DUE 5-12-16 AT 5:00P.M E.S.T BE ON TIME….Read this Scenario ……And Answer Why doAn “expectable” future in which policymakers promote health prevention and self-management and there is an expansion of the patient-centered medical home (PCMH) model with the adoption of sophisticated electronic medical record (EMR) systems and health information technology to improve the cost and quality of primary care.Primary care improved significantly throughout the 2010s as payment system changes offered incentives for collaborative care using the PCMH model. Reductions in payment rates to health care providers by government and private payers, along with changes in payment approaches, forced providers to reduce costs. Providers accomplished some cost reductions by focusing on prevention, shifting tasks to nonphysician providers, and increasing the share of patient contact that occurred online or by phone. Such efforts were coordinated using EMRs that captured patients’ health data and used genetic and other personal information to anticipate the health challenges they might face. With the establishment of health insurance exchanges mandated by the Patient Protection and Affordable Care Act (ACA) of 2010, many employers terminated their company health insurance benefit plans. The effectiveness of the health insurance exchanges in increasing access and reducing cost, however, varied widely from state to state. Health insurance exchanges in some states enhanced quality, pressed for lower cost and promoted competition. In other states, the exchanges offered little more than options that had already been available without encouraging better quality or lower prices. Some states moved to a single payer for the state—a move that tended to increase health care quality and constrain costs. A significant portion of Americans fulfilled the individual insurance mandate by buying consumer-directed health plans (CDHPs), which left them paying for much of their primary care out of pocket. A shortage of primary care providers in the United States continued to be a problem. To compensate for the shortages, primary care teams expanded and most team members worked at the top of their licenses. Nurse practitioner-managed primary care increased in many states. As the primary care teams broadened, more nurses, social workers, community health workers, and pharmacists joined the team. Many of the primary care teams added care in virtual space on the Internet to their phone and email interactions with patients. The primary care provider shortages were also mitigated somewhat by the availability of support technologies like IBM’s “Dr. Watson” and its successors and competitors, which provided clinicians with easy access to a wealth of proprietary and public health information.
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