Coverage Matters

Coverage Matters
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 204
Release: 2001-10-27
Genre: Medical
ISBN: 0309076099

Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Access to Health Care in America

Access to Health Care in America
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 240
Release: 1993-02-01
Genre: Medical
ISBN: 0309047420

Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

The Affordable Care Act

The Affordable Care Act
Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
Total Pages: 130
Release: 2014-12-02
Genre: Young Adult Nonfiction
ISBN: 0737771496

The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Communities in Action

Communities in Action
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 583
Release: 2017-04-27
Genre: Medical
ISBN: 0309452961

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Health Insurance Today - E-Book

Health Insurance Today - E-Book
Author: Janet I. Beik
Publisher: Elsevier Health Sciences
Total Pages: 522
Release: 2020-09-10
Genre: Medical
ISBN: 0323655548

Master the complexities of health insurance with this easy-to-understand guide! Health Insurance Today: A Practical Approach, 7th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve website. This edition adds coverage of the latest advances and issues in health insurance, including EHRs, Medicare, and other types of carriers. Written by Medical Assisting educators Janet Beik and Julie Pepper, this resource prepares you for a successful career as a health insurance professional. - What Did You Learn? review questions, Imagine This! scenarios, and Stop and Think exercises ensure that you understand the material, can apply it to real-life situations, and develop critical thinking skills. - Clear, attainable learning objectives highlight the most important information in each chapter. - CMS-1500 software with case studies on the Evolve companion website provides hands-on practice with filling in a CMS-1500 form electronically. - UNIQUE! UB-04 software with case studies on Evolve provides hands-on practice with filling in UB-04 forms electronically. - UNIQUE! SimChart® for the Medical Office (SCMO) cases on Evolve give you real-world practice in an EHR environment. - HIPAA Tips emphasize the importance of privacy and of following government rules and regulations. - Direct, conversational writing style makes it easier to learn and remember the material. - End-of-chapter summaries relate to the chapter-opening learning objectives, provide a thorough review of key content, and allow you to quickly find information for further review. - Chapter review questions on Evolve help you assess your comprehension of key concepts - NEW and UNIQUE! Patient's Point of View boxes enable you to imagine yourself on the other side of the desk. - NEW and UNIQUE! Opening and closing chapter scenarios present on-the-job challenges that must be resolved using critical thinking skills. - NEW! End-of-chapter review questions ensure that you can understand and apply the material. - NEW! Clear explanations show how electronic technology is used in patient verification, electronic claims, and claims follow-up. - NEW! Coverage of the Affordable Care Act introduces new and innovative ways that modifications to the ACA allow people to acquire healthcare coverage. - NEW! Updated information addresses all health insurance topics, including key topics like Medicare and Electronic Health Records. - NEW! More emphasis on electronic claims submission has been added. - NEW! Updated figures, graphs, and tables summarize the latest health insurance information.

Beik's Health Insurance Today - E-Book

Beik's Health Insurance Today - E-Book
Author: Julie Pepper
Publisher: Elsevier Health Sciences
Total Pages: 506
Release: 2023-09-14
Genre: Medical
ISBN: 0323934102

**Selected for Doody's Core Titles® 2024 in Managed Care** Master the complexities of health insurance with this easy-to-understand guide! Beik's Health Insurance Today, 8th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve companion website. This edition adds up-to-date coverage of cybersecurity, COVID-19, crowdfunding for medical bills, and cost/value calculators. Making difficult concepts seem anything but, this resource prepares you for a successful career as a health insurance professional. - Direct, conversational writing style makes learning insurance and billing concepts easier. - Clear and attainable learning objectives, with chapter content that follows the order of the objectives, make learning easier for students and make chapter content easier to teach for educators. - Learning features include review questions, scenarios, and additional exercises to ensure comprehension, critical thought, and application to practice. - Hands-on practice with a fillable CMS-1500 form and accompanying case studies and unique UB-04 forms on the companion Evolve website, ensure practicum- and job-readiness. - HIPAA Tips emphasize the importance of privacy and government rules and regulations, ensuring a solid foundation in regulatory compliance. - NEW! Additional content on cybersecurity emphasizes the importance of keeping digital information private and secure. - NEW! Information on crowdfunding for medical bills discusses how this practice affects billing. - NEW! Geographic Practice Cost Indexes/Resource Based Relative Value Scale (GPCI/RBPVU) calculators are included. - NEW! Coverage of COVID-19 explores its impact on billing, reimbursement, and employment.