Paper Example: What Is an Almshouse?

What is an Almshouse?

An almshouse is a house mostly founded by charity organizations to offer accommodation to particular people in society. In most circumstances, almshouses are meant for the poor residents, the old as well as the distressed people in society (Age, 2019). Almshouses are maintained by charity organizations or trustees who offer support. The church system is the one that started the almshouses, and local authorities and officials later adopted them. Boston, Massachusetts, was the first place in the United States to have an almshouse in 1622(Age, 2019). Local officials were seen to control the almshouses, and they did not give proper care and attention to the people in the almshouses. As time continued, states were seen to create boards that were supposed to regulate, inspect, and report on the state of the almshouses. Almshouses faced many challenges, such as the fact that they were not often self-sustaining, costly to run, and did not have enough staff.

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Question 2

Why is Florence Nightingale Important to the History of Hospitals?

Nightingale is essential to the history of hospitals. She undertook a nursing job where she tackled various challenges. One challenge was the cholera outbreak that had been fuelled by unsanitary conditions that were present in the hospital. She made sure that the hygiene practices in the hospital were improved, which lowered the hospital's death rate. She later went to the Crimean war, where she was tasked with the obligation of taking care of soldiers who had been injured. The conditions at the hospital were horrible, and soldiers died more of infectious diseases such as typhoid than from injuries (Nevils-Karakeci, 2020). She improved the sanitary conditions at the hospital, and this reduced the death rate by two-thirds. She later wrote a book where she proposed reforms that needed to be undertaken in other military hospitals. She later established St. Thomas' Hospital and the Nightingale Training School for Nurses, where she trained other girls who aspired to be like her.

Question 3

What is AMA and Why is it Important?

AMA refers to the American Medical Association. It is the largest and oldest physician organization in the United States. It is crucial and plays a significant role in the United States. They include the development of American healthcare policy. It is also important because it publishes research to advance public health. AMA is also seen to advocate for the interests of registered physician members (AMA, 2020). AMA is also seen to publish peer-reviewed medical journals that are aimed at educating physicians on advancements in the field of medicine as well as the proper delivery of healthcare to the community (AMA, 2020). AMA is seen to collaborate with other entities to ask for changes or updates of health policies in the United States that affect its citizens. It also ensures that ethical practices are maintained in the field of medicine.

Question 4

What Was It That Likely Boosted the Adoption of Health Insurance Programs By Some Employers?

In the 20th century, people knew very little about health insurance (Enthoven & Fuchs, 2017). Doctors later found out that money could be made through health insurance and formed different insurance plans, namely Blue Cross and the Blue Shield, which were meant to help people buy their services. The insurance bought in the 20th century was private and very few people bought it. The main reason most employers adopted the health insurance program was World War 2 (Enthoven & Fuchs, 2017). The war made many workers enter the military, and the United States was facing a shortage of employees. Businesses had to cope with the challenge of a labor shortage by raising salaries to attract employees. However, the government froze wages, and businesses were not allowed to raise salaries to attract employees. To attract employees, businesses opted to give benefits such as good health insurance packages to their employees. Employer-based health insurance was also exempted from tax, making it cheaper to have health insurance through a job.

Question 5

What are The Several Ways in Which Hospitals Can Be Classified?

Hospitals may be classified into different groups. They include, according to size, location, specialty, governmental, or nongovernmental. Those classified according to size include small, medium, and large hospitals. Small hospitals have fewer than 100 beds. Medium hospitals have less 100 to 500 hospitals, while large hospitals have more than 500 beds (Gallagher Healthcare, 2018). Those classified according to the location are rural and urban hospitals. Rural hospitals serve small communities, and they face shortages in terms of hospital equipment. Urban hospitals serve large cities, and they are, in most circumstances, seen to have many treatment options. Specialty hospitals are those that serve specific conditions, and they include cardiac and oncology hospitals. Nongovernmental hospitals are built by other members other than the government (Gallagher Healthcare, 2018). Such organizations may include religious organizations or communities. Governmental hospitals are funded and supported by the state or federal government, and the most common is the veteran hospitals.

Question 6

How are Medicare and Medicaid Financed?

Medicare is financed mainly by two trust funds. They are the Hospital Insurance (HI) trust fund and the Supplementary Medical Insurance (SMI) trust fund. The HI trust fund is funded by a payroll tax of 2.9% of the employers' earnings while the employees pay 1.45% each (Cubanski, 2016). On the other hand, general revenues, premiums, and interests finance the SMI trust fund.

The government also finances Medicaid in different ways. The use of the Federal Medical Assistance Percentage (FMAP) ensures that the states get one dollar for every dollar spent in the state. It ensures that they are funded based on actual costs (Snyder & Rudowitz, 2016). The Enhanced Matching Rates are also used to fund Medicaid, and the federal match rates are tied to specific years. The Disproportionate Share Hospital payments (DSH) also fund Medicaid in hospitals with many Medicaid patients who have low-income and are uninsured. Finally, there is the State Financing of the Non-Federal Share, which mainly comes from the state general fund appropriations.

Question 7

What Impact Did HMOs Have On The Delivery Of Hospital Care?

HMOs, refer to Health Maintenance Organizations. They have affected the delivery of hospital care in a very big way. HMOs have acknowledged that big companies need to offer health insurance and, therefore, make it possible by bringing together hospitals, specialists, and primary care physicians to receive care in one place. Patients are required to receive health care at specific facilities and specialists (Rusnak, 2016).HMOs, therefore, receive fixed payments for their services per patient at specific periods. HMOs have made the delivery of care at hospitals less costly as a person’s monthly payments remain the same despite the services received. The overall healthcare costs are also reduced due to the large number of people that HMOs cover. HMOs have been seen to improve the quality of care, reduce the cost of receiving the care, and increase access to care in hospitals.

Question 8

Where Does The Money Come From To Pay For Healthcare Goods And Services?

The money that pays for healthcare goods and services comes from various places. They include the entitlement programs where federal programs or laws require specific payments to people or organizations that meet the criteria established. The money may also come from group health benefit plans. These are insurances made by groups for its members. In most cases, the insurance it at a lower cost as it is spread across all its members (Schrek, 2020). Finally, the money may come from individual coverage. People may pay the expenses out of their markets. In most cases, people have flexible spending accounts or health saving accounts where they save money that they can use in case of emergencies.

Question 9

What are Bundled Payments and Why are They Increasingly Important in Health Finance?

Bundled payments may be defined as the reimbursement of healthcare providers based on expected costs for clinically defined episodes of care (HealthPayerIntelligence, 2017). A single payment is made to hospitals and doctors for a defined episode of care. Bundled payments are becoming increasingly important in healthcare because of the following reasons. Payers using bundled payments are presented with low-risk ways to manage healthcare payments. Payers are also seen to benefit as they participate with providers in value-based care and an increase in quality of care. Payers can also effectively define the total cost of care, and they are, therefore, able to manage high healthcare spending.

Question 10

Identify How the Fee-For-Volume Model Differs From the Fee-For-Value Model

The fee-for-volume model is also referred to as a fee-for-service model. In this model, the healthcare providers are paid for the number of services performed. It makes the healthcare providers think more about making money or incentives rather than providing the best services (RevCycleIntelligence, 2019). The model was faced with challenges such as the fact that each patient's claim has to be processed by the physician. The fee-to-service model is disadvantageous because there is no limit in the number of services, and healthcare providers have to be paid regardless of pf the outcome.

On the other hand, the fee-for-value model ties payments made by customers to the quality of care provided. It rewards healthcare providers who are effective and efficient while corrects those whose services were not desirable (RevCycleIntelligence, 2019). Healthcare providers who provide quality services are rewarded and encouraged to provide better care for their patients while at the same time, reducing the healthcare costs. The focus of value-based models is patient outcomes and the improvement of the quality of services offered.

Question 11

Discuss the Differences among an Agreement, Joint Venture, and a Merger or Acquisition

Agreements are a consensus to integrate clinical service lines, either fully or partially, in day to day organizational regular workflow activities. A joint venture as a partnership practice involves the retention of organizational identity between two organizations that create a new organization structured to achieve a specific task. A merger involves acquiring significant control powers over another organization through a mutual agreement where one organization has more than 50.1% of the board and management control entitled to it (McConnell, 2019). It is a formal and legal agreement to create a new organization with a new name (McConnell, 2019). A merger increases fear of potential job loss for workers. While horizontal merger involves companies in the same industry offering similar services and products, vertical merger involves organizations in the different industry offering different goods and services that aim at increasing operational efficiency and expand services (McConnell, 2019). An acquisition occurs when the other as an acquired entity absorbs one organization.