Healthcare open enrollment in the US

Good Health Leads To Peak Performance – Kristen Johnson Brogan

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This is the latest edition of the Google Trends newsletter, with a focus today on healthcare open enrollment in the US.  Published October 19, 2023

Top Trending Healthcare Questions

Past month, US

What is the term given to total good health?

The term often used to describe total or overall good health is “well-being.” Well-being encompasses not only physical health but also mental and emotional health, social and interpersonal relationships, and a sense of purpose and fulfillment in life. It represents a holistic view of an individual’s quality of life and their overall state of wellness.

The word health refers to a state of complete emotional, mental, and physical well-being. Healthcare exists to help people stay well in these key areas of life.

Learn more: Dimensions of wellness: Change your habits, change your life

What is EMTALA in healthcare

PPT - EMTALA Emergency Medical Treatment and Active Labor Act PowerPoint  Presentation - ID:3866256

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What is PPS in healthcare

In healthcare, “PPS” can refer to several different terms, but the most common usage is related to the term “Prospective Payment System.” Here’s an explanation of Prospective Payment System (PPS) in the healthcare context:

Prospective Payment System (PPS): PPS is a method used by the U.S. Medicare program to reimburse hospitals and other healthcare providers a predetermined, fixed amount for each patient’s care based on their diagnosis, treatment, or condition. This fixed payment is made in advance and is intended to cover all the costs associated with a patient’s care during a specific period, such as an inpatient hospital stay.

There are various PPS models in healthcare, including:

Diagnosis-Related Groups (DRGs): Under the DRG-based PPS, hospitals are paid a predetermined amount for each Medicare patient based on their diagnosis. The goal is to control healthcare costs by standardizing payments for specific conditions.

Home Health PPS: This system applies to home health agencies and provides a predetermined payment for a defined episode of care based on the patient’s condition and needs.

Skilled Nursing Facility PPS: This method applies to Medicare payments for care in skilled nursing facilities and is based on the patient’s clinical condition, as well as the services provided.

Inpatient Psychiatric Facility PPS: This system is used for reimbursing inpatient psychiatric facilities.

The key idea behind PPS is to promote efficiency and cost control within the healthcare system. By establishing fixed payments in advance, it encourages providers to deliver care more efficiently, reducing unnecessary tests, treatments, and extended hospital stays. This is in contrast to the traditional “fee-for-service” model, where healthcare providers are paid based on the number and type of services they deliver, which can lead to overutilization and escalating costs.

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What is healthcare reform

Healthcare reform refers to efforts and changes made to improve the healthcare system, with the goal of enhancing the quality, accessibility, and affordability of healthcare services. Healthcare reform can encompass various policies, laws, regulations, and initiatives aimed at addressing the challenges and shortcomings of the healthcare system. The specific objectives and approaches of healthcare reform may vary from one country to another. Here are some common areas of focus in healthcare reform:

Access to Healthcare: Many healthcare reform efforts aim to increase access to healthcare services, ensuring that a larger portion of the population can receive necessary medical care. This may involve expanding insurance coverage, reducing barriers to care, and increasing the number of healthcare providers.

Health Insurance Reform: This involves changes to the health insurance system, such as creating insurance marketplaces, expanding Medicaid, and regulating insurance practices to protect consumers. The goal is often to make insurance more affordable and accessible.

Cost Containment: Healthcare costs can be a significant burden for individuals, businesses, and governments. Reform efforts may focus on strategies to control and reduce healthcare costs while maintaining or improving the quality of care. This can involve measures like value-based care, bundled payments, and cost transparency.

Quality Improvement: Healthcare reform often aims to improve the quality of care delivered by healthcare providers. Initiatives may focus on patient safety, care coordination, and the use of evidence-based practices.

Preventive Care and Public Health: Healthcare reform may include initiatives to promote preventive care, public health, and healthy lifestyles. Preventing illness and addressing health disparities can be cost-effective in the long run.

Electronic Health Records (EHRs) and Health Information Exchange: The adoption of EHRs and the exchange of health information among providers can enhance patient care, reduce duplication of tests, and improve care coordination.

Patient Rights and Protections: Healthcare reform efforts often emphasize protecting the rights of patients, such as privacy and informed consent, and ensuring that patients have the information and tools needed to make informed decisions about their care.

Mental Health and Behavioral Health: Expanding access to mental health and substance abuse treatment services is a significant component of some healthcare reform efforts, particularly given the growing awareness of the importance of mental health.

Innovation and Technology: Embracing healthcare innovation and technology, such as telemedicine and precision medicine, can be a part of healthcare reform to improve access and quality of care.

Healthcare reform is a complex and multifaceted process that requires the collaboration of policymakers, healthcare providers, insurers, and the public. The specific reform measures and their success can vary widely depending on the political, economic, and healthcare system contexts of a given country or region.

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