Health Services: Policy and Systems for Therapists (3rd Edition)
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This extensively updated text fully equips today’s occupational and physical therapists with indispensable knowledge about rapidly-evolving policy developments that are reshaping their professions. Health Services, Third Edition reflects PPACA (US health care reform); major changes to Medicare and reimbursement policies, and other key trends that are impacting practitioners or soon will. Health Services, Third Edition explains the principles and major structures of health services; reviews how policies and systems affect therapists’ ability to serve patients, and shows how to be an effective advocate for both private and public policy change. The authors explore access, cost, quality, licensure, informed consent, medical liability, and many other key issues. A new chapter on global and population health integrates important public health topics, and substantial new content is provided on special education and mental health care systems.
Persons receiving Supplemental Security Income (SSI) (e.g., some persons with disabilities) qualify for Medicaid. Supplemental Security Income was established by Congress in 1972 to provide a monthly cash benefit to low-income (annual income < 75% FPL) citizens with disabilities (including persons who are blind) and persons over age 65. In addition, individuals may not have assets exceeding $2,000 (or $3,000 for couples). The 2012 federal monthly cash benefit is $698 for individuals and $1,048
be able to accept and manage capitated contracts to successfully deliver comprehensive health services to its population. In both cases, they are intended to address known problems with the expensive, fragmented delivery of health care in the United States and improve patient outcomes. The PPACA provides for financial incentives (“shared savings”) from the government to these organizations who provide care for Medicare beneficiaries (Longworth 2011). Data, information technology, quality
direct access to physical therapy in military health care facilities. J Orthop Sports Phys Ther 35(10): 674–78. National Center for Health Statistics. 2006. Characteristics on trends in the health of Americans. Hyattsville MD. Peden, E.A., and M.S. Freeland. 1995. A historical analysis of medical spending growth, 1960–1993. Health Affairs 14(2): 235–47. Penchansky, R., and J.W. Thomas. 1981. The concept of access: Definition and relationship to consumer satisfaction. Med Care 19(2): 127–140.
technology, especially because technology is such a rapidly developing area. Therapists may refer their clients to state centers established by this law, to familiarize them with the most current technology available. People in state centers encourage client access to technology, provide technological assistance and education, and possibly provide loaner equipment programs (Brachtesende 2003). In addition, the act may help therapy clients through funded research for the development of new
capitation reimbursement amount, then profits are realized. Thus, the incentive is to engage in coordinated preventive care and keep patients healthy while avoiding expensive or extensive health care services. These incentives are so powerful that, in some cases, the withholding of necessary services has been alleged against providers and MCOs using capitated payment models. Enhanced Quality-Improvement Monitoring Managed care plans intend to integrate the financial and delivery mechanisms of