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Essay / Research Paper Abstract
Three questions answered in 7 pages regarding the effects of managed care and Medicare’s transition from the retrospective cost based reimbursement system to the DRG/RUG/PPS systems currently in use today. Questions address cost, utilization, access and quality. Bibliography lists 7 sources.
Page Count:
7 pages (~225 words per page)
File: CC6_KSmediMgdCarQues.rtf
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Unformatted sample text from the term paper:
health care As a percentage of gross national product (GNP), health care spending was 6 percent in 1965. That figure had risen
to 14 percent of GNP by 1993 (Lindsey, 1993), even though GNP itself also had increased dramatically: by 1994, that percentage of GNP had increased to 15 percent and
had topped the $1 trillion mark for a total of more than $4,000 for every citizen of the country (Grumbach and Bodenheimer, 1994). Plagued by overspending for years, the
general system also has been characterized by underinclusion as well - in 1993, there were no less than 35 million Americans without health insurance coverage of any kind (Lindsey, 1993).
A decade later, that figure has more than doubled. The original federal legislation enabling the existence of HMOs was passed in 1973
(Ellwood, 2002). Some early HMOs such as Kaiser Permanente Health Plan had succeeded in containing costs in the 1980s, but 1993 was the first year that health care costs
did not rise at a greater rate than the consumer price index (Ellwood, 2002). Those savings were real, as evidenced by total health care spending in the period 1993-2000.
Unlike the nonprofit hospitals that are becoming increasingly rare, HMOs are not required to provide any service to anyone who is not a
member of the organization. HMOs generally allow unlimited access to a primary care physician, but they require physician referral for the member to be able to see another doctor
for the same problem. Of course individuals can see anyone they please, but in order to have their HMO share the cost, the insured must remain within the network.
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