The concept of “value-based health care” in the U.S. health care market was, for many years, not considered applicable. Recent initiatives and policy changes, particularly those related to the Affordable Care Act (ACA), have started to shift the U.S. health care market from “volume-based” to “value-based” care. The Centers for Medicare and Medicaid Services (CMS) is the federal agency that administers the social health insurance programs such as Medicare for the elderly. Medicaid is a joint federal and state program that helps with medical costs for patients with limited income and resources. The American Society for Therapeutic Radiology and Oncology (ASTRO) currently assesses emerging technologies through a task force within its Evaluation Subcommittee to evaluate emerging technologies. The Emerging Technology Committee (ETC) explicitly states that its primary role is to “provide technology assessments regarding emerging technologies to various stakeholders within and outside the society.
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This chapter describes the structure and trends of postacute care (PAC) in the United States and includes an overview of each of the types of providers, including the provider definition and characteristics, the provider payment system, and, where available, patient characteristics and quality data. It also describes the clinical and nonclinical factors associated with PAC utilization. The chapter discusses the current issues facing PAC providers and efforts to reform the delivery of health care services in the United States. Skilled nursing facilities (SNFs), the most numerous of the PAC providers, are certified by the Centers for Medicare and Medicaid Services to provide skilled nursing and therapy services. Utilization of PAC services increased when acute care lengths of stays (LOS) decreased. As further changes in health care delivery systems take place, undoubtedly more changes in PAC utilization will also occur.
Lactation consultants understand the mechanisms and research supporting breastfeeding's positive impact on infant mortality reduction, including lifelong health outcomes and associated cost savings. Lactation services can enhance the success of programs intended to improve infant mortality rates, health outcomes, and cost effectiveness.
As leaders serving the Ohio Lactation Consultant Association (OLCA), we pursued engagement with Ohio Department of Medicaid policy chiefs to ensure incorporation of these facts as programs are created to improve health and optimize allocation of Medicaid resources.
After a productive meeting, we specifically proposed that professional lactation services be standard care and fully integrated across the healthcare continuum regardless of setting and ability to pay.Source:
The population of older adults in the United States has grown exponentially over the past few decades. This chapter looks at the unique challenges of meeting the comprehensive healthcare needs of this population. It examines the implications for social policy and gerontological practice and highlights the current models of entitlements and support services for older adults. The chapter also illustrates knowledge and skills required by social workers in this field, and discusses the recommendations for holistic competence. It focuses on four federal social policies that have guided the development of healthcare in the United States. These policies have had a substantial impact on who is eligible for services, the type of services one is entitled to, the quality of services provided, and ultimately the lives of individuals affected by them. The four major social policies are Medicare, Medicaid, the Older Americans Act (OAA), and the Supplemental Nutritional Assistance Program (SNAP).