Medicare, Medicaid, and the Delivery System Case Study

Medicare, Medicaid, and the Delivery System - Case Study Example All these approaches have incentives that seem to motivate a certain trend (Guterman, Davis, Schoenbaum & Shih, w238). However, of the above three, the fee-for-service is the traditional one. The capitation approach is up-to-date and is meant to be a step up concerning creating better incentives for preventive care, efficiency, and cost control in health care. Under this payment system, a hospital, a physician, or a medical group receives a given flat fee per month for caring for a patient registered in a managed health care plan, despite the cost of the patient’s care. In the global capitation mode, whole networks of physicians and hospitals band in unison to obtain single fixed per-month payments for registered health plan individuals. The providers sign one contract with a health plan covering the care group signatories, and then they must establish a way of dividing the capitated check among the members. Flexibility in shared savings symbolizes a major feature of the proposed Medicare ACO rule. As such, even though ACOs will be reimbursed by fee-for-services, CMS are also scheduled to come up with benchmarks designed towards every individual ACO. In case the ACO exceeds its specified standard in Medicare cost savings, it definitely qualifies for shared savings. However, it will as well be held accountable for any incurred losses for failing to meet the set benchmarks. In addition, CMS has proposed creating a minimum sharing rate meant to account for normal differences in expenditure that could determine whether ACO reaches or goes beyond its benchmark (Guterman, Davis, Schoenbaum & Shih, w250). In the proposed rules, CMS has set forth two tracks for ACO reimbursement models. Here, ACOs will be asked to serve at least five thousand Medicare beneficiaries for a period of 3years. This new rule gives ACO an opportunity to follow a one-sided risk approach, where only

Imagining the west Thesis Example | Topics and Well Written Essays - 1000 words

Imagining the west - Thesis Example The proclaimed ideological objective of Early American expansionists was to secure living space in the entire American West for the whites agricultural settlement by cleansing the new space for â€Å"whites† through the displacement of the Native Americans (Carroll 8). The ‘American West† involved racial-imperialist continental territorial expansion incorporating ‘taking’ indigenous’ land by force (Carroll 43). In 1893, Jackson Frederick Turner, a historian of the American West, expressed that frontier and westbound expansion served numerous purposes. The frontier acted like the â€Å"safety valve† reducing overpopulation by allowing Americans to free land. Moreover, the frontier exhibited new financial or economic opportunities as people searched for resources and land to exploit with the goal to guarantee prosperity (Koetzing 4). Turner’s Frontier Thesis accounts factors in the course of American imperialism since it crystallizes many of the desires and hopes that Americans had in the last decades of the nineteenth century (Koetzing 5). According to Turner, the frontier was "the gathering, meeting, point in the middle of civilization2 and savagery". Turners idea of the frontier enveloped ideas of progress, conquest, and individual accomplishment or achievement. Turners concept resonates with the definition of what it is to be an American today: he believed that the advancements of American settlements westwards with the conquest or triumph of landscape clarified American development (Koetzing 6) Turners frontier myth, the "gathering, meeting, point between of civilization and savagery", characterized the American’s relationship with the natural world found and misused for the name of advancement. The West availed the free land on which democracy and equality based system could thrive. The present of a continuously growing frontier was to account for remarkable American qualities: "the presence of a zone of free land, its consistent