality of Ontario is a system that seeks to monitor the progress that healthcare organizations are making in trying to improve their services. A QI plan will provide them with information on the various steps of improvement they have
  • 2. taken. The QI plan’s major objective is to ensure that a formal process exists to monitor and evaluate the quality of both clinical and operational services. The QI plan provides information on the general medicine, behavioral health and oral health care services that are used to facilitate the improvement of the performance. Comment by Dr. Cynthia Hughes: Introduction should discuss the salient points to be discussed in your paper. Authority, structure, and organization An organizational structure is a formal system that incorporates the people, information and technology in the organization to attain a common goal. Ontario health care organization has a major goal of maximizing the organizations value by ensuring the mission and vision promotes quality improvement. The board of directors,executive leaders,committee for quality improvement,departmentand medical staff, middle management all have different roles to play. Leadership and the organization structure are vital aspects to be considered during the implementation process of a QI plan. In order to establish an effective QI plan the organizational culture has to change over time to adopt the new changes in the organizational goals of quality. All the protocols involved in the implementation of the QI plan should embrace their roles. The executive leadership is composed of the senior leaders and the chief medical officers. They are the highest authority in the organizational chart. Their main leadership role includes that of leading the organization towards the achievement of their goal of quality. They also provide guidance towards achieving the goals. The executive leaders should possess a level of commitment and should be available physical to ensure they lead by example hence promoting the quality improvement in the organization. The board of directors contributes to quality care in the organization. The main objective of a health care organization is to provide safety to their patients. The board of directors can meet this objective indirectly by being committed
  • 3. and overseeing the safety measurements being practiced in the organization on a regular basis. The organization should involve the board of directors in the implementation of the plan. Communication The quality improvement committee is answerable to the board of directors and is responsible for writing a report which should be presented to the board annually. The chair of the quality improvement committee should account for the certification of the approval of the QI plan. The middle management works in unison with the board of directors and the quality improvement committee to facilitate in the implementation of the QI plan. Their roles include providing all the data and information required by the committee and the board. They are required to write monitoring reports on their progress that should be presented to the board on a regular basis. The medical staff is involved in the implementation of the QI plan by suggesting areas that require improvement and strategies to achieve them. The department staff plays the role of connecting support staff and the quality improvement team. They are responsible for the communication flow between the two. During the performance improvement phase, data management plays a huge role. In this stage the data is collected, monitored, analyzed and interpreted. This is a very important step in the implementation of a QI plan because it formulates and implements areas that can be improved and monitors the progress. The evaluation of the progress made is normally done once a year. The top management evaluates the objectives to monitor the progress achieved during the implementation of the QI plan. In order to achieve an effective plan the collection of data should be more frequency than a once a year basis. An individual is tasked with the collection of data and providing it when it is required. The duties and responsibilities of this individual are outlined clearly and separated from other staff members to reduce any disruptions incurred during transitions. The individual is required to
  • 4. possess the quality of responsibility. Education The leadership of the organization has the responsibility of providing structures that will support the improvement efforts, form values, enhance the education of the plan to employees, form support policies and allocate resources that will facilitate the improvement. The board has a role to play in this leadership. They are responsible for providing support, evaluating, and approving the plan every year. They are responsible to ensure the allocated resources are approved and provided for. The organization should provide training programs and technical assistance to the employees. The health care organization has imposed certain environmental standards which should be engineered to suit the QI plan. The health care environment should be developed based on national quality measurement and reporting systems. These strategies will enhance the efforts made to develop strategies in the implementation process. Annual Evaluation A QI plan is normally evaluated annually as the improvement activities of the previous year are reviewed and recommendations for the next year are made. In the annual evaluation, the QI plan is updated and the medical staff approves it. It is basically a two years plan of the clinical and service improvement attributes for improving events in the organization. In order to achieve an effective implementation plan, monitoring is recommended to be continuous with a minimum time frame of a year. When monitoring the clinical indicators, a study by the medical staff in the organization should be considered. This aids in the development of new strategies of the plan. The administrative indicators are reviewed on a departmental view. Each department formulates their own strategies and they are approved by the department managers. This should be done a regular time frame and should air the complaints of the staff. This will enable the organization to determine important areas that require improvement.
  • 5. External Entities The government uses agencies such as certification agencies and the joint commission to evaluate the health care organization. This will involve the agencies assigning trained personnel to visit the organization, interview its staff, review their documents and inspect the facilities used by the organization. The experts define standards that should be met by health care organizations and they gauge them against this. The hospitals pay a fee to be reviewed. The joint commission accredits these organizations which are then viewed to meet the required specifications of Medicare. The Medicare Certification is a compulsory requirement for all health care organizations. These are mainly tailored for organization that seek to provide Medicare but not accredited. There is no fee charged for this service. The appointed state agencies are paid and trained by the health care financing administration. Challenges The improvement efforts are propelled by the leadership and the organizational culture. However, they are limited by certain limiting issues. The staff may fail to comprehend the demand that comes with the quality improvement. The organization has the mandate of aligning the general and specific goals to avoid any confusion. Another challenge encountered is that the process of data collection is time consuming and hence requires external support. The concept of providing incentives to enhance improvement works only for the short term. In the long run the organization should prioritize on encouraging change and highlighting the benefits that come with it. Despite the many short falls of implementing a QI plan, an organization still benefits from it. It enhances improvements in the quality of life of patients that require long term attention. Conclusion Quality improvement process' main goal is to improve and assure the safety, quality, and cost efficiency of a health care organization, whereas performance measurement in reality measures the progress of these goals. Performance measurement
  • 6. and quality improvement processes are very different in the way that the information is handled. The consumer has a great deal of say into how an organization improves on their processes. Most consumers are more than happy to give their input and participate in an organization's quality improvement plan. Comment by Dr. Cynthia Hughes: Conclusion should summarize the major points discussed in your paper. ReferencesBeers, L. (2010). Quality Improvement. Pediatric news, 44(10), 55-55.doi:10.1016/S0031-398X(10)70482- 3Kinsman, L. (2004). Clinical pathway compliance and quality improvement. Nursing Standard, 18(18), 33-5. Retrieved from http://search.proquest.com/docview/219838395?accountid=458S ukhneet P, Andrew C, Sarah S, Aziz S. (2014). Patient Safety and Healthcare Improvement at a Glance. Retrieved from: http://books.google.com/books/about/Patient_Safety_and_Healt hcare_Improvemen.html?hl=&id=LQDeAwAAQBAJTimothy J, Eric N. (2011). Great Health Care: Making It Happen. Retrieved from:http://books.google.com/books/about/Great_Health_Care.h tml?hl=&id=-FuuG4fQU-IC Grading CriteriaQI Plan Part 3 This assignment is due in Week 5. Content 60 Percent Points Available
  • 7. 6 Points Earned X/6 Additional Comments: Student chose a health care organization for which to create a QI plan. Student wrote a paper that includes the following: Authority, structure, and organization Describe the authority structure of the plan’s implementation. This must describe who is responsible for implementing the plan. Include a description of each role involved in the plan: Board of directors Executive leadership Quality improvement committee Medical staff Middle management Department staff Communication Identify who the performance activity outcomes are communicated to and who does the communicating. This describes who is responsible for overseeing data collection and preparing data reports. Education Describe how staff will be educated regarding the plan. This covers how each staff member will be initially oriented to the plan and how each employee fits into the plan based on job responsibilities.
  • 8. Annual evaluation Describe what elements of the plan are annually evaluated for improvement. Identify how to monitor the effect of changes implemented from the decision-making process. External entities Describe the effect of external entities—governmental agencies, accrediting bodies, and professional interest groups—on the quality and performance measure of an organization’s decision- making processes. Challenges Identify barriers that can interfere with the implementation or revision of quality measures. Determine strategies to ensure successful implementation of new quality measures. The student cited at least three sources to support his or her information. 6 Required areas were discussed in a substantive way in your paper. Please see comments. Organization/Development 20 Percent Points Available 2 Points Earned X/2 Additional Comments: · The paper is 1,050 to 1,400 words in length. · The introduction provides sufficient background on the topic
  • 9. and previews major points. · The conclusion is logical, flows, and reviews the major points. 1.5 Please see comments about introduction and conclusion. Mechanics 20 Percent Points Available 2 Points Earned X/2 Additional Comments: · The paper is consistent with APA guidelines as directed by the facilitator. The paper is laid out with effective use of headings, font styles, and white space. · Rules of grammar, usage, and punctuation are followed; spelling is correct. 2 . Total Available Total Earned 10 9.5 PRINTED BY: [email protected] Printing is for personal,
  • 10. private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. Bookshelf </> Essentials of Health Policy & Law, 2nd Edition Shop <http://store.vitalsource.com/> * User Info </user/edit?page=info> * Device Activations </user/edit?page=activations> * Resources </user/edit?page=resources> * Print on Demand </user/edit?page=pod> * Settings </user/edit?page=settings> * Privacy <http://bookshelf.vitalsource.com/privacy-policy> * Support <http://support.vitalsource.com> * Sign Out </signout> Book <#choose-search> * Book <https://online.vitalsource.com/search/9781284021646> * Figures <https://online.vitalsource.com/search/9781284021646/figures> * Highlights <https://online.vitalsource.com/search/9781284021646/highlight s> Search Search Loading
  • 11. * Contents </books/9781284021646/toc?xhr=true>Tab currently selected * Figures </books/9781284021646/figures?xhr=true> * Highlights </books/9781284021646/highlights> Manage <#manage> * Manage Highlighters </markers> * Manage Subscriptions </subscriptions> * Printed page number: Essentials of Health Policy &amp; Law </books/9781284021646/pages/163742917> * Expand <#>Printed page number: Front Matter </books/9781284021646/pages/163742918> o Printed page number: viiPrologue </books/9781284021646/pages/163742919> o Printed page number: ixPreface </books/9781284021646/pages/163742920> o Printed page number: xiiiAcknowledgments </books/9781284021646/pages/163742921> o Printed page number: xvAbout the Authors </books/9781284021646/pages/163742922> o Printed page number: xviiContributors </books/9781284021646/pages/163742923> * Expand <#>Printed page number: Part I Setting the Stage: An Overview of Health Policy and Law </books/9781284021646/pages/163742924>
  • 12. o Expand <#>Printed page number: 3CHAPTER 1 Understanding the Role of and Conceptualizing Health Policy and Law </books/9781284021646/pages/163742925> + Printed page number: 3LEARNING OBJECTIVES </books/9781284021646/pages/163742925> + Printed page number: 3INTRODUCTION </books/9781284021646/pages/163742925> + Printed page number: 4ROLE OF POLICY AND LAW IN HEALTH CARE AND PUBLIC HEALTH </books/9781284021646/pages/163742926> + Expand <#>Printed page number: 5CONCEPTUALIZING HEALTH POLICY AND LAW </books/9781284021646/pages/163742927> # Printed page number: 5BOX 1-1 Three Conceptual Frameworks for Studying Health Policy and Law </books/9781284021646/pages/163742928> # Expand <#>Printed page number: 6The Three Broad Topical Domains of Health Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Health Care Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Public Health Policy and
  • 13. Law </books/9781284021646/pages/163742929> * Printed page number: 6Bioethics </books/9781284021646/pages/163742929> # Expand <#>Printed page number: 6Social, Political, and Economic Historical Context </books/9781284021646/pages/163742930> * Printed page number: 6Professional Autonomy Perspective </books/9781284021646/pages/163742930> * Printed page number: 6Social Contract Perspective </books/9781284021646/pages/163742930> * Printed page number: 7Free Market Perspective </books/9781284021646/pages/163742931> # Printed page number: 8Key Stakeholders </books/9781284021646/pages/163742932> + Printed page number: 8CONCLUSION </books/9781284021646/pages/163742932> + Printed page number: 9ENDNOTES </books/9781284021646/pages/163742934> o Expand <#>Printed page number: 11CHAPTER 2 Policy and the Policymaking Process </books/9781284021646/pages/163742935> + Printed page number: 11LEARNING OBJECTIVES
  • 14. </books/9781284021646/pages/163742935> + Printed page number: 11INTRODUCTION </books/9781284021646/pages/163742935> + Expand <#>Printed page number: 12DEFINING POLICY </books/9781284021646/pages/163742936> # Printed page number: 12Identifying Public Problems </books/9781284021646/pages/163742936> # Printed page number: 12Structuring Policy Options </books/9781284021646/pages/163742937> + Expand <#>Printed page number: 13PUBLIC POLICYMAKING STRUCTURE AND PROCESS </books/9781284021646/pages/163742938> # Printed page number: 13State-Level Policymaking </books/9781284021646/pages/163742938> # Expand <#>Printed page number: 14The Federal Legislative Branch </books/9781284021646/pages/163742939> * Printed page number: 14Leadership Positions </books/9781284021646/pages/163742939> * Printed page number: 14Committees </books/9781284021646/pages/163742940> * Printed page number: 15Congressional Commissions and Staff Agencies
  • 15. </books/9781284021646/pages/163742941> * Printed page number: 17How Laws Are Made </books/9781284021646/pages/163742945> * Printed page number: 18Congressional Budget and Appropriations Process11,12 </books/9781284021646/pages/163742946> * Printed page number: 19Constituents </books/9781284021646/pages/163742947> # Expand <#>Printed page number: 20The Federal Executive Branch </books/9781284021646/pages/163742948> * Expand <#>Printed page number: 20The Presidency </books/9781284021646/pages/163742949> o Printed page number: 20BOX 2-1 Office of Management and Budget (OMB) </books/9781284021646/pages/163742949> o Printed page number: 21Agenda Setting </books/9781284021646/pages/163742950> o Printed page number: 22Presidential Powers </books/9781284021646/pages/163742951> o Printed page number: 22Constituents </books/9781284021646/pages/163742951> * Expand <#>Printed page number: 23Administrative Agencies
  • 16. </books/9781284021646/pages/163742952> o Printed page number: 23Agency Powers </books/9781284021646/pages/163742953> o Printed page number: 24Constituents </books/9781284021646/pages/163742954> + Expand <#>Printed page number: 24THE HEALTH BUREAUCRACY </books/9781284021646/pages/163742954> # Expand <#>Printed page number: 24The Federal Government </books/9781284021646/pages/163742954> * Printed page number: 24Department of Health and Human Services </books/9781284021646/pages/163742954> * Printed page number: 27Department of Veterans Affairs and Department of Defense </books/9781284021646/pages/163742957> # Printed page number: 27State and Local Governments </books/9781284021646/pages/163742957> + Expand <#>Printed page number: 28INTEREST GROUPS </books/9781284021646/pages/163742958> # Printed page number: 29Interest Group Powers </books/9781284021646/pages/163742959> + Printed page number: 29CONCLUSION
  • 17. </books/9781284021646/pages/163742959> + Printed page number: 29REFERENCES </books/9781284021646/pages/163742959> + Printed page number: 30ENDNOTES </books/9781284021646/pages/163742960> o Expand <#>Printed page number: 31CHAPTER 3 Law and the Legal System </books/9781284021646/pages/163742961> + Printed page number: 31LEARNING OBJECTIVES </books/9781284021646/pages/163742961> + Printed page number: 32INTRODUCTION </books/9781284021646/pages/163742962> + Printed page number: 32THE ROLE OF LAW </books/9781284021646/pages/163742963> + Expand <#>Printed page number: 33THE DEFINITION AND SOURCES OF LAW </books/9781284021646/pages/163742964> # Printed page number: 33Defining ?Law? </books/9781284021646/pages/163742964> # Expand <#>Printed page number: 33Sources of Law </books/9781284021646/pages/163742964> * Printed page number: 34Constitutions </books/9781284021646/pages/163742965> * Printed page number: 35Statutes </books/9781284021646/pages/163742966>
  • 18. * Printed page number: 35Administrative Regulations </books/9781284021646/pages/163742967> * Printed page number: 36Common Law </books/9781284021646/pages/163742968> + Expand <#>Printed page number: 37KEY FEATURES OF THE LEGAL SYSTEM </books/9781284021646/pages/163742969> # Printed page number: 37Separation of Powers </books/9781284021646/pages/163742969> # Printed page number: 38Federalism: Allocation of Federal and State Legal Authority </books/9781284021646/pages/163742970> # Expand <#>Printed page number: 40The Role of Courts </books/9781284021646/pages/163742972> * Printed page number: 40Enforcing Legal Rights </books/9781284021646/pages/163742973> * Printed page number: 41Reviewing the Actions of the Political Branches </books/9781284021646/pages/163742974> * Printed page number: 43Maintaining Stability in the Law </books/9781284021646/pages/163742976> +
  • 19. Printed page number: 44CONCLUSION </books/9781284021646/pages/163742978> + Printed page number: 44REFERENCES </books/9781284021646/pages/163742978> + Printed page number: 44ENDNOTES </books/9781284021646/pages/163742979> o Expand <#>Printed page number: 45CHAPTER 4 Overview of the United States Healthcare System </books/9781284021646/pages/163742980> + Printed page number: 45LEARNING OBJECTIVES </books/9781284021646/pages/163742980> + Printed page number: 45INTRODUCTION </books/9781284021646/pages/163742980> + Expand <#>Printed page number: 47HEALTHCARE FINANCE </books/9781284021646/pages/163742982> # Printed page number: 47Health Insurance </books/9781284021646/pages/163742982> # Printed page number: 49Direct Services Programs </books/9781284021646/pages/163742984> + Expand <#>Printed page number: 50HEALTHCARE ACCESS </books/9781284021646/pages/163742985> # Expand <#>Printed page number: 50The Uninsured </books/9781284021646/pages/163742985>
  • 20. * Expand <#>Printed page number: 50Characteristics of the Uninsured </books/9781284021646/pages/163742985> o Printed page number: 50Income Level </books/9781284021646/pages/163742985> o Printed page number: 51Employment Status </books/9781284021646/pages/163742986> o Printed page number: 51Age </books/9781284021646/pages/163742986> o Printed page number: 52Education Level </books/9781284021646/pages/163742987> o Printed page number: 52Race, Ethnicity, and Immigrant Status </books/9781284021646/pages/163742987> o Printed page number: 53Gender </books/9781284021646/pages/163742988> o Expand <#>Printed page number: 53Geography </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-1 Discussion Questions </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-2 Discussion Questions </books/9781284021646/pages/163742988> *
  • 21. Printed page number: 54The Importance of Health Insurance Coverage to Health Status </books/9781284021646/pages/163742989> * Printed page number: 54Ways to Assess the Cost of Being Uninsured </books/9781284021646/pages/163742990> # Printed page number: 54The Underinsured </books/9781284021646/pages/163742990> # Printed page number: 55Insurance Coverage Limitations </books/9781284021646/pages/163742991> # Printed page number: 57Safety Net Providers </books/9781284021646/pages/163742993> # Expand <#>Printed page number: 58Workforce Issues </books/9781284021646/pages/163742995> * Printed page number: 58BOX 4-3 Discussion Questions </books/9781284021646/pages/163742995> * Printed page number: 61BOX 4-4 Discussion Questions </books/9781284021646/pages/163742998> + Expand <#>Printed page number: 62HEALTHCARE QUALITY </books/9781284021646/pages/163742999> # Printed page number: 63BOX 4-5 Discussion
  • 22. Questions </books/9781284021646/pages/163743000> + Expand <#>Printed page number: 64COMPARATIVE HEALTH SYSTEMS </books/9781284021646/pages/163743002> # Printed page number: 65A National Health Insurance System: Canada </books/9781284021646/pages/163743003> # Printed page number: 67A National Health System: Great Britain </books/9781284021646/pages/163743005> # Expand <#>Printed page number: 67A Socialized Insurance System: Germany </books/9781284021646/pages/163743005> * Printed page number: 67BOX 4-6 Discussion Questions </books/9781284021646/pages/163743006> # Printed page number: 67The Importance of Health Insurance Design </books/9781284021646/pages/163743006> + Printed page number: 70CONCLUSION </books/9781284021646/pages/163743008> + Printed page number: 72REFERENCES </books/9781284021646/pages/163743009> o Expand <#>Printed page number: 73CHAPTER 5 Public Health
  • 23. Institutions and Systems </books/9781284021646/pages/163743010> + Printed page number: 73LEARNING OBJECTIVES </books/9781284021646/pages/163743010> + Printed page number: 74WHAT ARE THE GOALS AND ROLES OF GOVERNMENTAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743011> + Printed page number: 75WHAT ARE THE TEN ESSENTIAL PUBLIC HEALTH SERVICES? </books/9781284021646/pages/163743012> + Expand <#>Printed page number: 77WHAT ARE THE ROLES OF LOCAL AND STATE PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743013> # Printed page number: 78BOX 5-1 Brief History of American Public Health Agencies </books/9781284021646/pages/163743014> + Printed page number: 79WHAT ARE THE ROLES OF FEDERAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743015> + Printed page number: 80WHAT ARE THE ROLES OF GLOBAL HEALTH ORGANIZATIONS AND AGENCIES? </books/9781284021646/pages/163743016> +
  • 24. Printed page number: 82HOW CAN PUBLIC HEALTH AGENCIES WORK TOGETHER? </books/9781284021646/pages/163743017> + Expand <#>Printed page number: 83WHAT OTHER GOVERNMENT AGENCIES ARE INVOLVED IN HEALTH ISSUES? </books/9781284021646/pages/163743018> # Printed page number: 83BOX 5-3 SARS and the Public Health Response </books/9781284021646/pages/163743018> + Printed page number: 84WHAT ROLES DO NONGOVERNMENTAL ORGANIZATIONS PLAY IN PUBLIC HEALTH? </books/9781284021646/pages/163743019> + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH AGENCIES PARTNER WITH HEALTH CARE TO IMPROVE THE RESPONSE TO HEALTH PROBLEMS? </books/9781284021646/pages/163743020> # Printed page number: 85BOX 5-4 National Vaccine Plan </books/9781284021646/pages/163743020> + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH TAKE THE LEAD IN MOBILIZING COMMUNITY PARTNERSHIPS TO IDENTIFY AND SOLVE HEALT
  • 25. </books/9781284021646/pages/163743021> # Printed page number: 85BOX 5-5 Community Oriented Primary Care (COPC) </books/9781284021646/pages/163743021> # Printed page number: 87BOX 5-6 Child Oral Health and Community Oriented Public Health (COPH) </books/9781284021646/pages/163743023> # Printed page number: 87Discussion Questions </books/9781284021646/pages/163743024> + Printed page number: 89REFERENCES </books/9781284021646/pages/163743025> + Printed page number: 89ENDNOTES </books/9781284021646/pages/163743025> + Printed page number: 89PART I ADDENDUM: Historical Contextual Timeline of Important Events in Health Policy and Law </books/9781284021646/pages/163743025> + Printed page number: 102PART I ADDENDUM REFERENCES </books/9781284021646/pages/163743037> * Expand <#>Printed page number: Part II Essential Issues in Health Policy and Law </books/9781284021646/pages/163743038> o Expand <#>Printed page number: 105CHAPTER 6
  • 26. Individual Rights in Health Care and Public Health </books/9781284021646/pages/163743039> + Printed page number: 105LEARNING OBJECTIVES </books/9781284021646/pages/163743039> + Printed page number: 105BOX 6-1 Vignette </books/9781284021646/pages/163743039> + Printed page number: 106INTRODUCTION </books/9781284021646/pages/163743040> + Printed page number: 106BACKGROUND </books/9781284021646/pages/163743040> + Expand <#>Printed page number: 108INDIVIDUAL RIGHTS AND HEALTH CARE: A GLOBAL PERSPECTIVE </books/9781284021646/pages/163743043> # Printed page number: 109BOX 6-2 Discussion Question </books/9781284021646/pages/163743044> + Expand <#>Printed page number: 109INDIVIDUAL RIGHTS AND THE HEALTHCARE SYSTEM </books/9781284021646/pages/163743044> # Expand <#>Printed page number: 109Rights Under Healthcare and Health Financing Laws </books/9781284021646/pages/163743045> * Printed page number: 110Rights Under Health Care
  • 27. Laws: Examination and Treatment for Emergency Medical Conditions and Women </books/9781284021646/pages/163743046> * Printed page number: 111Rights Under Healthcare Financing Laws: Medicaid </books/9781284021646/pages/163743047> * Printed page number: 111Rights Under Health Insurance Laws: The Affordable Care Act </books/9781284021646/pages/163743047> # Expand <#>Printed page number: 111Rights Related to Freedom of Choice and Freedom from Government Interference </books/9781284021646/pages/163743048> * Printed page number: 111The Right to Make Informed Healthcare Decisions </books/9781284021646/pages/163743048> * Expand <#>Printed page number: 112The Right to Personal Privacy </books/9781284021646/pages/163743049> o Printed page number: 113BOX 6-3 Discussion Questions </books/9781284021646/pages/163743050> o Printed page number: 113The Roe v. Wade Decision </books/9781284021646/pages/163743050> o Printed page number: 114The Planned
  • 28. Parenthood of Southeastern Pennsylvania v. Casey Decision </books/9781284021646/pages/163743052> o Printed page number: 115The Stenberg v. Carhart Decision </books/9781284021646/pages/163743053> o Printed page number: 115Partial Birth Abortion Ban Act of 2003 </books/9781284021646/pages/163743054> o Printed page number: 116The Gonzales v. Carhart Decision </books/9781284021646/pages/163743055> # Expand <#>Printed page number: 116The Right to Be Free from Wrongful Discrimination </books/9781284021646/pages/163743056> * Printed page number: 117BOX 6-4 Discussion Question </books/9781284021646/pages/163743057> * Printed page number: 117Race/Ethnicity Discrimination </books/9781284021646/pages/163743057> * Printed page number: 118Physical and Mental Disability Discrimination </books/9781284021646/pages/163743059> * Printed page number: 119Socioeconomic Status
  • 29. Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Gender Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Age Discrimination </books/9781284021646/pages/163743060> + Expand <#>Printed page number: 120INDIVIDUAL RIGHTS IN A PUBLIC HEALTH CONTEXT </books/9781284021646/pages/163743061> # Printed page number: 120Overview of Police Powers </books/9781284021646/pages/163743061> # Expand <#>Printed page number: 120The Jacobson v. Massachusetts Decision </books/9781284021646/pages/163743062> * Expand <#>Printed page number: 121The ?Negative Constitution? </books/9781284021646/pages/163743063> o Printed page number: 121BOX 6-5 Discussion Question </books/9781284021646/pages/163743063> o Printed page number: 123BOX 6-6 Discussion Questions </books/9781284021646/pages/163743067> + Printed page number: 123CONCLUSION
  • 30. </books/9781284021646/pages/163743067> + Printed page number: 124REFERENCES </books/9781284021646/pages/163743068> + Printed page number: 126ENDNOTES </books/9781284021646/pages/163743069> o Expand <#>Printed page number: 127CHAPTER 7 Understanding Health Insurance </books/9781284021646/pages/163743070> + Printed page number: 127LEARNING OBJECTIVES </books/9781284021646/pages/163743070> + Expand <#>Printed page number: 127INTRODUCTION </books/9781284021646/pages/163743070> # Printed page number: 128BOX 7-1 Vignette </books/9781284021646/pages/163743071> + Expand <#>Printed page number: 129A BRIEF HISTORY OF THE RISE OF HEALTH INSURANCE IN THE UNITED STATES </books/9781284021646/pages/163743072> # Printed page number: 129BOX 7-2 Discussion Questions </books/9781284021646/pages/163743073> + Expand <#>Printed page number: 130HOW HEALTH INSURANCE OPERATES </books/9781284021646/pages/163743074> #
  • 31. Expand <#>Printed page number: 130Basic Terminology </books/9781284021646/pages/163743074> * Printed page number: 131BOX 7-3 Discussion Questions </books/9781284021646/pages/163743075> # Expand <#>Printed page number: 131Uncertainty </books/9781284021646/pages/163743075> * Printed page number: 131BOX 7-4 Discussion Questions </books/9781284021646/pages/163743076> # Printed page number: 131Risk </books/9781284021646/pages/163743076> # Expand <#>Printed page number: 133Setting Premiums </books/9781284021646/pages/163743078> * Printed page number: 133BOX 7-5 Discussion Questions </books/9781284021646/pages/163743079> * Printed page number: 134BOX 7-6 Discussion Questions </books/9781284021646/pages/163743080> * Printed page number: 134BOX 7-7 Discussion Questions </books/9781284021646/pages/163743080> # Printed page number: 135Medical Underwriting </books/9781284021646/pages/163743081>
  • 32. + Expand <#>Printed page number: 136MANAGED CARE </books/9781284021646/pages/163743082> # Expand <#>Printed page number: 137Cost Containment and Utilization Tools </books/9781284021646/pages/163743083> * Printed page number: 137Provider Payment Tools </books/9781284021646/pages/163743083> # Printed page number: 137Utilization Control Tools </books/9781284021646/pages/163743084> # Expand <#>Printed page number: 139Common Managed Care Structures </books/9781284021646/pages/163743087> * Printed page number: 139BOX 7-8 Discussion Questions </books/9781284021646/pages/163743087> * Printed page number: 139Health Maintenance Organizations </books/9781284021646/pages/163743087> * Expand <#>Printed page number: 140Preferred Provider Organizations </books/9781284021646/pages/163743088> o Printed page number: 142BOX 7-9 Discussion Questions
  • 33. </books/9781284021646/pages/163743090> * Printed page number: 142Point-of-Service Plans </books/9781284021646/pages/163743090> # Printed page number: 142The Future of Managed Care </books/9781284021646/pages/163743090> + Printed page number: 143CONCLUSION </books/9781284021646/pages/163743091> + Printed page number: 143REFERENCES </books/9781284021646/pages/163743091> + Printed page number: 143ENDNOTES </books/9781284021646/pages/163743091> o Expand <#>Printed page number: 145CHAPTER 8 Health Economics in a Health Policy Context </books/9781284021646/pages/163743092> + Printed page number: 145LEARNING OBJECTIVES </books/9781284021646/pages/163743092> + Expand <#>Printed page number: 145INTRODUCTION </books/9781284021646/pages/163743092> # Printed page number: 146BOX 8-1 Vignette </books/9781284021646/pages/163743094> + Expand <#>Printed page number: 146HEALTH ECONOMICS DEFINED </books/9781284021646/pages/163743094> #
  • 34. Expand <#>Printed page number: 146How Economists View Decision Making </books/9781284021646/pages/163743094> * Printed page number: 147Utility Analysis </books/9781284021646/pages/163743095> * Printed page number: 148Scarce Resources </books/9781284021646/pages/163743096> # Printed page number: 148How Economists View Health Care </books/9781284021646/pages/163743097> + Expand <#>Printed page number: 148ECONOMIC BASICS: DEMAND </books/9781284021646/pages/163743097> # Expand <#>Printed page number: 148Demand Changers </books/9781284021646/pages/163743097> * Printed page number: 149BOX 8-2 Discussion Questions </books/9781284021646/pages/163743098> # Expand <#>Printed page number: 150Elasticity </books/9781284021646/pages/163743099> * Printed page number: 150Demand Elasticity </books/9781284021646/pages/163743099> * Printed page number: 151Supply Elasticity </books/9781284021646/pages/163743100> #
  • 35. Printed page number: 151Health Insurance and Demand </books/9781284021646/pages/163743100> + Expand <#>Printed page number: 151ECONOMIC BASICS: SUPPLY </books/9781284021646/pages/163743101> # Printed page number: 152Costs </books/9781284021646/pages/163743102> # Printed page number: 152Supply Changers </books/9781284021646/pages/163743102> # Printed page number: 153Profit Maximization </books/9781284021646/pages/163743103> # Printed page number: 154Health Insurance and Supply </books/9781284021646/pages/163743104> + Expand <#>Printed page number: 154ECONOMIC BASICS: MARKETS </books/9781284021646/pages/163743104> # Printed page number: 154Health Insurance and Markets </books/9781284021646/pages/163743104> # Printed page number: 154Market Structure </books/9781284021646/pages/163743105> # Expand <#>Printed page number: 155Market Failure </books/9781284021646/pages/163743106> * Printed page number: 155Public Goods
  • 36. </books/9781284021646/pages/163743106> * Printed page number: 156Externalities </books/9781284021646/pages/163743107> * Expand <#>Printed page number: 157Government Intervention </books/9781284021646/pages/163743108> o Printed page number: 157Government Finances or Directly Provides Public Goods. </books/9781284021646/pages/163743108> o Printed page number: 157Government Increases Taxes, Tax Deductions, or Subsidies. </books/9781284021646/pages/163743108> o Printed page number: 157Government Issues Regulatory Mandates. </books/9781284021646/pages/163743109> o Expand <#>Printed page number: 157Government Prohibitions. </books/9781284021646/pages/163743109> + Printed page number: 158BOX 8-3 Discussion Questions </books/9781284021646/pages/163743110> o Printed page number: 158Redistribution of Income. </books/9781284021646/pages/163743110> +
  • 37. Printed page number: 158CONCLUSION </books/9781284021646/pages/163743110> + Printed page number: 158REFERENCES </books/9781284021646/pages/163743111> + Printed page number: 158ENDNOTES </books/9781284021646/pages/163743111> o Expand <#>Printed page number: 159CHAPTER 9 Health Reform in the United States </books/9781284021646/pages/163743112> + Printed page number: 159LEARNING OBJECTIVES </books/9781284021646/pages/163743112> + Printed page number: 159VIGNETTE </books/9781284021646/pages/163743112> + Printed page number: 160INTRODUCTION </books/9781284021646/pages/163743113> + Expand <#>Printed page number: 160DIFFICULTY OF HEALTH REFORM IN THE UNITED STATES </books/9781284021646/pages/163743113> # Printed page number: 161Culture </books/9781284021646/pages/163743114> # Printed page number: 161U.S. Political System </books/9781284021646/pages/163743114> # Printed page number: 162Interest Groups </books/9781284021646/pages/163743116> #
  • 38. Printed page number: 162Path Dependency </books/9781284021646/pages/163743116> + Printed page number: 163UNSUCCESSFUL ATTEMPTS TO PASS NATIONAL HEALTH REFORM </books/9781284021646/pages/163743117> + Expand <#>Printed page number: 165WHY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT PASSED </books/9781284021646/pages/163743120> # Printed page number: 166Commitment and Leadership </books/9781284021646/pages/163743121> # Printed page number: 167Lessons from Failed Health Reform Efforts </books/9781284021646/pages/163743123> # Printed page number: 170Political Pragmatism </books/9781284021646/pages/163743126> + Expand <#>Printed page number: 170PATIENT PROTECTION AND AFFORDABLE CARE ACT </books/9781284021646/pages/163743126> # Printed page number: 170Individual Mandate </books/9781284021646/pages/163743127> # Expand <#>Printed page number: 171State Health Insurance Exchanges </books/9781284021646/pages/163743128>
  • 39. * Printed page number: 171BOX 9-1 Discussion Questions </books/9781284021646/pages/163743128> # Expand <#>Printed page number: 173Premium and Cost-Sharing Subsidies </books/9781284021646/pages/163743132> * Printed page number: 173BOX 9-2 Discussion Questions </books/9781284021646/pages/163743132> # Expand <#>Printed page number: 174Employer Mandate </books/9781284021646/pages/163743134> * Printed page number: 174BOX 9-3 Discussion Questions </books/9781284021646/pages/163743136> # Printed page number: 174Changes to the Private Insurance Market </books/9781284021646/pages/163743136> # Expand <#>Printed page number: 176Financing Health Reform </books/9781284021646/pages/163743139> * Printed page number: 177BOX 9-4 Discussion Questions </books/9781284021646/pages/163743140> # Expand <#>Printed page number: 177Public Health, Workforce, Prevention, and Quality </books/9781284021646/pages/163743141>
  • 40. * Printed page number: 177BOX 9-5 Discussion Questions </books/9781284021646/pages/163743141> # Printed page number: 179States and Health Reform </books/9781284021646/pages/163743142> + Printed page number: 179CONClUSION </books/9781284021646/pages/163743142> + Printed page number: 181REFERENCES </books/9781284021646/pages/163743143> + Printed page number: 182ENDNOTES </books/9781284021646/pages/163743144> o Expand <#>Printed page number: 183CHAPTER 10 Government Health Insurance Programs: Medicaid, CHIP, and Medicare </books/9781284021646/pages/163743145> + Printed page number: 183LEARNING OBJECTIVES </books/9781284021646/pages/163743145> + Expand <#>Printed page number: 184INTRODUCTION </books/9781284021646/pages/163743146> # Printed page number: 184BOX 10-1 Vignette </books/9781284021646/pages/163743146> # Printed page number: 185BOX 10-2 Discussion Questions </books/9781284021646/pages/163743148> + Expand <#>Printed page number: 185MEDICAID
  • 41. </books/9781284021646/pages/163743148> # Expand <#>Printed page number: 185Program Administration </books/9781284021646/pages/163743148> * Printed page number: 186BOX 10-3 Discussion Questions </books/9781284021646/pages/163743149> # Expand <#>Printed page number: 186Eligibility </books/9781284021646/pages/163743149> * Printed page number: 186BOX 10-4 Federal Poverty Level </books/9781284021646/pages/163743150> * Printed page number: 187Eligibility Requirements </books/9781284021646/pages/163743151> * Expand <#>Printed page number: 188Medically Needy </books/9781284021646/pages/163743152> o Printed page number: 189BOX 10-5 Discussion Questions </books/9781284021646/pages/163743153> * Printed page number: 189Immigrants </books/9781284021646/pages/163743153> # Expand <#>Printed page number: 189Medicaid Eligibility Expansion Under the Affordable Care Act </books/9781284021646/pages/163743154> *
  • 42. Printed page number: 189BOX 10-6 Discussion Questions </books/9781284021646/pages/163743154> * Printed page number: 190BOX 10-7 Discussion Questions </books/9781284021646/pages/163743155> # Expand <#>Printed page number: 190Benefits </books/9781284021646/pages/163743155> * Printed page number: 192BOX 10-8 DRA Benefit Options </books/9781284021646/pages/163743158> # Expand <#>Printed page number: 192Amount, Duration, and Scope, and Reasonableness Requirements </books/9781284021646/pages/163743159> * Printed page number: 192BOX 10-9 Idaho Implementation of DRA25 </books/9781284021646/pages/163743159> # Expand <#>Printed page number: 193Medicaid Spending </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-10 Discussion Questions </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-11 Discussion Questions </books/9781284021646/pages/163743160> #
  • 43. Expand <#>Printed page number: 194Medicaid Financing </books/9781284021646/pages/163743162> * Printed page number: 195BOX 10-12 Discussion Questions </books/9781284021646/pages/163743163> * Printed page number: 196BOX 10-13 Discussion Questions </books/9781284021646/pages/163743164> # Expand <#>Printed page number: 196Medicaid Provider Reimbursement </books/9781284021646/pages/163743165> * Printed page number: 196Fee-for-Service Reimbursement </books/9781284021646/pages/163743165> * Expand <#>Printed page number: 196Managed Care Reimbursement </books/9781284021646/pages/163743165> o Printed page number: 197BOX 10-14 Discussion Questions </books/9781284021646/pages/163743166> o Printed page number: 197BOX 10-15 Discussion Questions </books/9781284021646/pages/163743166> #
  • 44. Printed page number: 197Medicaid Waivers </books/9781284021646/pages/163743167> # Expand <#>Printed page number: 198The Future of Medicaid </books/9781284021646/pages/163743168> * Printed page number: 198BOX 10-16 Discussion Questions </books/9781284021646/pages/163743168> + Expand <#>Printed page number: 198STATE CHILDREN?S HEALTH INSURANCE PROGRAM </books/9781284021646/pages/163743168> # Printed page number: 199CHIP Structure and Financing </books/9781284021646/pages/163743169> # Expand <#>Printed page number: 199CHIP Eligibility </books/9781284021646/pages/163743170> * Printed page number: 199BOX 10-17 Discussion Questions </books/9781284021646/pages/163743170> # Expand <#>Printed page number: 200CHIP Benefits and Beneficiary Safeguards </books/9781284021646/pages/163743171> * Printed page number: 201BOX 10-18 Discussion Questions </books/9781284021646/pages/163743172>
  • 45. # Printed page number: 201CHIP and Private Insurance Coverage </books/9781284021646/pages/163743172> # Printed page number: 201CHIP Waivers </books/9781284021646/pages/163743173> # Printed page number: 201The Future of CHIP </books/9781284021646/pages/163743173> + Expand <#>Printed page number: 201MEDICARE </books/9781284021646/pages/163743173> # Printed page number: 202BOX 10-19 Discussion Questions </books/9781284021646/pages/163743174> # Printed page number: 202Medicare Eligibility </books/9781284021646/pages/163743174> # Printed page number: 202Medicare Benefits </books/9781284021646/pages/163743174> # Expand <#>Printed page number: 204Medicare Spending </books/9781284021646/pages/163743177> * Printed page number: 205BOX 10-20 Discussion Questions </books/9781284021646/pages/163743178> # Printed page number: 205Medicare Financing </books/9781284021646/pages/163743178> # Expand <#>Printed page number: 207Medicare
  • 46. Provider Reimbursement </books/9781284021646/pages/163743181> * Expand <#>Printed page number: 208Physician Reimbursement </books/9781284021646/pages/163743182> o Printed page number: 208BOX 10-21 Discussion Questions </books/9781284021646/pages/163743182> o Printed page number: 209BOX 10-22 Discussion Questions </books/9781284021646/pages/163743183> * Printed page number: 209Hospital Reimbursement </books/9781284021646/pages/163743183> * Printed page number: 209Medicare Advantage Reimbursement </books/9781284021646/pages/163743184> + Printed page number: 209CONCLUSION </books/9781284021646/pages/163743184> + Printed page number: 210REFERENCES </books/9781284021646/pages/163743185> + Printed page number: 212ENDNOTES </books/9781284021646/pages/163743186> o Expand <#>Printed page number: 213CHAPTER 11 Healthcare Quality
  • 47. Policy and Law </books/9781284021646/pages/163743187> + Printed page number: 213LEARNING OBJECTIVES </books/9781284021646/pages/163743187> + Printed page number: 213BOX 11-1 Vignette </books/9781284021646/pages/163743187> + Printed page number: 214INTRODUCTION </books/9781284021646/pages/163743188> + Printed page number: 215QUALITY CONTROL THROUGH LICENSURE AND ACCREDITATION </books/9781284021646/pages/163743189> + Expand <#>Printed page number: 216MEDICAL ERRORS AS A PUBLIC HEALTH CONCERN </books/9781284021646/pages/163743190> # Printed page number: 216BOX 11-2 Discussion Questions </books/9781284021646/pages/163743191> + Expand <#>Printed page number: 217PROMOTING HEALTHCARE QUALITY THROUGH THE STANDARD OF CARE </books/9781284021646/pages/163743192> # Printed page number: 217The Origins of the Standard of Care </books/9781284021646/pages/163743192> # Expand <#>Printed page number: 218The Evolution
  • 48. of the Standard of Care </books/9781284021646/pages/163743193> * Printed page number: 218The Professional Custom Rule </books/9781284021646/pages/163743193> * Expand <#>Printed page number: 218The Locality Rule </books/9781284021646/pages/163743194> o Printed page number: 220BOX 11-3 Discussion Questions </books/9781284021646/pages/163743196> + Expand <#>Printed page number: 220TORT LIABILITY OF HOSPITALS, INSURERS, AND MANAGED CARE ORGANIZATIONS </books/9781284021646/pages/163743196> # Expand <#>Printed page number: 220Hospital Liability </books/9781284021646/pages/163743196> * Printed page number: 220Vicarious Liability </books/9781284021646/pages/163743196> * Printed page number: 221Corporate Liability </books/9781284021646/pages/163743198> # Printed page number: 221Insurer Liability </books/9781284021646/pages/163743198> # Expand <#>Printed page number: 222Managed Care
  • 49. Liability </books/9781284021646/pages/163743199> * Printed page number: 222BOX 11-4 Discussion Questions </books/9781284021646/pages/163743200> + Expand <#>Printed page number: 222FEDERAL PREEMPTION OF STATE LIABILITY LAWS UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT </books/9781284021646/pages/163743200> # Printed page number: 222Overview of ERISA </books/9781284021646/pages/163743200> # Printed page number: 224ERISA Preemption </books/9781284021646/pages/163743202> # Expand <#>Printed page number: 225The Intersection of ERISA Preemption and Managed Care Professional Medical Liability </books/9781284021646/pages/163743203> * Printed page number: 226BOX 11-5 Discussion Questions </books/9781284021646/pages/163743205> + Expand <#>Printed page number: 226MEASURING AND INCENTIVIZING HEALTHCARE QUALITYg </books/9781284021646/pages/163743205> # Printed page number: 227Quality Measure
  • 50. Development </books/9781284021646/pages/163743206> # Printed page number: 228Quality Measurement </books/9781284021646/pages/163743207> # Printed page number: 228Public Reporting </books/9781284021646/pages/163743207> # Printed page number: 228Value-Based Purchasing </books/9781284021646/pages/163743207> # Printed page number: 228National Quality Strategy </books/9781284021646/pages/163743208> + Printed page number: 230CONCLUSION </books/9781284021646/pages/163743210> + Printed page number: 230REFERENCES </books/9781284021646/pages/163743210> + Printed page number: 230ENDNOTES </books/9781284021646/pages/163743211> o Expand <#>Printed page number: 231CHAPTER 12 Public Health Preparedness Policy </books/9781284021646/pages/163743212> + Printed page number: 231LEARNING OBJECTIVES </books/9781284021646/pages/163743212> + Printed page number: 231INTRODUCTION </books/9781284021646/pages/163743212> + Expand <#>Printed page number: 232DEFINING
  • 51. PUBLIC HEALTH PREPAREDNESS </books/9781284021646/pages/163743213> # Expand <#>Printed page number: 233Threats to Public Health </books/9781284021646/pages/163743215> * Printed page number: 233BOX 12-1 Discussion Questions </books/9781284021646/pages/163743215> * Expand <#>Printed page number: 233Chemical, Biological, Radiological, and Nuclear Agents </books/9781284021646/pages/163743215> o Expand <#>Printed page number: 233Chemical Agents </books/9781284021646/pages/163743215> + Printed page number: 233BOX 12-2 Types of Chemical Agents </books/9781284021646/pages/163743216> o Expand <#>Printed page number: 234Biological Agents </books/9781284021646/pages/163743217> + Printed page number: 234BOX 12-3 Examples of Chemical Agents Impacting Public Health </books/9781284021646/pages/163743217> + Printed page number: 234BOX 12-4 Biological Agents in Nature
  • 52. </books/9781284021646/pages/163743218> + Printed page number: 235BOX 12-5 Category A, B, and C Biological Threat Agents </books/9781284021646/pages/163743219> o Expand <#>Printed page number: 236Radiological and Nuclear Agents </books/9781284021646/pages/163743224> + Printed page number: 236BOX 12-6 Anthrax Event in Sverdlovsk </books/9781284021646/pages/163743225> * Expand <#>Printed page number: 237Naturally-Occurring Disease Threats </books/9781284021646/pages/163743226> o Printed page number: 237BOX 12-7 Chernobyl Nuclear Power Plant Accident </books/9781284021646/pages/163743226> o Printed page number: 238BOX 12-8 National Security Strategy: The Threat of Naturally Occurring Disease </books/9781284021646/pages/163743227> o Printed page number: 238BOX 12-9 Discussion Question </books/9781284021646/pages/163743228> * Expand <#>Printed page number: 238Natural Disasters </books/9781284021646/pages/163743228>
  • 53. o Printed page number: 239BOX 12-10 Hurricane Katrina and the Public Health Response </books/9781284021646/pages/163743229> * Expand <#>Printed page number: 240Manmade Environmental Disasters </books/9781284021646/pages/163743230> o Printed page number: 240BOX 12-11 Discussion Questions </books/9781284021646/pages/163743230> + Expand <#>Printed page number: 240PUBLIC HEALTH PREPAREDNESS POLICY </books/9781284021646/pages/163743230> # Expand <#>Printed page number: 241Department of Health and Human Services (HHS) </books/9781284021646/pages/163743231> * Printed page number: 241Office of the Assistant Secretary for Preparedness and Response </books/9781284021646/pages/163743231> * Printed page number: 241Centers for Disease Control and Prevention </books/9781284021646/pages/163743231> * Printed page number: 241National Institutes of Health </books/9781284021646/pages/163743231> *
  • 54. Printed page number: 241The Food and Drug Administration </books/9781284021646/pages/163743231> # Printed page number: 242Department of Agriculture </books/9781284021646/pages/163743232> # Printed page number: 242Department of Justice, Federal Bureau of Investigation </books/9781284021646/pages/163743232> # Printed page number: 242Department of Defense </books/9781284021646/pages/163743232> # Expand <#>Printed page number: 242Preparedness Statutes, Regulations, and Policy Guidance </books/9781284021646/pages/163743232> * Printed page number: 242Public Health Improvement Act of 2000 (Public Law 106-505) </books/9781284021646/pages/163743233> * Printed page number: 242USA PATRIOT Act of 2001 (Public Law 107-56) </books/9781284021646/pages/163743233> * Printed page number: 242Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (Public Law 107-188) </books/9781284021646/pages/163743233>
  • 55. * Printed page number: 243Smallpox Emergency Personnel Protection Act of 2003 (Public Law 108-20) </books/9781284021646/pages/163743234> * Printed page number: 243The Project Bioshield Act of 2004 (Public Law 108-276) </books/9781284021646/pages/163743234> * Printed page number: 243Public Readiness and Emergency Preparedness (PREP) Act of 2005 (Division C of the Department of Defe </books/9781284021646/pages/163743234> * Expand <#>Printed page number: 243Pandemic and All-Hazards Preparedness Act of 2006 (Public Law 109-417) </books/9781284021646/pages/163743234> o Printed page number: 244BOX 12-12 Discussion Question </books/9781284021646/pages/163743235> * Printed page number: 244Implementing Recommendations of the 9/11 Commission Act of 2007 (Public Law 110-53) </books/9781284021646/pages/163743235> * Printed page number: 244Biodefense for the 21st
  • 56. Century: National Security Presidential Directive 33/Homeland Security Presi </books/9781284021646/pages/163743235> * Printed page number: 244Medical Countermeasures Against Weapons of Mass Destruction: Homeland Security Presidential Directiv </books/9781284021646/pages/163743235> * Printed page number: 244Public Health and Medical Preparedness: Homeland Security Presidential Directive 21. October 2007 </books/9781284021646/pages/163743236> * Printed page number: 244Establishing Federal Capability for the Timely Provision of Medical Countermeasures Following a Biol </books/9781284021646/pages/163743236> * Printed page number: 244National Strategy for Countering Biological Threats, Presidential Policy Directive 2. November 2009 </books/9781284021646/pages/163743236> * Expand <#>Printed page number: 245National Preparedness Presidential Policy Directive 8. March 2011 </books/9781284021646/pages/163743237> o Printed page number: 246BOX 12-13 Discussion Questions </books/9781284021646/pages/163743238> +
  • 57. Printed page number: 246PUBLIC HEALTH PREPAREDNESS FEDERALISM </books/9781284021646/pages/163743238> + Expand <#>Printed page number: 246CONCLUSION </books/9781284021646/pages/163743239> # Printed page number: 247BOX 12-14 Discussion Question </books/9781284021646/pages/163743240> + Printed page number: 247REFERENCES </books/9781284021646/pages/163743240> + Printed page number: 248ENDNOTES </books/9781284021646/pages/163743241> * Expand <#>Printed page number: Part III Basic Skills in Health Policy Analysis </books/9781284021646/pages/163743242> o Expand <#>Printed page number: 251CHAPTER 13 The Art of Structuring and Writing a Health Policy Analysis </books/9781284021646/pages/163743243> + Printed page number: 251LEARNING OBJECTIVES </books/9781284021646/pages/163743243> + Printed page number: 251Defining Policy Analysis </books/9781284021646/pages/163743243> + Printed page number: 251INTRODUCTION </books/9781284021646/pages/163743243> +
  • 58. Expand <#>Printed page number: 252POLICY ANALYSIS OVERVIEW </books/9781284021646/pages/163743244> # Printed page number: 253Multiple Purposes </books/9781284021646/pages/163743246> + Expand <#>Printed page number: 253STRUCTURING A POLICY ANALYSIS </books/9781284021646/pages/163743246> # Expand <#>Printed page number: 254The Problem Statement </books/9781284021646/pages/163743247> * Printed page number: 255Make the Problem Statement Analytically Manageable </books/9781284021646/pages/163743248> * Printed page number: 256Do Not Include the Recommendation in Your Problem Statement </books/9781284021646/pages/163743249> # Printed page number: 256The Background Section </books/9781284021646/pages/163743250> # Expand <#>Printed page number: 257The Landscape Section </books/9781284021646/pages/163743251> * Printed page number: 257Identifying Key Stakeholders </books/9781284021646/pages/163743251> * Printed page number: 257Identifying Key Factors
  • 59. </books/9781284021646/pages/163743252> * Expand <#>Printed page number: 258Writing Structure </books/9781284021646/pages/163743253> o Printed page number: 258BOX 13-1 Possible Factors to Include in a Landscape Section </books/9781284021646/pages/163743253> # Expand <#>Printed page number: 259The Options Section </books/9781284021646/pages/163743255> * Printed page number: 259Identifying Options </books/9781284021646/pages/163743255> * Expand <#>Printed page number: 260Assessing Your Options </books/9781284021646/pages/163743256> o Printed page number: 261BOX 13-2 Sample Options Criteria </books/9781284021646/pages/163743257> * Printed page number: 261Writing Structure </books/9781284021646/pages/163743257> * Printed page number: 261Side-by-Side Tables </books/9781284021646/pages/163743258> # Expand <#>Printed page number: 262The Recommendation Section </books/9781284021646/pages/163743259>
  • 60. * Printed page number: 262BOX 13-3 Checklist for Writing a Policy Analysis </books/9781284021646/pages/163743259> + Printed page number: 263CONCLUSION </books/9781284021646/pages/163743260> + Printed page number: 263REFERENCES </books/9781284021646/pages/163743260> * Expand <#>Printed page number: Back Matter </books/9781284021646/pages/163743261> o Printed page number: 265Glossary </books/9781284021646/pages/163743262> o Printed page number: 271Index </books/9781284021646/pages/163743263> <#resize-toc> CHAPTER 6 Individual Rights in Health Care and Public Health Previous Page <https://online.vitalsource.com/books/9781284021646/pages/16 3743045> CHAPTER 6 Individual Rights in Health Care and Public Health <#> Next Page
  • 61. <https://online.vitalsource.com/books/9781284021646/pages/16 3743047> Loading */Rights Under Health Care Laws: Examination and Treatment for Emergency Medical Conditions and Women in Labor Act/ * Because EMTALA represents the only truly universal legal right to health care in this countryâ��the right to access emergency hospital servicesâ��it is often described as one of the building blocks of health rights. EMTALA was enacted by Congress in 1986 to prevent the practice of â��patient dumpingâ��â��that is, the turning away of poor or uninsured persons in need of hospital care. Patient dumping was a common strategy among private hospitals aiming to shield themselves from the potentially uncompensated costs associated with treating poor and/or uninsured patients. By refusing to treat these individuals and instead â��dumpingâ�� them on public hospitals, private institutions were effectively limiting their patients to those whose treatment costs would likely be covered out-of-pocket or by insurers. Note that the no-duty principle made this type of strategy possible. EMTALA was a conscious effort on the part of elected federal
  • 62. officials to chip away at the no-duty principle: By creating legally enforceable rights to emergency hospital care for all individuals regardless of their income or health insurance status, Congress created a corresponding legal /duty/ of care on the part of hospitals. At its core, EMTALA includes two related duties, which technically attach only to hospitals that participate in the Medicare program (but then again, nearly every hospital in the country participates). The first duty requires covered hospitals to provide an â��appropriateâ�� screening examination to all individuals who present at a hospitalâ��s emergency department seeking care for an â��emergency medical condition.â�� Under the law, an appropriate medical 109110screening is one that is nondiscriminatory and that adheres to a hospitalâ��s established emergency care guidelines. EMTALA defines an emergency medical condition as a * medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in (i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, (ii) serious impairment to bodily functions, or (iii) serious dysfunction of any bodily organ or part; or with
  • 63. respect to a pregnant woman who is having contractions, that there is inadequate time to effect a safe transfer to another hospital before delivery, or that transfer may pose a threat to the health or safety of the woman or the unborn child.^20 </books/9781284021646/content/id/ch06bib20> Page Goto the specified printed page number Print Activate the following button to retrieve the URL to cite or link to this pageCite/Link PRINTED BY: [email protected] Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. Bookshelf </> Essentials of Health Policy & Law, 2nd Edition Shop <http://store.vitalsource.com/> * User Info </user/edit?page=info> * Device Activations </user/edit?page=activations> * Resources </user/edit?page=resources> * Print on Demand </user/edit?page=pod> * Settings </user/edit?page=settings> * Privacy <http://bookshelf.vitalsource.com/privacy-policy> * Support <http://support.vitalsource.com> * Sign Out </signout>
  • 64. Book <#choose-search> * Book <https://online.vitalsource.com/search/9781284021646> * Figures <https://online.vitalsource.com/search/9781284021646/figures> * Highlights <https://online.vitalsource.com/search/9781284021646/highlight s> Search Search Loading * Contents </books/9781284021646/toc?xhr=true>Tab currently selected * Figures </books/9781284021646/figures?xhr=true> * Highlights </books/9781284021646/highlights> Manage <#manage> * Manage Highlighters </markers> * Manage Subscriptions </subscriptions> * Printed page number: Essentials of Health Policy &amp; Law </books/9781284021646/pages/163742917> * Expand <#>Printed page number: Front Matter </books/9781284021646/pages/163742918> o Printed page number: viiPrologue </books/9781284021646/pages/163742919>
  • 65. o Printed page number: ixPreface </books/9781284021646/pages/163742920> o Printed page number: xiiiAcknowledgments </books/9781284021646/pages/163742921> o Printed page number: xvAbout the Authors </books/9781284021646/pages/163742922> o Printed page number: xviiContributors </books/9781284021646/pages/163742923> * Expand <#>Printed page number: Part I Setting the Stage: An Overview of Health Policy and Law </books/9781284021646/pages/163742924> o Expand <#>Printed page number: 3CHAPTER 1 Understanding the Role of and Conceptualizing Health Policy and Law </books/9781284021646/pages/163742925> + Printed page number: 3LEARNING OBJECTIVES </books/9781284021646/pages/163742925> + Printed page number: 3INTRODUCTION </books/9781284021646/pages/163742925> + Printed page number: 4ROLE OF POLICY AND LAW IN HEALTH CARE AND PUBLIC HEALTH </books/9781284021646/pages/163742926> + Expand <#>Printed page number: 5CONCEPTUALIZING HEALTH
  • 66. POLICY AND LAW </books/9781284021646/pages/163742927> # Printed page number: 5BOX 1-1 Three Conceptual Frameworks for Studying Health Policy and Law </books/9781284021646/pages/163742928> # Expand <#>Printed page number: 6The Three Broad Topical Domains of Health Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Health Care Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Public Health Policy and Law </books/9781284021646/pages/163742929> * Printed page number: 6Bioethics </books/9781284021646/pages/163742929> # Expand <#>Printed page number: 6Social, Political, and Economic Historical Context </books/9781284021646/pages/163742930> * Printed page number: 6Professional Autonomy Perspective </books/9781284021646/pages/163742930> * Printed page number: 6Social Contract Perspective </books/9781284021646/pages/163742930> * Printed page number: 7Free Market Perspective
  • 67. </books/9781284021646/pages/163742931> # Printed page number: 8Key Stakeholders </books/9781284021646/pages/163742932> + Printed page number: 8CONCLUSION </books/9781284021646/pages/163742932> + Printed page number: 9ENDNOTES </books/9781284021646/pages/163742934> o Expand <#>Printed page number: 11CHAPTER 2 Policy and the Policymaking Process </books/9781284021646/pages/163742935> + Printed page number: 11LEARNING OBJECTIVES </books/9781284021646/pages/163742935> + Printed page number: 11INTRODUCTION </books/9781284021646/pages/163742935> + Expand <#>Printed page number: 12DEFINING POLICY </books/9781284021646/pages/163742936> # Printed page number: 12Identifying Public Problems </books/9781284021646/pages/163742936> # Printed page number: 12Structuring Policy Options </books/9781284021646/pages/163742937> + Expand <#>Printed page number: 13PUBLIC POLICYMAKING STRUCTURE AND PROCESS </books/9781284021646/pages/163742938>
  • 68. # Printed page number: 13State-Level Policymaking </books/9781284021646/pages/163742938> # Expand <#>Printed page number: 14The Federal Legislative Branch </books/9781284021646/pages/163742939> * Printed page number: 14Leadership Positions </books/9781284021646/pages/163742939> * Printed page number: 14Committees </books/9781284021646/pages/163742940> * Printed page number: 15Congressional Commissions and Staff Agencies </books/9781284021646/pages/163742941> * Printed page number: 17How Laws Are Made </books/9781284021646/pages/163742945> * Printed page number: 18Congressional Budget and Appropriations Process11,12 </books/9781284021646/pages/163742946> * Printed page number: 19Constituents </books/9781284021646/pages/163742947> # Expand <#>Printed page number: 20The Federal Executive Branch </books/9781284021646/pages/163742948> * Expand <#>Printed page number: 20The Presidency </books/9781284021646/pages/163742949>
  • 69. o Printed page number: 20BOX 2-1 Office of Management and Budget (OMB) </books/9781284021646/pages/163742949> o Printed page number: 21Agenda Setting </books/9781284021646/pages/163742950> o Printed page number: 22Presidential Powers </books/9781284021646/pages/163742951> o Printed page number: 22Constituents </books/9781284021646/pages/163742951> * Expand <#>Printed page number: 23Administrative Agencies </books/9781284021646/pages/163742952> o Printed page number: 23Agency Powers </books/9781284021646/pages/163742953> o Printed page number: 24Constituents </books/9781284021646/pages/163742954> + Expand <#>Printed page number: 24THE HEALTH BUREAUCRACY </books/9781284021646/pages/163742954> # Expand <#>Printed page number: 24The Federal Government </books/9781284021646/pages/163742954> * Printed page number: 24Department of Health and Human Services </books/9781284021646/pages/163742954>
  • 70. * Printed page number: 27Department of Veterans Affairs and Department of Defense </books/9781284021646/pages/163742957> # Printed page number: 27State and Local Governments </books/9781284021646/pages/163742957> + Expand <#>Printed page number: 28INTEREST GROUPS </books/9781284021646/pages/163742958> # Printed page number: 29Interest Group Powers </books/9781284021646/pages/163742959> + Printed page number: 29CONCLUSION </books/9781284021646/pages/163742959> + Printed page number: 29REFERENCES </books/9781284021646/pages/163742959> + Printed page number: 30ENDNOTES </books/9781284021646/pages/163742960> o Expand <#>Printed page number: 31CHAPTER 3 Law and the Legal System </books/9781284021646/pages/163742961> + Printed page number: 31LEARNING OBJECTIVES </books/9781284021646/pages/163742961> + Printed page number: 32INTRODUCTION </books/9781284021646/pages/163742962> + Printed page number: 32THE ROLE OF LAW
  • 71. </books/9781284021646/pages/163742963> + Expand <#>Printed page number: 33THE DEFINITION AND SOURCES OF LAW </books/9781284021646/pages/163742964> # Printed page number: 33Defining ?Law? </books/9781284021646/pages/163742964> # Expand <#>Printed page number: 33Sources of Law </books/9781284021646/pages/163742964> * Printed page number: 34Constitutions </books/9781284021646/pages/163742965> * Printed page number: 35Statutes </books/9781284021646/pages/163742966> * Printed page number: 35Administrative Regulations </books/9781284021646/pages/163742967> * Printed page number: 36Common Law </books/9781284021646/pages/163742968> + Expand <#>Printed page number: 37KEY FEATURES OF THE LEGAL SYSTEM </books/9781284021646/pages/163742969> # Printed page number: 37Separation of Powers </books/9781284021646/pages/163742969> # Printed page number: 38Federalism: Allocation of Federal and State Legal Authority </books/9781284021646/pages/163742970>
  • 72. # Expand <#>Printed page number: 40The Role of Courts </books/9781284021646/pages/163742972> * Printed page number: 40Enforcing Legal Rights </books/9781284021646/pages/163742973> * Printed page number: 41Reviewing the Actions of the Political Branches </books/9781284021646/pages/163742974> * Printed page number: 43Maintaining Stability in the Law </books/9781284021646/pages/163742976> + Printed page number: 44CONCLUSION </books/9781284021646/pages/163742978> + Printed page number: 44REFERENCES </books/9781284021646/pages/163742978> + Printed page number: 44ENDNOTES </books/9781284021646/pages/163742979> o Expand <#>Printed page number: 45CHAPTER 4 Overview of the United States Healthcare System </books/9781284021646/pages/163742980> + Printed page number: 45LEARNING OBJECTIVES </books/9781284021646/pages/163742980> + Printed page number: 45INTRODUCTION </books/9781284021646/pages/163742980>
  • 73. + Expand <#>Printed page number: 47HEALTHCARE FINANCE </books/9781284021646/pages/163742982> # Printed page number: 47Health Insurance </books/9781284021646/pages/163742982> # Printed page number: 49Direct Services Programs </books/9781284021646/pages/163742984> + Expand <#>Printed page number: 50HEALTHCARE ACCESS </books/9781284021646/pages/163742985> # Expand <#>Printed page number: 50The Uninsured </books/9781284021646/pages/163742985> * Expand <#>Printed page number: 50Characteristics of the Uninsured </books/9781284021646/pages/163742985> o Printed page number: 50Income Level </books/9781284021646/pages/163742985> o Printed page number: 51Employment Status </books/9781284021646/pages/163742986> o Printed page number: 51Age </books/9781284021646/pages/163742986> o Printed page number: 52Education Level </books/9781284021646/pages/163742987> o Printed page number: 52Race, Ethnicity, and
  • 74. Immigrant Status </books/9781284021646/pages/163742987> o Printed page number: 53Gender </books/9781284021646/pages/163742988> o Expand <#>Printed page number: 53Geography </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-1 Discussion Questions </books/9781284021646/pages/163742988> + Printed page number: 53BOX 4-2 Discussion Questions </books/9781284021646/pages/163742988> * Printed page number: 54The Importance of Health Insurance Coverage to Health Status </books/9781284021646/pages/163742989> * Printed page number: 54Ways to Assess the Cost of Being Uninsured </books/9781284021646/pages/163742990> # Printed page number: 54The Underinsured </books/9781284021646/pages/163742990> # Printed page number: 55Insurance Coverage Limitations </books/9781284021646/pages/163742991> # Printed page number: 57Safety Net Providers </books/9781284021646/pages/163742993> #
  • 75. Expand <#>Printed page number: 58Workforce Issues </books/9781284021646/pages/163742995> * Printed page number: 58BOX 4-3 Discussion Questions </books/9781284021646/pages/163742995> * Printed page number: 61BOX 4-4 Discussion Questions </books/9781284021646/pages/163742998> + Expand <#>Printed page number: 62HEALTHCARE QUALITY </books/9781284021646/pages/163742999> # Printed page number: 63BOX 4-5 Discussion Questions </books/9781284021646/pages/163743000> + Expand <#>Printed page number: 64COMPARATIVE HEALTH SYSTEMS </books/9781284021646/pages/163743002> # Printed page number: 65A National Health Insurance System: Canada </books/9781284021646/pages/163743003> # Printed page number: 67A National Health System: Great Britain </books/9781284021646/pages/163743005> # Expand <#>Printed page number: 67A Socialized Insurance System: Germany </books/9781284021646/pages/163743005>
  • 76. * Printed page number: 67BOX 4-6 Discussion Questions </books/9781284021646/pages/163743006> # Printed page number: 67The Importance of Health Insurance Design </books/9781284021646/pages/163743006> + Printed page number: 70CONCLUSION </books/9781284021646/pages/163743008> + Printed page number: 72REFERENCES </books/9781284021646/pages/163743009> o Expand <#>Printed page number: 73CHAPTER 5 Public Health Institutions and Systems </books/9781284021646/pages/163743010> + Printed page number: 73LEARNING OBJECTIVES </books/9781284021646/pages/163743010> + Printed page number: 74WHAT ARE THE GOALS AND ROLES OF GOVERNMENTAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743011> + Printed page number: 75WHAT ARE THE TEN ESSENTIAL PUBLIC HEALTH SERVICES? </books/9781284021646/pages/163743012> + Expand <#>Printed page number: 77WHAT ARE THE ROLES OF LOCAL AND STATE PUBLIC HEALTH AGENCIES?
  • 77. </books/9781284021646/pages/163743013> # Printed page number: 78BOX 5-1 Brief History of American Public Health Agencies </books/9781284021646/pages/163743014> + Printed page number: 79WHAT ARE THE ROLES OF FEDERAL PUBLIC HEALTH AGENCIES? </books/9781284021646/pages/163743015> + Printed page number: 80WHAT ARE THE ROLES OF GLOBAL HEALTH ORGANIZATIONS AND AGENCIES? </books/9781284021646/pages/163743016> + Printed page number: 82HOW CAN PUBLIC HEALTH AGENCIES WORK TOGETHER? </books/9781284021646/pages/163743017> + Expand <#>Printed page number: 83WHAT OTHER GOVERNMENT AGENCIES ARE INVOLVED IN HEALTH ISSUES? </books/9781284021646/pages/163743018> # Printed page number: 83BOX 5-3 SARS and the Public Health Response </books/9781284021646/pages/163743018> + Printed page number: 84WHAT ROLES DO NONGOVERNMENTAL ORGANIZATIONS PLAY IN PUBLIC HEALTH? </books/9781284021646/pages/163743019>
  • 78. + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH AGENCIES PARTNER WITH HEALTH CARE TO IMPROVE THE RESPONSE TO HEALTH PROBLEMS? </books/9781284021646/pages/163743020> # Printed page number: 85BOX 5-4 National Vaccine Plan </books/9781284021646/pages/163743020> + Expand <#>Printed page number: 85HOW CAN PUBLIC HEALTH TAKE THE LEAD IN MOBILIZING COMMUNITY PARTNERSHIPS TO IDENTIFY AND SOLVE HEALT </books/9781284021646/pages/163743021> # Printed page number: 85BOX 5-5 Community Oriented Primary Care (COPC) </books/9781284021646/pages/163743021> # Printed page number: 87BOX 5-6 Child Oral Health and Community Oriented Public Health (COPH) </books/9781284021646/pages/163743023> # Printed page number: 87Discussion Questions </books/9781284021646/pages/163743024> + Printed page number: 89REFERENCES </books/9781284021646/pages/163743025> + Printed page number: 89ENDNOTES
  • 79. </books/9781284021646/pages/163743025> + Printed page number: 89PART I ADDENDUM: Historical Contextual Timeline of Important Events in Health Policy and Law </books/9781284021646/pages/163743025> + Printed page number: 102PART I ADDENDUM REFERENCES </books/9781284021646/pages/163743037> * Expand <#>Printed page number: Part II Essential Issues in Health Policy and Law </books/9781284021646/pages/163743038> o Expand <#>Printed page number: 105CHAPTER 6 Individual Rights in Health Care and Public Health </books/9781284021646/pages/163743039> + Printed page number: 105LEARNING OBJECTIVES </books/9781284021646/pages/163743039> + Printed page number: 105BOX 6-1 Vignette </books/9781284021646/pages/163743039> + Printed page number: 106INTRODUCTION </books/9781284021646/pages/163743040> + Printed page number: 106BACKGROUND </books/9781284021646/pages/163743040> + Expand <#>Printed page number: 108INDIVIDUAL RIGHTS AND HEALTH CARE: A GLOBAL PERSPECTIVE
  • 80. </books/9781284021646/pages/163743043> # Printed page number: 109BOX 6-2 Discussion Question </books/9781284021646/pages/163743044> + Expand <#>Printed page number: 109INDIVIDUAL RIGHTS AND THE HEALTHCARE SYSTEM </books/9781284021646/pages/163743044> # Expand <#>Printed page number: 109Rights Under Healthcare and Health Financing Laws </books/9781284021646/pages/163743045> * Printed page number: 110Rights Under Health Care Laws: Examination and Treatment for Emergency Medical Conditions and Women </books/9781284021646/pages/163743046> * Printed page number: 111Rights Under Healthcare Financing Laws: Medicaid </books/9781284021646/pages/163743047> * Printed page number: 111Rights Under Health Insurance Laws: The Affordable Care Act </books/9781284021646/pages/163743047> # Expand <#>Printed page number: 111Rights Related to Freedom of Choice and Freedom from Government Interference </books/9781284021646/pages/163743048> * Printed page number: 111The Right to Make
  • 81. Informed Healthcare Decisions </books/9781284021646/pages/163743048> * Expand <#>Printed page number: 112The Right to Personal Privacy </books/9781284021646/pages/163743049> o Printed page number: 113BOX 6-3 Discussion Questions </books/9781284021646/pages/163743050> o Printed page number: 113The Roe v. Wade Decision </books/9781284021646/pages/163743050> o Printed page number: 114The Planned Parenthood of Southeastern Pennsylvania v. Casey Decision </books/9781284021646/pages/163743052> o Printed page number: 115The Stenberg v. Carhart Decision </books/9781284021646/pages/163743053> o Printed page number: 115Partial Birth Abortion Ban Act of 2003 </books/9781284021646/pages/163743054> o Printed page number: 116The Gonzales v. Carhart Decision </books/9781284021646/pages/163743055> # Expand <#>Printed page number: 116The Right to Be
  • 82. Free from Wrongful Discrimination </books/9781284021646/pages/163743056> * Printed page number: 117BOX 6-4 Discussion Question </books/9781284021646/pages/163743057> * Printed page number: 117Race/Ethnicity Discrimination </books/9781284021646/pages/163743057> * Printed page number: 118Physical and Mental Disability Discrimination </books/9781284021646/pages/163743059> * Printed page number: 119Socioeconomic Status Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Gender Discrimination </books/9781284021646/pages/163743060> * Printed page number: 119Age Discrimination </books/9781284021646/pages/163743060> + Expand <#>Printed page number: 120INDIVIDUAL RIGHTS IN A PUBLIC HEALTH CONTEXT </books/9781284021646/pages/163743061> # Printed page number: 120Overview of Police Powers </books/9781284021646/pages/163743061> # Expand <#>Printed page number: 120The Jacobson v.
  • 83. Massachusetts Decision </books/9781284021646/pages/163743062> * Expand <#>Printed page number: 121The ?Negative Constitution? </books/9781284021646/pages/163743063> o Printed page number: 121BOX 6-5 Discussion Question </books/9781284021646/pages/163743063> o Printed page number: 123BOX 6-6 Discussion Questions </books/9781284021646/pages/163743067> + Printed page number: 123CONCLUSION </books/9781284021646/pages/163743067> + Printed page number: 124REFERENCES </books/9781284021646/pages/163743068> + Printed page number: 126ENDNOTES </books/9781284021646/pages/163743069> o Expand <#>Printed page number: 127CHAPTER 7 Understanding Health Insurance </books/9781284021646/pages/163743070> + Printed page number: 127LEARNING OBJECTIVES </books/9781284021646/pages/163743070> + Expand <#>Printed page number: 127INTRODUCTION </books/9781284021646/pages/163743070> # Printed page number: 128BOX 7-1 Vignette
  • 84. </books/9781284021646/pages/163743071> + Expand <#>Printed page number: 129A BRIEF HISTORY OF THE RISE OF HEALTH INSURANCE IN THE UNITED STATES </books/9781284021646/pages/163743072> # Printed page number: 129BOX 7-2 Discussion Questions </books/9781284021646/pages/163743073> + Expand <#>Printed page number: 130HOW HEALTH INSURANCE OPERATES </books/9781284021646/pages/163743074> # Expand <#>Printed page number: 130Basic Terminology </books/9781284021646/pages/163743074> * Printed page number: 131BOX 7-3 Discussion Questions </books/9781284021646/pages/163743075> # Expand <#>Printed page number: 131Uncertainty </books/9781284021646/pages/163743075> * Printed page number: 131BOX 7-4 Discussion Questions </books/9781284021646/pages/163743076> # Printed page number: 131Risk </books/9781284021646/pages/163743076> # Expand <#>Printed page number: 133Setting
  • 85. Premiums </books/9781284021646/pages/163743078> * Printed page number: 133BOX 7-5 Discussion Questions </books/9781284021646/pages/163743079> * Printed page number: 134BOX 7-6 Discussion Questions </books/9781284021646/pages/163743080> * Printed page number: 134BOX 7-7 Discussion Questions </books/9781284021646/pages/163743080> # Printed page number: 135Medical Underwriting </books/9781284021646/pages/163743081> + Expand <#>Printed page number: 136MANAGED CARE </books/9781284021646/pages/163743082> # Expand <#>Printed page number: 137Cost Containment and Utilization Tools </books/9781284021646/pages/163743083> * Printed page number: 137Provider Payment Tools </books/9781284021646/pages/163743083> # Printed page number: 137Utilization Control Tools </books/9781284021646/pages/163743084> # Expand <#>Printed page number: 139Common Managed Care Structures
  • 86. </books/9781284021646/pages/163743087> * Printed page number: 139BOX 7-8 Discussion Questions </books/9781284021646/pages/163743087> * Printed page number: 139Health Maintenance Organizations </books/9781284021646/pages/163743087> * Expand <#>Printed page number: 140Preferred Provider Organizations </books/9781284021646/pages/163743088> o Printed page number: 142BOX 7-9 Discussion Questions </books/9781284021646/pages/163743090> * Printed page number: 142Point-of-Service Plans </books/9781284021646/pages/163743090> # Printed page number: 142The Future of Managed Care </books/9781284021646/pages/163743090> + Printed page number: 143CONCLUSION </books/9781284021646/pages/163743091> + Printed page number: 143REFERENCES </books/9781284021646/pages/163743091> + Printed page number: 143ENDNOTES </books/9781284021646/pages/163743091> o Expand <#>Printed page number: 145CHAPTER 8 Health
  • 87. Economics in a Health Policy Context </books/9781284021646/pages/163743092> + Printed page number: 145LEARNING OBJECTIVES </books/9781284021646/pages/163743092> + Expand <#>Printed page number: 145INTRODUCTION </books/9781284021646/pages/163743092> # Printed page number: 146BOX 8-1 Vignette </books/9781284021646/pages/163743094> + Expand <#>Printed page number: 146HEALTH ECONOMICS DEFINED </books/9781284021646/pages/163743094> # Expand <#>Printed page number: 146How Economists View Decision Making </books/9781284021646/pages/163743094> * Printed page number: 147Utility Analysis </books/9781284021646/pages/163743095> * Printed page number: 148Scarce Resources </books/9781284021646/pages/163743096> # Printed page number: 148How Economists View Health Care </books/9781284021646/pages/163743097> + Expand <#>Printed page number: 148ECONOMIC BASICS: DEMAND </books/9781284021646/pages/163743097> #
  • 88. Expand <#>Printed page number: 148Demand Changers </books/9781284021646/pages/163743097> * Printed page number: 149BOX 8-2 Discussion Questions </books/9781284021646/pages/163743098> # Expand <#>Printed page number: 150Elasticity </books/9781284021646/pages/163743099> * Printed page number: 150Demand Elasticity </books/9781284021646/pages/163743099> * Printed page number: 151Supply Elasticity </books/9781284021646/pages/163743100> # Printed page number: 151Health Insurance and Demand </books/9781284021646/pages/163743100> + Expand <#>Printed page number: 151ECONOMIC BASICS: SUPPLY </books/9781284021646/pages/163743101> # Printed page number: 152Costs </books/9781284021646/pages/163743102> # Printed page number: 152Supply Changers </books/9781284021646/pages/163743102> # Printed page number: 153Profit Maximization </books/9781284021646/pages/163743103> # Printed page number: 154Health Insurance and Supply
  • 89. </books/9781284021646/pages/163743104> + Expand <#>Printed page number: 154ECONOMIC BASICS: MARKETS </books/9781284021646/pages/163743104> # Printed page number: 154Health Insurance and Markets </books/9781284021646/pages/163743104> # Printed page number: 154Market Structure </books/9781284021646/pages/163743105> # Expand <#>Printed page number: 155Market Failure </books/9781284021646/pages/163743106> * Printed page number: 155Public Goods </books/9781284021646/pages/163743106> * Printed page number: 156Externalities </books/9781284021646/pages/163743107> * Expand <#>Printed page number: 157Government Intervention </books/9781284021646/pages/163743108> o Printed page number: 157Government Finances or Directly Provides Public Goods. </books/9781284021646/pages/163743108> o Printed page number: 157Government Increases Taxes, Tax Deductions, or Subsidies. </books/9781284021646/pages/163743108> o Printed page number: 157Government Issues
  • 90. Regulatory Mandates. </books/9781284021646/pages/163743109> o Expand <#>Printed page number: 157Government Prohibitions. </books/9781284021646/pages/163743109> + Printed page number: 158BOX 8-3 Discussion Questions </books/9781284021646/pages/163743110> o Printed page number: 158Redistribution of Income. </books/9781284021646/pages/163743110> + Printed page number: 158CONCLUSION </books/9781284021646/pages/163743110> + Printed page number: 158REFERENCES </books/9781284021646/pages/163743111> + Printed page number: 158ENDNOTES </books/9781284021646/pages/163743111> o Expand <#>Printed page number: 159CHAPTER 9 Health Reform in the United States </books/9781284021646/pages/163743112> + Printed page number: 159LEARNING OBJECTIVES </books/9781284021646/pages/163743112> + Printed page number: 159VIGNETTE </books/9781284021646/pages/163743112> +
  • 91. Printed page number: 160INTRODUCTION </books/9781284021646/pages/163743113> + Expand <#>Printed page number: 160DIFFICULTY OF HEALTH REFORM IN THE UNITED STATES </books/9781284021646/pages/163743113> # Printed page number: 161Culture </books/9781284021646/pages/163743114> # Printed page number: 161U.S. Political System </books/9781284021646/pages/163743114> # Printed page number: 162Interest Groups </books/9781284021646/pages/163743116> # Printed page number: 162Path Dependency </books/9781284021646/pages/163743116> + Printed page number: 163UNSUCCESSFUL ATTEMPTS TO PASS NATIONAL HEALTH REFORM </books/9781284021646/pages/163743117> + Expand <#>Printed page number: 165WHY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT PASSED </books/9781284021646/pages/163743120> # Printed page number: 166Commitment and Leadership </books/9781284021646/pages/163743121> # Printed page number: 167Lessons from Failed Health Reform Efforts
  • 92. </books/9781284021646/pages/163743123> # Printed page number: 170Political Pragmatism </books/9781284021646/pages/163743126> + Expand <#>Printed page number: 170PATIENT PROTECTION AND AFFORDABLE CARE ACT </books/9781284021646/pages/163743126> # Printed page number: 170Individual Mandate </books/9781284021646/pages/163743127> # Expand <#>Printed page number: 171State Health Insurance Exchanges </books/9781284021646/pages/163743128> * Printed page number: 171BOX 9-1 Discussion Questions </books/9781284021646/pages/163743128> # Expand <#>Printed page number: 173Premium and Cost-Sharing Subsidies </books/9781284021646/pages/163743132> * Printed page number: 173BOX 9-2 Discussion Questions </books/9781284021646/pages/163743132> # Expand <#>Printed page number: 174Employer Mandate </books/9781284021646/pages/163743134> * Printed page number: 174BOX 9-3 Discussion Questions
  • 93. </books/9781284021646/pages/163743136> # Printed page number: 174Changes to the Private Insurance Market </books/9781284021646/pages/163743136> # Expand <#>Printed page number: 176Financing Health Reform </books/9781284021646/pages/163743139> * Printed page number: 177BOX 9-4 Discussion Questions </books/9781284021646/pages/163743140> # Expand <#>Printed page number: 177Public Health, Workforce, Prevention, and Quality </books/9781284021646/pages/163743141> * Printed page number: 177BOX 9-5 Discussion Questions </books/9781284021646/pages/163743141> # Printed page number: 179States and Health Reform </books/9781284021646/pages/163743142> + Printed page number: 179CONClUSION </books/9781284021646/pages/163743142> + Printed page number: 181REFERENCES </books/9781284021646/pages/163743143> + Printed page number: 182ENDNOTES </books/9781284021646/pages/163743144> o Expand <#>Printed page number: 183CHAPTER 10 Government Health
  • 94. Insurance Programs: Medicaid, CHIP, and Medicare </books/9781284021646/pages/163743145> + Printed page number: 183LEARNING OBJECTIVES </books/9781284021646/pages/163743145> + Expand <#>Printed page number: 184INTRODUCTION </books/9781284021646/pages/163743146> # Printed page number: 184BOX 10-1 Vignette </books/9781284021646/pages/163743146> # Printed page number: 185BOX 10-2 Discussion Questions </books/9781284021646/pages/163743148> + Expand <#>Printed page number: 185MEDICAID </books/9781284021646/pages/163743148> # Expand <#>Printed page number: 185Program Administration </books/9781284021646/pages/163743148> * Printed page number: 186BOX 10-3 Discussion Questions </books/9781284021646/pages/163743149> # Expand <#>Printed page number: 186Eligibility </books/9781284021646/pages/163743149> * Printed page number: 186BOX 10-4 Federal Poverty Level </books/9781284021646/pages/163743150> * Printed page number: 187Eligibility Requirements </books/9781284021646/pages/163743151>
  • 95. * Expand <#>Printed page number: 188Medically Needy </books/9781284021646/pages/163743152> o Printed page number: 189BOX 10-5 Discussion Questions </books/9781284021646/pages/163743153> * Printed page number: 189Immigrants </books/9781284021646/pages/163743153> # Expand <#>Printed page number: 189Medicaid Eligibility Expansion Under the Affordable Care Act </books/9781284021646/pages/163743154> * Printed page number: 189BOX 10-6 Discussion Questions </books/9781284021646/pages/163743154> * Printed page number: 190BOX 10-7 Discussion Questions </books/9781284021646/pages/163743155> # Expand <#>Printed page number: 190Benefits </books/9781284021646/pages/163743155> * Printed page number: 192BOX 10-8 DRA Benefit Options </books/9781284021646/pages/163743158> # Expand <#>Printed page number: 192Amount, Duration, and Scope, and Reasonableness Requirements </books/9781284021646/pages/163743159>
  • 96. * Printed page number: 192BOX 10-9 Idaho Implementation of DRA25 </books/9781284021646/pages/163743159> # Expand <#>Printed page number: 193Medicaid Spending </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-10 Discussion Questions </books/9781284021646/pages/163743160> * Printed page number: 193BOX 10-11 Discussion Questions </books/9781284021646/pages/163743160> # Expand <#>Printed page number: 194Medicaid Financing </books/9781284021646/pages/163743162> * Printed page number: 195BOX 10-12 Discussion Questions </books/9781284021646/pages/163743163> * Printed page number: 196BOX 10-13 Discussion Questions </books/9781284021646/pages/163743164> # Expand <#>Printed page number: 196Medicaid Provider Reimbursement </books/9781284021646/pages/163743165> * Printed page number: 196Fee-for-Service Reimbursement