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One of the possible solutions to the nations problem with lack of health insurance coverage for all is a pay-or-play program that puts the burden on employers to provide employees with health insurance or pay for insurance provided by the state. California will be implementing such a program as created in Senate Bill 2, which passed the legislature Sept. 12 and was signed by former Gov. Gray Davis Oct. 5, about six weeks before he left office.
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Often considered a bellwether state in health policy, California is demonstrating the extent of the problem of lack of health insurance, but it also will be seeing how one possible solution could work.
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A literature review, state survey, and expert meeting to look at the design and operation of Medicaid buy-in programs as a way to cover the uninsured have found that such programs have increased in both number and enrollment in recent years, and states have demonstrated that they can design and implement participant buy-in programs using existing waiver mechanisms.
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At the end of 2003, there was a flurry of reports on the problems of those without health insurance coverage for all or part of each year and what to do about them. The upcoming presidential campaign keeps the issue alive. Here is a summary of the reports and analyses that are likely to be the foundation for any policy changes.
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Home care providers and patients remain concerned about the decisions that managed care organizations (MCOs) and other payers make about whether to pay for care.
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Swallowing difficulties are complications in many diseases and conditions and are a recognized potential problem in the elderly, especially those with Parkinsons disease. Health care providers must be aware of these dangers of choking, learn methods to minimize them, and be prepared to intervene when choking occurs, regardless of the setting.
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Discharge planners at some facilities apparently are either unaware of or are ignoring a federal requirement that hospitals offer patients a choice of home care providers and that they tell patients when there is a financial interest between the hospital and an agency to which the patient is being referred.
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Even before the new survey process goes into effect, the Joint Commission on Accreditation of Healthcare Organizations has created options to the self-assessment portion of the survey.
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Hospital Home Health begins the year with a look at the challenges that will be faced by home health managers in 2004. This months cover story introduces a few of the key issues addressed by this new legislation. Next month, we will discuss other demonstration projects included in HR 1, such as the homebound definition, collaboration with adult day care, reimbursement based upon performance, and employee background checks.