As the science behind the health care industry continues to expand and new treatments and clinical trials are being run every day, it is important to have a method of disseminating information. This is especially true when the information will have an significant effect on the level of mortality and morbidity. Clinical alerts are used [...]
The Center for Medicare and Medicaid Services has established a rating system to be used in determining the overall quality of a nursing home. The Five-Star quality rating system was created in order to aid caregivers, families and consumers with the comparison of available nursing homes. The rating system is measured on a scale of [...]
Hierarchical Condition Categories, or HCC, were established in 2004 by the Centers for Medicare and Medicaid. This model is used in order to change the capitation payments that are paid to health insurance providers for an anticipated cost for Medicare or Medicaid enrollees. Each hierarchical condition category is assigned to a specific health condition. Through [...]
Within the health care industry, pay for performance, also known as P4P, is a method of payment that is becoming more popular both within the United States and Great Britain. Through this model of payment rewards, health care providers such as physicians, medical groups and hospitals are rewarded when certain measures of efficiency and quality [...]
Medicare Advantage was first established in 1997 when the Balanced Budget Act was passed. Through this act, those eligible for Medicate benefits were allowed to use private insurance plans and still receive their benefits. This was in lieu of having to use the Medicare plan, whether it had been Part A or Part B. When [...]
There are a number of different benefits that are known to be the result of an effectively utilized health information technology system. Health information technology, or health IT, is responsible for the complete management of health related information. This includes the exchange of information between all necessary entities including the consumers, insurers, government, and providers. [...]
Chronic care management is an important part of health care when it comes to those suffering with chronic sickness. Some examples of the diseases that chronic care management works with include common ailments such as high blood pressure, diabetes, sleep apnea, multiple sclerosis as well as lupus among many others. Through chronic care management, health [...]
The term case management is used within the health care system to describe a set of practices aimed at improving the care of individualized patients through the use of collaboration and personalized care. It is a process that has a number of different steps and aspects that work together in order to provide the highest [...]
The concept and practice of disease management within the health care system is based around the idea of knowledge building, the sharing of that knowledge and community building. It can be defined as a network of coordinated and integrated health care systems and professionals as well as family and friends which aim at improving the [...]
There are a number of health care providers who have started to utilize the practice of population management. This type of practice was developed and expanded from the practice of disease management, with many of the same goals in mind. Through population management health care providers hopes to not only provide their members with a [...]