Home Health and Hospice Essay Example | Topics and Well Written Essays - 750 words

Home Health and Hospice - Essay Example Medicare is composed of three parts; Part A, Part B, and most recently part D. Part A and B were the initial divisions of the Medicare Program. Part A covers the health care received in hospice and health care without monthly premiums. It is the insurance portion of Medicare. Part B covers doctors’ services as well as other outpatient care absent in part A with an added monthly premium, which in 2008 cost about $96.40 every month (Shi & Singh, 2010). Changes in payment permitted people to make hospice services payment on a prospective basis under four care levels and adjusted by the wage index in an area. The local adjustment was important because it allowed low rates in regions with low wage levels and high rates in regions with high wage levels. This was followed by a new wage index, which comprised of a mix of both new and old wage indexes however; the new index was still based on hospital wage data. The Medicare hospice rates also varied according to the level of care that a beneficiary received. Initially, the payment system by Medicare was linked to the â€Å"Balanced Budget Act of 1997 (BBA)†, and it had a huge influence on the number of home health as well as hospice care agencies. Initially, the implementation of BBA led to the exit of these agencies from the market as it reduced medical reimbursement, and the number of providers. Implementation of the prospective payment system (PPS) generated improved growth and financial stability of agencies. It stopped the decline in the number of home health providers. With the PPS, Medicare paid home health and hospice providers for every 60-day â€Å"episode of care.† The amount paid for the 60-day period was a set amount based on a standard rate and adjusted to the type as well as the intensity of care offered known as a case mix formula. The home health PPS depended on a 153-category case mix adjuster to set payment rates anchored in patients attributes like functional status, clinical ri gorousness, and the requirement for rehabilitative therapy examinations (Shi & Singh, 2010). Initially, Medicare hospice coverage consisted of 290-day benefit periods and an indefinite number of 60-day benefit time. Coverage can extend beyond this period given that a six-month prognosis is the doctor’s best estimate. There is also provision for patients to move out of and back into hospice care. When out of the care, patients regular Medicare or other insurance cover them. Medicare reimburses the providers of home health and hospice care on a per diem basis. This kind of payment covers all services offered by the hospice (Shi & Singh, 2010). There are numerous different rates that vary according to the level and type of care offered. Concerning eligibility for home and health care under Medicare, a patient has to present a medical justification to qualify hospice and home health benefits. Initially, eligibility criteria varied, depending on the hospice program. However, patie nts had to have a progressive, irreversible illness limited life expectancy, and they had to opt for palliative care instead of cure-focussed treatment. The presence of a family member or another caregiver was required continuously when the patient was no longer able to care for him or herself. Initially, for a person to be qualified for Medicare benefits, he or she had to be qualified f

Tourism, Leisure, Culture, Society & Politics Essay

Tourism, Leisure, Culture, Society & Politics - Essay Example First and foremost, tourism is a result of consumerism. It deals with a set of services people have at their disposal for a particular amount of money. The financial issue is one of the most significant drives in touristic choices (Haan, 2008). That is to say, tourism and consumerism are close in their practical meaning with landscape as the main medium of attraction for tourists (Aitchison, MacLeod, & Shaw, 2001). In turn, capitalism is always consumerism regarding to the notion among Western countries. Hence, it is indicative of many people to be troublemakers instead of tourists, as they intrude into the milieu of cultural and ethnical diversity of some people with no excuse as long as they are driven by the idea of their right for letting loose in accordance with money they spent for such a pleasure. Besides, there is a clear distinction between tourism and traveling. Andrews (2011) admits that tourism does more harm to the environment than traveling, since it the former touches upon invasion, pollution, and narrow-mindedness while the latter is characterized by discovery, understanding, intelligence, adventures, and broad-mindedness. In this vein, tourism is a mark of a person’s identity looking at the places one visits and the services one prefers most of all with an idea of a cultural merge in mind (Weiermair & Mathies, 2004). It is all about the financial substantiality of individuals. Thus, they want to pay for their pleasure in terms of the price to be paid for that. On the other hand, tourism, leisure, political activities, rights of individuals are all incorporated in the field of globalization. To say more, tourism and leisure are socially constructed and are subject to the power of a man’s feelings and inner states (Andrews, Deconstructing tourism & leisure, 2011). In the historical cut, individuals tried to perceive multiculturalism when traveling around the globe. In some cases it was favorable (India, Africa) in some other (Magell an and the Philippines) it ended up ferociously. Nonetheless, tourism has become an exploration of one’s ability to cope with different identities and in close relation with the local authenticity. The works by Paul Gauguin, Somerset Maugham, Jules Verne, and many other representatives of art and literature were among the pioneers of the global trend for cultural and aesthetical tourism. However, it was nice at a glance from the very outset. It changed significantly with the advent of commodification versus authenticity. Cole (2007) points out in his study that commodification of different places (so attractive for tourists) leads to negative outcomes based on the political manipulation over the villagers for the sake of the tourists’ well-being. In fact, such a trend designates the very purpose of tourism in this or that location and in accordance with this or that cultural identity. Talking on the commodification and authenticity, one should bear it in mind that tour ism is a direct search for difference and dominance as long as some experts compare it with neo-imperialism (Andrews, Creating ‘the Other’: People as Tourist Commodities, 2011). In addition, it is Western people who are more devoted to explore other countries in the same manner as their predecessors did in the colonial age. Thus, it is a hidden drive for pleasure and its