HIMA 240 American Military University Week 1 Healthcare Systems Peer Responses
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Respond back to these 4 responses: 240-Hi Class!
I have worked in healthcare for over 15 years and my experience involves home health, long term care and acute care. I have worked every job from shower team to transport to nursing. I started college last December and am on track to graduate sometime in 2024. I have had a small amount if any regarding health care reimbursement. I have helped my patients deal with medical insurance companies, written checks and assisted in the process of getting insurance or referrals but my experience beyond that is limited. Based on my limited experience, I know that most of the time, people are unaware of what their benefits cover, and confusion arises regarding what they are going to have to pay (if anything). I have encountered issues where the provider does not discuss insurance or costs with the patient and later, the patient gets a bill after they assumed insurance was going to take care of all costs. Education and communication are usually lacking.
Healthcare systems depend on the revenue cycle as their lifeblood. Reimbursements on claim submissions and out-of-pocket expenses by the patient, among other procedures that result in payment of services, majorly tie to the healthcare revenue cycle. Healthcare providers claim reimbursements for the services they render to patients, which resultantly contributes to their revenue (Chalasani & Koritala, 2019). The steps included in the healthcare revenue cycle promote prompt reimbursement payment to the provider and clarify the whole amount that the patient is eligible to pay. Reimbursement may be from insurance companies or the patient’s pocket. The reimbursement providers receive usually supplies them with revenue that they can use to invest in their patient care since quality patient care is the utmost goal of any healthcare provider.
I have to apologize for the late initial post. That is my fault for fully reading everything required of us to start this first week. I have been an Army medic for 17 years, I became a certified Radiology Technician 13 years ago with subsequent certification in Computed Radiography (CT), and training in MRI and Interventional Radiography. I have not dealt a whole lot with the revenue cycle other than getting emails asking why did a head CT for chest pain and things of that nature from our billing people because that makes it harder to get reimbursed for the exam from insurance. I understand where they are coming from however that’s usually what I get and there isn’t a whole lot I can do when the doctors order it that way. Doctor’s ordering things this way I believe slows down the reimbursement process and interferes in the revenue cycle.
250-Good evening class,
The quality of patient care has been pushed to improve because in the 1700s the U.S. was primarily rural communities. This means that people were born, treated for illnesses, and then died at home. Women were typically tasked with taking care of an illness until it became clear that a doctor was needed. The medical intervention continued to grow, however, training was never entirely focused on. Within the reading, it stated that private medical schools would just randomly appear and students would only train for six months! In today’s society doctors go to school for more than four years! Doctors now must also pass an exam to receive licensure to practice medicine.
In the 1800s physicians began to understand that germs and social conditions may spread diseases. Public health had become an interest for the government and soon after the implementation of hospitals not only focused on the poor but began to focus on those who could pay to be seen privately. This then led to public health becoming a concern as germs were typically the main cause of illness. Hygiene has been the biggest concern especially when trying to prevent illness.
At this point, everything had continued to change within healthcare. The illnesses, the way people paid for healthcare, and even technological advancements. As well as everyone else, Medical necessities had to stay up-to-date with everything changing. This means that with access to the internet and a computer, telehealth visits were created. Along with science becoming more innovative, vaccines and preventative medications are created at a faster rate than they were before. This allows for more people to be treated and potentially prevent illness rather than having to wait and with the possibility of getting sick and dying.
250-Quality improvement in healthcare has evolved over the past few centuries. Healthcare is currently focused on improving the quality of patient care and outcomes. Healthcare is also focused on multidisciplinary coordination of care efforts with the integration of technology to better, if not perfect the industry. However, that is not where the journey started.
Healthcare in the 1700s was a menace and intended for the selected few. Initially, hospitals were mere hosting places for the sick and the poor (University of Pennsylvania, n.d.). They were established in the mid-1700s and were known as isolation hospitals and almshouses where the destitute would be hosted. Hospitals also became places meant for medical education and for physicians to show off their prestige at that time (University of Pennsylvania, n.d.). In the 19th century, the poor and socially marginalized were the only people who would get institutionalized. The rich would get treated in the comfort of their beds, at home, and even in serious procedures such as surgeries. Later in the century, during the industrial revolution, health care practices and hospitals became more professionalized, making them become competitive commercial places for medical services. Everyone would get medical care in a hospital. The world wars also pressured the government to establish centers where people would get medical care. According to Marjoua & Bozic (2012), welfare medical care, as an improvement effort, called for the establishment of Medicare and Medicaid in 1965.
For healthcare to get where it is currently in the United States, many factors had to be adjusted. From being charity houses to centers of excellence, social and cultural shifts had to be made. Medical providers and political power had to change the way disease was defined. Economies had to adjust to pave the way for effective medical practices, geographic locations of hospitals had to be considered, equality of all ethnicities and religions had to be considered, patients’ socioeconomic status had to be overlooked, and technology upheld. These are some of the strategies that had to be upheld to result in a system of efficiency. One noticeable strategy is how the government has insured Americans through the Patient Protection and Affordable Care Act (ACA), for all populations, to medically cover anyone and everyone (Barrett, 2020). Hence, the current improvement in the overall healthcare infrastructure has resulted from accumulated efforts that are centuries-worth. As soon as the healthcare industry (and government) realized that it had a role in ensuring quality, the industry evolved steadily, prioritizing quality of care and developing systems that uphold the promise of care for Americans.
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