Health Care Planning

One of the foremost challenges faced by health care professionals is to formulate a well-devised, well-thought out plan for assisting both the patients as well as the health care givers. Care planning is an essential part of health care, but is often misunderstood or regarded as a waste of time. Without a specific document delineating the plan of care, important issues are likely to be neglected. Care planning provides a sort of ‘road map’, to guide all who are involved with the patient’s/resident’s care. The health care plan has long been associated with nursing; however, all health care professionals need to be assisted in the care giving process. In today’s world, highly expensive Health Insurance policies are not viable for most individuals. Therefore, the government needs to play a crucial part in ensuring that ‘health care’ is impartially and effectively provided to all citizens.

At the beginning of the 20th century, a new concept, the concept of ‘health promotion’ began to take shape. It was realized that public health had neglected the citizen as an individual and that the state had a direct responsibility for the health of the individual. Consequently, in addition to.disease control activities, one more goal was added to health-care planning- health promotion of individuals. It was initiated as personal health services such as mother and child health services, mental health and rehabilitation services. C.E.A.Winslow, one of the leading figures in the history of public health in 1920, defined public health care planning as: ‘the science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort.’

The first step in the health care planning program is accurate and comprehensive assessment. Once the initial assessment is completed, a problem list should be generated. This may be as simple as a list of medical diagnosis. The problem list may include family/relationship problems,which are affecting the parent’s overall well-being.

Following the problem list, the health-care professional must ask,’ will I be able to solve this problem?If yes, then the goal of the health-care professional must be to solve that particular problem. Moreover, this goal should be specific, measurable and attainable. The approaches towards achieving that goal should also be measurable and realistic. An example of a problem that could improve, would be health-care deficit related to hip fracture. With rehab, this problem is likely to resolve.

In case a medical problem is irreversible- such as diabetes- the next step would be to eliminate further complications or possible health deterioration. In the case of such health problems, the goal should be to retain the level of health at an optimum level.

In case of an illness, where further health complications are inevitable, the goal should be to improve the quality of life. It is note-worthy that for all medical problems, approaches must be ordered by the physician. The health care planning process is never completed until the patient is discharged from the current care setting. Periodic schedule re-evaluation is also necessary once the patient is discharged.

In the final analysis, the ultimate purpose of the health care plan is to guide all who are involved in the care of the patient and to provide appropriate treatment.

Have You Considered a Managed Health Care Plan Lately?

Managed health care plans are a variation from traditional private medical insurance plans like indemnity health insurance. Managed care was first tried in the United States on a large scale about 20 years ago. The advantage to these plans is that they are structured to keep provider costs under control which results in more predictable and less out of pocket costs for plan members to receive medical services.

It helps to understand the basis for how doctors, hospitals and other medical service providers get paid in the United States in order to understand why and how managed care plans evolved and will continue to evolve. Medical care in the United States is a fee for service arrangement between patients and doctors. Doctors provide specific health services like yearly checkups or treatment for minor aches or ailments for routine care and oversee hospitalization and treatment for more serious illnesses or medical conditions. Patients pay fees to the doctor, hospital and other medical service providers for each of these services.

A traditional indemnity plan is based on reimbursing a portion of the fees, usually 80%, that a patient pays for medical services. Usually, a doctor or hospital will bill the indemnity insurance for their portion of the charges first and then bill the patient for the remaining amount to pay. For many people, indemnity insurance can leave them under insured, meaning these people have a hard time paying 20% of medical service charges in addition to having to meet a health insurance deductible at 100% of the charges before the insurance starts paying anything for services billed.

Managed care plans can be a better option for people that are under insured when using an indemnity plan. These plans work with medical service providers like doctors and hospitals to agree in advance the fees that will be paid for specific medical services. In turn, members that use these plans agree to give up flexibility of choice and choose a doctor or hospital from within the network of providers approved by the plan. Plan members might also pay a higher premium. In exchange for this, members usually only owe a fixed dollar amount copay for routine medical services with no or a lower health insurance deductible.

In summary, managed care plans can provide more predictable and lower out of pocket costs for those people that find themselves under insured with other types of private health insurance. What you give up in flexibility of choice in your doctor or hospital, you can gain with more financial piece of mind when planning how to pay for your health care expenses.

Student Plans – Student Health Care Plans

Student health care programs offer health benefits at a greatly reduced cost, allowing students to pay for it themselves or allowing their parents to include their children’s health care plans with little additional cost to them. Student plans provide a great option to ensuring the good health of your children without having to take on a significant amount of extra financial burden, and also provide a way for students putting themselves through school (and supporting themselves financially) to maintain a level of health insurance. Here, we’ll go over how student health care plans work, as well as why you might want to consider them either for yourself if you are a student, or for your children.

Student health care plans can be acquired from a number of different sources. Some private insurance companies provide parents with health care options for their children, specifically geared towards keeping students healthy. There are also publicly and privately funded state and federal programs for helping students pay for health insurance. Some of these programs provide different benefits by working with individual schools to help set up unique types of plans for each student. This means it’s important to do a little research on your current health care provider, as well as the school you or your child is attending in order to find the best deal on student plans.

Student plans are used primarily to keep students in good health in order to allow them to go to school without missing attendance, as well as ensure their good mental health throughout their education. Students who are in better physical health exhibit higher test scores because they tend to miss fewer classes, and need to repeat classes much less frequently than those who have consistently poor health. A healthy student will also tend to be less stressed about school, and will be able to maintain a more active lifestyle both physically and socially.

The benefits of student plans are far reaching and very important to any young person going through an education. If you are a student or the parent of a student, looking into student health care is a great way not only to save money, but also to ensure that you or your child is in consistently good health. Student plans can range from typical care such as doctor’s visits, emergency care, and so on, to catastrophic coverage, dental, and other types of health benefits.

Health Care Plans – Traditional Health Care Plans

There are two basic types of health insurance plans available today. There is the traditional care health plan and the managed health care plan. We will examine the traditional health care plan and help you distinguish between the two.

Traditional care insurance can also be known as “fee for services” or “indemnity plans”. Traditional care insurance plans have the following features:

You usually pay a higher out of the pocket expense at the time of service. This can also include expenses up to a set deductible limit.

Once you meet the deductible limits, you then share the bill with the insurance company. For instance, your insurance company may pay 80 percent and you have to pay 20 percent. You will continue to share the bill until you reach your maximum out of pocket expenses. After this the insurance company will pay 100 percent of expenses up to its cap.

You could be responsible for keeping your own records of expenses. You might have to submit a request for reimbursement from your insurance company.

The insurance corporation will only pay for usual and customary expenses. Any additional charges or expenses will have to come out of your pocket.

Not every insurance company will offer a wellness or preventative care with this type of plan.

The traditional insurance corporation usually has very few restrictions on which medical providers and specialists you can see and use.

If your plan is a catastrophic or high deductible major medical health plan, you will generally have lower annual premiums than a plan with a lower deductible.

Today, traditional health care plans are becoming increasingly hard to find, as most insurance companies are switching to a managed care plan solution.