Can Psychologists Prescribe Medications

Can Psychologists Prescribe Medications Psychotherapy Print Can Psychologists Prescribe Medications? By Kendra Cherry facebook twitter Kendra Cherry, MS, is an author, educational consultant, and speaker focused on helping students learn about psychology. Learn about our editorial policy Kendra Cherry Updated on February 15, 2020 Hero Images / Getty Images More in Psychotherapy Online Therapy In the vast majority of cases, psychologists cannot prescribe medications to their patients. However, there has been a recent push in several states to grant psychologists prescribing privileges and there are actually already a few places where psychologists do have prescribing privileges. Where Can Psychologists Prescribe Medications? Psychologists are able to prescribe medications in the military and the Indian Health Service as well as in Louisiana, New Mexico and Illinois. Professional psychologists gained prescribing privileges in New Mexico in 2002 and in Louisiana in 2004. In 2014, Illinois became the third state to grant prescribing powers to psychologists who hold appropriate training. In such cases, psychologists are required to receive proper training and are permitted to prescribe certain medicines used in the treatment of mental disorders. What Training Do Prescribing Psychologists Have? What kind of training is needed? In Louisiana, for example, psychologists who want to gain prescribing powers must complete a post-doctoral masters degree in clinical psychopharmacology, pass a board-recognized national exam, and hold a certificate of responsibility from the Louisiana State Board of Examiners of Psychologists. In Louisiana: Psychologists must first complete a post-doctoral masters degree in clinical psychopharmacology before they can prescribe medications.In New Mexico: Psychologists must complete 450 hours of didactic training and 400 hours of supervised practice in psychopharmacology.In Illinois: Psychologists must receive specialized training in psychopharmacology. In addition to this training, they must complete a supervised clinical rotation that lasts 14 months and covers a variety of settings including hospitals, prisons, and mental health clinics. Psychologists are not the only non-physicians who have been granted prescribing rights. Advanced psychiatric nurses also have limited prescribing powers in at least 40 different states. Arguments for Prescribing Privileges Supporters of prescribing rights for psychologists include the National Alliance of Professional Psychology Providers. Advocates suggest that psychologists should be allowed to write prescriptions for a number of different reasons. Today, physicians prescribe approximately 70 percent of psychiatric medications even though they often have limited training and experience with mental illness.?? Proponents suggest that many people would be better served by a psychologist who can also utilize other treatment strategies outside of pharmacological interventions. Some other reasons cited by supporters include: Increase accessibility to mental health careAllow patients faster access to treatmentsHelp rural patients access treatments more readilyDecrease wait time for treatments; many states face a shortage of psychiatrists, making it difficult for clients to access mental health care in a timely manner.?? Arguments Against Prescribing Privileges Organizations against offering prescribing rights to psychologists include the American Medical Association, the American Psychiatric Association, and the National Alliance on Mental Illness. Opponents cite a number of reasons why psychologists should not be able to write prescriptions, including: Insufficient training in medicine and pharmacology.??Risks of side effects of medications.Danger of overlooking medical disorders that might be mistaken for mental disorders.Approximately half of all patients prescribed psychotropic medications also have one or more co-existing medical conditions.Physicians and psychiatrists are better trained to determine when and if medications are needed.

The Portal of Rouen Cathedral Light. - 686 Words

Art 2 The piece I chose was â€Å"The Portal of Rouen Cathedral in Morning Light,† painted by French artist Claude Monet in 1894. The medium Monet chose for this piece was oil on a 100.3 by 65.1 cm canvas. This Rouen Cathedral itself is a Roman Catholic cathedral that is located in northwestern France, and was something Monet found interesting enough to paint while his stay in France. The Rouen Cathedral was a one of the few paintings that caught my eyes, as it is very unique. I instantly knew the medium that was chosen was oil paint as it had a bit of texture due to the layering, as well as a slight glaze. Another reason why I found this piece so interesting, and what makes it so beautiful, is that Monet captured the cathedral in an†¦show more content†¦The principles of design used in this piece are variety, as well as balance, dominance, and harmony. The contrast of the shades of blue and glazes of pale yellow here and there create the most obvious contrast in the piece, as these two colors are complementary colors on the color wheel; this contrast captures the audience’s eyes. In terms of balance, this piece is asymmetrical because it is not identical on both sides. Instead, this piece is unequal when it comes to its proportion and overall picture. Harmony is present in the repeated shades of blue and pale yellow. There is also harmony in the repeated texture that is present throughout. Also, we can see dominance in the cathedral that is present as it occupies most of the canvas and is therefore what stands out; Monet really emphasizes the cathedral. Overall, Monet’s piece is well designed because it is able to capture your attention. The hues he chose really captures the quiet, yet upcoming warmth of the sun that is present in the morning when the sun is starting to rise. His portrayal of the cathedral on the canvas is very abstract, making it unconventional and unique. Therefore, I think his work is very well designed. Monet was an Impressionist, meaning he was interested in capturing things in the moment. The story behind this piece was that in 1892, Monet set up a studio in a hotel across from the Rouen Cathedral. Seeing the cathedral every day, day in and day out, he decided to paint aShow MoreRelatedFriday Of The Getty With Paul1007 Words   |  5 Pagesartwork dating as far back as the 1300s. I focused on art that was featured in different galleries of the museum including Italian Renaissance era and early Christian work. The paintings that I finally decided to write about were The Portal of Rouen Cathedral in Morning Light, The Arrival of Saint Ursula at Cologne and An Allegory of Fortune (both Dosso Dossi and Salvator Rosa’s paintings). Dosso Dossi’s An Allegory of Time, painted around 1530, depicts a nude woman, portraying Fortune, facing out towardRead MoreAutumn on the Seine, Argenteuil by Claude Monet Essay963 Words   |  4 PagesClaude Monet was no exception to this statement. Like in Claude Monet’s Rouen Cathedral: The Portal (in Sun) (Garnier, 824), sunlight is an important part in scene created in Autumn on the Seine, Argenteuil, though is not the real subject of the piece like it is in Rouen Cathedral: The Portal (in Sun). In Autumn on the Seine, Argenteuil, Claude Monet used darker hues of the colors to capture the light and the absence of light throughout the painting. The sun itself cannot be seen, but the intensityRead MoreClaude Monet Essay1193 Words   |  5 Pagescoast, France. This piece was made in March or April of 1873. The piece’s present location is the J. Paul Getty Museum, west pavilion, gallery w204. The medium is oil on canvas and is next to another piece made by M onet called The Portal of Rouen Cathedral in the morning light. Claude Monet was part of the impressionist movement that changes French paintings of the nineteenth century. For Sunrise (1872), people criticized the paint due to the appearance of an unfinished painting, however other artistRead More The Contrast between Gothic Architecture and Romanesque Architecture1934 Words   |  8 Pagesstyle, being inspired by the Roman architecture, used the plan of the basilica style. Romanesque cathedrals were not originally designed for aesthetic purposes. Romanesque style replaced flat wood ceilings with stone vaulting. It was one of the first styles to use mainly all stone, but the walls of the Romanesque cathedrals were built very thickly. They were almost like a fortress. Romanesque cathedrals had few windows as a result of their thick walls so the churches were very dark. In a sense, this

No Pains No Gains Distributed Database Solutions

NO PAINS NO GAINS: DISTRIBUTED DATABASE SOLUTIONS CSC 633 RAJEEV SAGAR REDDY MERUGU. INTRODUCTION: Database management has undergone more than four decades of evolution producing vast range of research and extensive array of technology solutions. The database research community and software industry has responded to numerous challenges resulting from changes in user requirements and opportunities presented by hardware advances. The relational database approach as represented by SQL databases has been particularly successful and one of the most durable paradigms in computing. Most recent database challenges include internet-scale databases – databases that manage hundreds of millions of users and cloud databases that use novel techniques†¦show more content†¦RDBMS stores the data in the form of tables and can be retrieved from the tables with the help of SQL Language. SQL was invented only after the invention of RDBMS. SQL – Sequential Query Language. Most common RDBMS’s are My SQL, DB2, Oracle, and Microsoft SQL. The reason for using RDBMS rather than a DBMS is that DBMS stores data in the form of Files whereas RDBMS stores data in the form of Tables containing rows and columns and there exists a primary key relationship such that the data stored in multiple tables can be retrieved using SQL. As RDBMS is a relational database model, the data is stored in the tables in the form of relations. RDBMS supports Distributed database and is designed to handle large amounts of data. Database research and associated standardization activities have successfully guided the development of database technology over the last four decades and SQL relational databases remain the dominant database technology today. This effort to innovate relational databases to address the needs of new applications is continuing today. Recent examples of database innovation include the development of streaming SQL technology that is 170 George Feuerlicht used to process rapidly flowing data (â€Å"data in flight†) minimizing latency in Web 2.0 applications, and database appliances that simplify DBMS deployment on cloud computing platforms. It is also evident from the above discussion that the relationalShow MoreRelatedCisco System Case Study1510 Words   |  7 PagesFinance and Order Entry system corrupted the core application database malfunctioning of the system and cisco was shut down for 2 days virtually. This moment has made management to take critical decisions on their IT system. Cisco decided to have a single integrated solution for all the 3 functional areas and with help of KPMG as an integration partner, Cisco has selected Oracle ERP product as their IT solution partner and deployed solution in production by Jan 1995. Also, by 2001, Cisco has successfullyRead MoreNew Pains, New Gains3369 Words   |  14 PagesNew Pains, New Gains: Distributed Database Solutions are on their way D atabase is a collection of data which describes the activities of one or more organizations in a well-defined structure and the structure of a database is specific and it has a purpose. Database Management System (DBMS) is used to control or organize the data in a database. Database Management System (DBMS) is also used for maintaining large collections of data. Distributed database can be defined as a collection of variousRead MoreWhat s The Real Role Of Your Network?1967 Words   |  8 PagesApplications Are Performing Increase productivity by implementing more robust application monitoring [p. 1: Introduction] Corporate networks are facing an unprecedented number of challenges, from ensuring data security to increasing mobility across a distributed workforce. As IT manages all the components of network performance, like storage, switches, servers and firewall, there s a need to take a deeper dive into the question: What s the real role of your network? For most, if not all, businesses inRead MoreSupply Chain Business Intelligence Technologies, Issues and Trends9649 Words   |  39 Pagesservices. Many companies are beginning their search for a solution to implementing an electronically oriented supply chain management system that provides connection to customers and to suppliers. This integrated supply chain may be based on new M. Bramer (Ed.): Artificial Intelligence, LNAI 5640, pp. 217 – 245, 2009.  © IFIP International Federation for Information Processing 2009 218 N. Stefanovic and D. Stefanovic software solutions or based on enhanced communication capabilities. The ultimateRead MoreConstructing the Written Evidence-Based Proposal: Patient Quality Service When Dealing with Urinary Tract Infections5418 Words   |  22 Pagesincorporated, solution identification, incorporating a theory, implementation plan, evaluation plan, dissemination of results Literature Review. The main focus of the paper is the patient quality service when dealing with urinary tract infections (UTI), catheter-associated urinary tract infections (CAUTIs). UTI is an infection of the urethra, bladder, ureters and kidneys that occurs when bacteria gain access to the urinary system. This infects the urine of the patients and leads to pain in the lowerRead MoreThe Problem Of Organ Trafficking2906 Words   |  12 Pagesboth children and adults are victims of organ trafficking. Those who have their organs unwillingly removed and sold are likely to also be victims of human trafficking. Many of these people ar e lured in with promises of a â€Å"better life† or monetary gain, more often than not these are empty promises that result in dangerous situations. Within the black-market trade of organs, also referred to as the â€Å"red-market†, the amount of money or even the sales of these organs are also effected by the culturalRead MoreDo-Not-Resuscitate: Legal and Ethical Issues Essay3308 Words   |  14 Pagespopular subject of many fictional books. However, as technology evolves and the story of Frankenstein reborn with a bolt of lighting has come true with the external or implanted defibrillators, the natural process of death slows as much of society gains the knowledge to live longer than nature intended. The Red Cross Association taught many organizations like the girl and boy scouts the methods of mouth-to-mouth resuscitation and Cardiopulmonary resuscitation or CPR, a manual manipulation of theRead MoreHofstede cultural dimension: spain1888 Words   |  8 Pages(Lane at al 2006). Geert Hofstede analyzed in terms of his study a large database of employee values scores collected by IBM between 1967 and 1973. From the results Hofstede developed four dimension models that differentiate cultures according to: Power Distance Index (PDI) - the extent to which the less powerful members of organizations and institutions (like the family) accept and expect that power is distributed unequally. Individualism (IDV) - the one side versus its opposite, collectivismRead MoreStudy Habits2859 Words   |  12 PagesSUBJECT: NURSING EDUCATION SEMINAR ON: DEVLOPMENT OF EFFECTVE STUDY HABIT General Objectives: The students will gain in depth knowledge about various methods of effective learning and practice it during their study time. Specific Objectives: At the end of the seminar the students will be able to, 1) Define learning and study habits 2) Explain the concept of Study skills 3) Describe the Process of study 4) Enlist the Types of learning 5) Develop Effective Study Habits 6) ElaborateRead MoreHigh Fidelity Patient Simulation For Nursing Education6315 Words   |  26 Pagesreliable care to the population it serves. This barrier affects nurses since they gain little clinical skills and experience to deal with various health problems. Despite the literature content that nurses may gain from the classroom, this content alone is not adequate for clinical practice. Therefore, substantial interventions are necessary to improve the clinical experience gained within practice settings. One solution to address this problem has been the integration of high-fidelity simulation [HFS]

Benefits of Cost Accounting Information Free Essays

Cost accounting offers benefits for manufacturing companies. A cost accounting information system offers benefits for many companies. Cost accounting is a type of accounting method concerned with the cost of goods manufactured and /or sold. We will write a custom essay sample on Benefits of Cost Accounting Information or any similar topic only for you Order Now Many factors are taken into consideration when cost accountants analyze business costs . The information determined by these accountants is used for inventory valuation , financial statements and decision making . Inventory Valuation Cost accounting offers the benefit of having an accurate inventory valuation of all inventories on hand . This includes all raw products used to make goods , all work-in -process inventories and all finished goods ready for sale. Cost accountants take all costs into consideration and are able to determine the value of all of these inventories on hand . This information is useful for financial statements and for management of the company . Managers use this information to determine selling goals and production needs . Maximum Efficiency Cost accounting is beneficial to determine the maximum efficiency production amounts . Cost accountants take all costs into consideration when calculating this amount . Manufacturing costs consist of direct labor , materials and manufacturing overhead. These costs are all calculated and added up to find a per- unit cost price for manufactured items. When the cost price is calculated, these accountants begin determining a hypothesis of production rates . Many times cost accountants determine that if production is increased slightly, overhead costs remain the same. If this is the case, increasing production actually results in a lower per -unit cost for production , and the end result is a higher profit . Decision Making The information determined by cost accountants is used for decision making for future company needs . Short -term goals and decisions are made as well as long-term strategic decisions. The analysis of cost information is used to compare projected costs to actual costs . This is useful for businesses when budgets are created . Often times, unforeseen costs occur with production , and they are determined in this way. Unforeseen costs are added into the future budgets at rates calculated by cost accountants . Cost accounting also helps companies establish approximate future cash flows . Short -term production goals and marketing decisions are set based on this information. Long -term production plans are also calculated. How to cite Benefits of Cost Accounting Information, Papers

Teamwork Building a Formidable Team Essay Example For Students

Teamwork Building a Formidable Team Essay Generally, good teams consist of a diverse mix of people, who think, work and do things differently. They may be complete opposites but still get along well. Why? Because there is also some aspect of humanity or values that they share – all of which are, sadly, subjective. They are similar to the pieces of a jigsaw puzzle; individually different pieces, together, making the final outcome a magnificent creation. I personally feel that the term ‘good team’ is a slightly ludicrous ambiguity for what I call a ‘SMART TEAM’. Why again? Having a diverse set of people would of course create conflict and arguments, but when you share a common goal as a group of smart men and women, you will always collectively find a way through! The key factor of a good team is open communication. Many people tend to remain part of a team simply out of fear, fright or due to the lack of any other option. This means that it always boils down to leadership, to create an atmosphere where all members – or rather, ‘team players’ – are so gelled, that no one is afraid of being humiliated or unvalued in opinion, to speak out confidently, regardless of how sensible or cynical their thoughts are. We will write a custom essay on Teamwork Building a Formidable Team specifically for you for only $16.38 $13.9/page Order now In a great team, no voice is unimportant, and we must not forget how the craziest of thoughts might actually spark the reaction for amazing ideas and brainstorming. For instance, it was only recently my friends and I created a website on Wildlife for the Young Computer Scientists competition; but little did people know what really inspired us was, ‘I like to Move It’ from Madagascar, which the two boys in my group sang spontaneously. What started with perhaps the most hilarious song in the history of animations resulted in a merit award on a national level! However, we cannot put this all in the hands of a proclaimed ‘leader’! A ‘leader’ in this context, could facilitate and push for activities to closely knit together his/her teammates, but it is the duty of all to understand each other and choose to spend more time with any member you feel you may be still new or uncomfortable with. The best team isn’t necessarily one where all the members have known each other for ages, nor is it a collection of the best keyboardist in the world, best guitarist in the world, and the best possible drummer on Earth, say, in a band! A team would be a comfortable and secure place for all members if mutual respect reigned, be it for one’s abilities, background, religion or cultural diversity. Be open, but otherwise, speak cautiously – one should identify the personalities of the others. Of course, I’m not saying to think one thing, and say something else – don’t live in lies – so, perhaps feel free to even talk about, discuss and exchange views. This might even help in bonding! A good team must collaborate. This may seem very complicated, but to put it simply, it means working in unison to achieve a common goal. Effective collaboration – understanding your own talents and what YOU can contribute to the team; each role is multilaterally crucial! Most importantly, the team should build a strong, effective strategy that enables problem-solving and conflict-managing wisely. Creating a shared mission among the team will increase the enthusiasm and interest in accomplishing each role (which, in turn, is the team’s goal), triumphantly. In my eyes, a good team member should be honest, straightforward, and fair-minded, carrying a sense of equity and fairness. Of course a sense of good humor too! Reliability – listen to Bruno Mars, â€Å"You can count on me like 1, 2, 3, I’ll be there†! Did you stop and start, or laugh at that? Yes, everybody loves a good laugh, but more so a good laugher! .u80a309c16b85bb6d5628014f9ba79fb9 , .u80a309c16b85bb6d5628014f9ba79fb9 .postImageUrl , .u80a309c16b85bb6d5628014f9ba79fb9 .centered-text-area { min-height: 80px; position: relative; } .u80a309c16b85bb6d5628014f9ba79fb9 , .u80a309c16b85bb6d5628014f9ba79fb9:hover , .u80a309c16b85bb6d5628014f9ba79fb9:visited , .u80a309c16b85bb6d5628014f9ba79fb9:active { border:0!important; } .u80a309c16b85bb6d5628014f9ba79fb9 .clearfix:after { content: ""; display: table; clear: both; } .u80a309c16b85bb6d5628014f9ba79fb9 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u80a309c16b85bb6d5628014f9ba79fb9:active , .u80a309c16b85bb6d5628014f9ba79fb9:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u80a309c16b85bb6d5628014f9ba79fb9 .centered-text-area { width: 100%; position: relative ; } .u80a309c16b85bb6d5628014f9ba79fb9 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u80a309c16b85bb6d5628014f9ba79fb9 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u80a309c16b85bb6d5628014f9ba79fb9 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u80a309c16b85bb6d5628014f9ba79fb9:hover .ctaButton { background-color: #34495E!important; } .u80a309c16b85bb6d5628014f9ba79fb9 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u80a309c16b85bb6d5628014f9ba79fb9 .u80a309c16b85bb6d5628014f9ba79fb9-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u80a309c16b85bb6d5628014f9ba79fb9:after { content: ""; display: block; clear: both; } READ: Movie Overview - Boy EssayFinally, the most vital aspect; â€Å"A positive attitude causes a chain reaction of positive thoughts, events and outcomes. It is a catalyst and it sparks extraordinary results. † – Wade Boggs. No one enjoys working together with a pessimistic person – as our school motto goes, ‘YES WE CAN! ’ There really is no perfect, hard and fast ‘recipe’ for an indomitable team – it is up to all of us to put our team – player modes on, get out of our comfort zones, and go find out! So – what are you waiting for?

Medicare Ambulatory Paymant System Essay Example

Medicare Ambulatory Paymant System Essay Example Medicare Ambulatory Paymant System Paper Medicare Ambulatory Paymant System Paper Ambulatory payment system commonly referred to as the Ambulatory Payment Category (APC) was adopted by the United States government in order to facilitate easy, faster and convenient outpatient services for the Medicare program. The federal government through it budget act of 1997, it established a new program under the major medical cover that takes care of the old people to create what is called Outpatient Prospective payment system abbreviated as OPPS. This method is only applicable to hospitals and that physicians could get their payment through other means like the current procedural terminology. The Ambulatory payment category usually come to use when a patient is discharged from the hospital’s emergency department or clinic or get a transfer to another health facility which is not allied to the hospital of origin where the patient was initially treated as an outpatient. Basically the ambulatory payment system begun as a federal government’s initiative and have gained popularity in that the state programs like Medicaid is also considering adoption of the same method. If these programs keep on succeeding, definitely the third part insurance companies in the healthcare system may also adopt it. Establishment The balanced budget act of the year 1997 (BBA) section 4523 gives authority and allows CMS to execute the prospective payment system which operated under the Medicare program and servicing the outpatients. This act was modified in 1999 and all the services that are paid under this prospective payment system are categorized into various groups which are termed as ambulatory payment classifications (APC’s). Generally all the services in the ambulatory payment system have comparable resource requirement and are identical or clinically similar. Services in each APC are reimbursed according to the services provided by the hospital and the hospitals could be paid for more than one APC for a single encounter (Medicare 1998). The modification of the section 4523 of balanced budget led to changes in the method of determining the beneficiary coinsurance for the services provided under the prospective payment system. In essence a coinsurance amount is calculated for every APC depending on the 20% of the national median payment for services in the APC. The coinsurance amount remains constant with any changes until the time when the amount becomes 20% of the total APC reimbursement. The act also provides that not amount of coinsurance would be greater than the yearly deductibles of the hospital inpatient. The two amounts, that is APC payment and coinsurance will be adjusted to indicate the geographic salary variation by use of the hospital age index and the assumption that the part of the payment or coinsurance that is attributed to labor is 60% (Hyman 2005). The proposed changes in the medical program of the United States targets to the Medicaid and Medicare programs since they major bodies that are concerned with healthcare coverage for the old who generally cannot afford a health insurance (third party coverage) US Division of the Federal Register. (2005). The federal operates the Medicare program and it’s the main source of the transformation initiative. Under this, the payment rates in following sections of Medicare will be transformed; payment rates for 2009, ambulatory surgical center 2009, hospital conditions of participation etc. The Previous Medicare Payment System There are three basic methods by which the citizens of the United States take care of their medical bill and they are; Medicare program, Medicaid program and the third party cover by insurance companies. It is estimated that the hospitals in the US receive over thirty percent of their revenue from the Medicare program. Most of the payments made directly to the hospitals by the program come from the inpatient cases and this is approximated to be about 88% while the rest covers the outpatients (Medicare 1998). The method used by the Medicare to cover expenses by the inpatient is as follows, there several disease conditions which are categorized as the diagnosis related groups (DRGs) there are about 600 cases in the groups and the Medicare only pays flat rates for a single hospital session. Each DRG is assigned certain weight and to compute the actual fee to be paid in each of the DRGs for a specific year, the DRGs relative payment weight is multiplied by the monetary exchange factor of that particular year is dollars. The value obtained is further adjusted in accordance to the variations in the labor cost of that region and of other facility inputs and for the local factors that could result in variations in the price of providing care(Hyman 2005). In order to take care of the complicated cases whose resources use significantly excesses that foreseen in the closest DRG, the system gives the outlier imbursement that in principle are meant to imply the estimates by the hospital for providing the extra supplies and services employed. The DRG weight that are being used were initially (since early 1980s) based on the relative average expenses of cases in the DRG’s. Some changes have been made to the calculation including average standardized, paid expenses for all cases that fall into each DRG in the recent Medicare records. The DRGs have since then been adjusted based on the standard, paid expenses of for all the cases that are covered under each of the DRGs in the current Medicare documents (Cleverley Cameron 2006). The outpatients initially compensated the hospital in a retrospective manner for the allowable, costs incurred for which the owners of the Medicare were supposed to make co-payments. These payments increased considerably since the early 1980s and by 1997 they were about 50% of the whole amount of healthcare expenses for the outpatient services. This called for some intervention and in 1997; a balanced budget act was established to drive the Medicare into controlling the apparently inflationary, full cost compensation system with a new one that would adopt a prospective cost schedule, and that the basic unit for the payment would be a specific service or procedure (Hyman 2005). This schedule was meant to be effected in the new millennium. In its efforts to develop new fee calendar, Medicare had to package as much as reasonable the whole set of supplies and services linked with main procedure into one large group. The groups were to contain the main processes that are clinically comparable and used equivalent amount of resources. These groupings were done according to the ambulatory payment categorization (APC) that was designed by researchers in the health services study and investigation undertakings. These APC’s are still developing and expanding as the Medicare program attains greater heights of knowledge and experience as well as with the advent of new technologies (Medicare 1998). Similar to the DRG system that is used in the inpatient system to pay hospital bills, APC dollar amount is also derived by multiplication of the relative cost weight of the specific APC (founded on the median of the particular APC) by a monetary exchange factor. Additional adjustments are made by considering aspects like cost of facilities, salaries and other factors that contribute to the cost of outpatient medication. The Medicare system is very complicated, partly because of the government’s involvement to regulate the operations of the system and ensuring fairness, responsibility, and meeting the social objectives. Most of the critics of the program overlook the fact that these obligations are a driving force to the public medical service and a challenge to the privatized medical care services (Hyman 2005). Nonetheless, the myriad of distinct imbursement schemes for the United States private insurance companies are complicated as well, by the global standards and mostly still founded on paper claims. The Transformations Last year there were announcements by the Medicare program about the new rule to increase the reimbursement rate for hospital outpatient sections and the ambulatory surgical departments by 3% throughout 2009 however those that do not comply with the new quality reporting regulation will see that pay rate increase only by one percent. It’s generally the first time that the services provided by the Medicare program are correlated to the quality of the services. The Medicare intends to entrench a culture of cautious purchasing of medical services from hospitals not based on the quantity alone but also quality and this would be in effect by the strict observance of the rule builds on transforming the program. Researches in the medical sector trends have indicated that more people prefer the outpatient settings as opposed to the inpatient service. For this reason, the center for Medicare administrator (CMS), Kerry Weems last year declared that Medicare would commit itself to work in conjunction with the hospital so as to make sure that their clients (people with Medicare) get the best quality of healthcare and in proper settings(Medicare 1998). The proposed changes for the year 2009 are meant to allow the hospital more fluidity in their operations so that management of the resources is improved and also give them the incentive to enhance the effectiveness where both beneficiaries and citizens (taxpayers) get the best worth for their healthcare expenses. The proposed rule to start operation in 2009 will ensure that there are up to date rates of payment in both the outpatient prospective payment system and ambulance surgery center prospective system (ASC-PPS) which would operational in the second year would seek to put in the same category the ASC rates and ambulatory payment classification groups that are currently used for reimbursement of the outpatient hospital department. The new rule will also address the 3% update on inflation rate per year to Medicare payment rates for most services that would be paid by the outpatient prospective payment system to an excess of over 4,000 hospitals and community mental healthcare centers in Calendar Year 2009. There are more changes in the in the new proposed changes to take care of the outpatient services provided by general acute care hospitals, community mental care facility, inpatient psychotherapy amenities, long-term acute care hospitals, pediatric hospital and cancer hospitals(Medicare 1998). The centre for Medicare and Medicaid projected that hospitals in the United States would receive about $28. 7 billion in Calendar Year 2009 for services provide to people who have Medicare coverage. In addition to that, center for Medicare and Medicaid will pay about $ 3. 9 billion in the year 2009 to over five thousand people who operate ambulatory surgery center program with Medicare. This is a major improvement in the health care sector since in the past years; the payment of the outpatient services was not in accordance with the quality of healthcare provided (Cleverley Cameron 2006). In the new preview, the proposed changes will demand that the outpatient prospective payment system updates be cut down by at least 2% for hospitals which do not comply with the quality reporting demands. For the reports to be fully informative and up to date, for the services provided in the year 2009, the hospitals will be required by the new law to give reports of the year 2008 on seven quality dimension of emergency department and pre-operative surgical procedures. Initially the seven dimensions were not strictly considered because of laxity but the new CMS has introduced four new dimensions of imaging effectiveness to the seven presented value measures for reason that it would useful for 2010 updates. CMS also intends to introduce public comment on other quality measures in sectors like the testing for the probable risk of cancer. Center for Medicare and Medicaid services seeks to improve and reinforce the program and enhance association between the value of care and Medicare imbursement, by obtaining public comment on the various options and contemplations for transforming payment methods for offering treatment to the conditions that are basically preventable if the practitioner follows the established guidelines. Currently, the center for Medicare and Medicaid is working on a policy implementation strategy to offer a similar change to the inpatient services as provided for by the Deficit Reduction Act of 2005. Under such regulations, the CMS will not make high payment rates to the hospitals for the giving treatment to various disease conditions which are predetermined to be realistically preventable as provided in the guidelines when they are attained during the patient’s stay in the hospital. For this, the hospitals will have an incentive to provide quality healthcare by following the guidelines already in place to cut down the number of cases that get infected by preventable conditions that occur as a consequence of the treatment (Medicare 1998). When these changes are fully followed and strictly observed, then the healthcare will have attained that status that one can comfortably say that it is reliable and of good quality services. Proposed Changes for Imaging Services There are instances when several imaging services are provided in one session, the CMS is also seeking to promote greater effectiveness by changing its way of making such payments for the multiple services in one sitting. This means that CMS will only make single imbursement for the multiple imaging services of a specific type for instance several ultrasound processes done in one session in the healthcare facility. Apart from the ultrasound processes, CMS will also include other services like the magnetic resonance Imaging (MRI) and Computer Tomography scans (CT-scans). The proposal also covers the changes that have to be used to enhance the accuracy of healthcare cost estimates which are used to set up prices for drugs and biologically active substances, United States Division of the Federal Register. (2005). Medical Cost Decrease According the statement by the management of Medicare program, the amount of expenses that the Medicare beneficiary would pay for the outpatient will decrease depending on the strategy put in place by the Medicare regulation which will translate to gradual changeover to 20% coinsurance. Before the implementation of the changes in outpatient prospective payment system (OPPS) for the year 2000, those serviced by Medicare used to take care of about 20% of the hospitals expenses instead of the 20% of the Medicare charges for services given to outpatients(Hyman 2005). Since the medical cost in hospital rose at a faster rate compared to the Medicare coverage for the same services, the Medicare beneficiaries share usually got beyond 50% of the whole amount paid to the hospital for the services. In the estimates made by the CMS analysts, about 25% of all the services that would be provided to the outpatients will be subjected to 20% coinsurance in the year 2009 cutting down from the 23% that was being used in 2008. The Benefits The anticipated transformation in the handling of the outpatient under the Medicare program is expected to bring about some uneasy feelings and also different reactions for different people. However most will agree that it will provide a very effective tool for the management to ensure that the management is efficient and also initiate responsibility and as a result, the profitability of the facilities will increase (Medicare 1998). The introduction of the Diagnosis Related Grouper (DRGs) for the compensation of the inpatients in 1983 was also faced with so much resistance with many critics insinuating that it would be a flop and the prospective payment would result in more problems. Contrary to the prediction of the critics, there were so many improvements in the superseding years in the overall operating margins for the inpatient services in most of the hospitals according to data from American Hospital Association. A similar improvement is anticipated in the year 2009 onwards in the outpatient services which will give the owners a lot of convenience and great assistance. The managers in particular will have a succinct data structure of management which will translate to efficiency because this is a very important tool for addressing product line concerns (Cleverley Cameron 2006). The information obtained will be used for the evaluation of the outpatient services, to practice expense regulation and to precisely bargain managed healthcare contracts. Most of the benefits will be enjoyed by mangers and those serviced by the Medicare program which means the plan is cost effective and that none of the parties involved will be exploited. The major benefits include the following; managers will have a means of spotting and correcting problems in the practice for instance inaccurate coding, unfinished documentation process and unwarranted supplementary services (Hyman 2005); the APC system will provide a method of facilitating cost reduction, comparison of expenses, alleviate instances of payment delays and carry out financial evaluations like the profit and loss calculation and analyses; the financial manger will be in comfortable position when making measurement of there competitiveness, making comparisons of the services with other local or even the national standards; outpatient hospital financial administrator can be able to develop case mix or make other measurements of resources utilization based on the number of people serviced, such kind of information can de very beneficial in the evaluation of the managed healthcare contracts; and finally the execution of the proposed changes in the OPPS section of Medicare w ill enable easy and accurate predictability of the imbursement which means that the manager can authenticate the accurateness of the compensation received (Cleverley Cameron 2006). Conclusion The transition in the needs of the US citizens and the globalization process has led to the increased need to improve healthcare. It such efforts, the health care practitioners and providers can work together to provide services to the clients. The development of the Ambulatory payment system (APC’s) was intended to provide quality healthcare on fee for service terms because of the development of the information sector and free market situation. Furthermore APC’s are also aimed at transferring some of the monetary risk for the services offered to the outpatient from the federal government to specific hospitals that provide the services and in this way, it is cost effective to operate the program. This is considered an inducement to better performance which is economical, efficient and profitable References Cleverley W. O Cameron (2006). Essentials of Health Care Finance. Jones Bartlett Publishers. Hyman D (2005). Improving Healthcare. A Dose of Competition. A Report by the Federal Trade Commission and the Department of Justice (July, 2004), with Various Supplementary Materials. Birkhauser. Medicare (1998). Prospective Payment System for Hospital Outpatient Services. Proposed Rules. Federal Register. Retrieved on 17th February 2009 from acess. opo. gov/su. docs/aces/aces140html United States Division of the Federal Register. (2005). Code of Federal Regulations. United States Federal Register Division. Office of the Federal Register, National Archives and Records Administration

Using the Spanish Pronoun ‘Nada’

Using the Spanish Pronoun ‘Nada’ Nada is the usual Spanish pronoun meaning nothing- but because double negatives are common in Spanish, the word nada can often be translated as anything. Nada Meaning Nothing When nada indeed means nothing, usually as the subject of a sentence, the use of nada is straightforward for English speakers: Nada es mejor que la maternidad. (Nothing is better than motherhood.)Nada es ms importante en este momento de nuestra historia. (Nothing is more important at this time in our history.)Nada puede cambiarme. (Nothing can change me.)Nada tiene ms vida que las cosas que se recuerdan. (Nothing has more life than the things that are remembered.)Nada es lo que parece. (Nothing is what it seems.)No quiero participar en la discusià ³n sobre nada importante.  (I dont want to participate in the discussion about nothing important.) When  the Verb With Nada Is Negated However, when nada is the object of a verb, it is normal for the verb itself to be negated. Therefore, when translating such sentences, you usually have to translate nada as anything or something similar, or use the verb in a positive form. In the following examples, either translation is acceptable: No hay nada ms. (There isnt anything more. There is nothing more.)Este congreso no sirve para nada. (This Congress isnt worth anything. This Congress is worthless.)El manifestante hablà ³ dos horas sin decir nada. (The protester spoke for two hours without saying anything. The protester spoke for two hours and said nothing.)No hay nada ms grande que proteger los nià ±os. (There is nothing more important than protecting children. There isnt anything more important than protecting children.He decidido que no quiero comer nada con conservantes o aditivos. (I have decided I dont want to eat anything with preservatives or additives. I have decided I want to eat nothing with preservatives or additives.)No me gusta nada. (I dont like anything. I like nothing. Technically, nada is the subject of this sentence, but the double-negative rule still applies.) Using Nada for Emphasis Sometimes youll hear nada used as an adverb, where (after taking the double negative into account) it is usually used as an intensifier and thus can mean not at all: Mi hermano no estudia nada y no ayuda nada en casa. (My brother doesnt study at all nor help out at home at all.)Si tengo paraguas no corro nada.  (If I have an umbrella I dont run at all.)No aprendà ­ nada difà ­cil. (I didnt learn anything difficult at all.) Using Nada in Questions In questions, nada is nearly always used with a negative verb:  ¿No ha estudiado nada de eso? (You havent studied any of that?) ¿No puede ver nada el nià ±o?  (Cant the boy see anything?) ¿Por quà © no tenemos nada? (Why dont we have anything?) Phrases Using Nada Here are some common phrases using nada: ahà ­ es nada (similar to no big deal, a way of emphasizing and downplaying something at the same time): Han estado casados por 50 aà ±os. Ahi es nada. (They have been married for 50 years. No big deal.) antes que nada (most importantly, above everything else): Antes que nada, queremos que viva. (Above everything, we want him to live.)   de nada (unimportant, of little value): Traje a casa una monedas de nada. (I brought home some worthless coins.) The phrase de nada is also frequently used as the equivalent of youre welcome after gracias (thank you), similar to saying Its nothing after being thanked.   como si nada (as if it were nothing): Despuà ©s de todo lo que dije, salià ³ como si nada. (After everything I told him, he left as if it were nothing.) nada como (nothing like): No hay nada como el hogar. (There is no place like home.) Avoiding Confusion With Conjugated Nadar Nada meaning nothing shouldnt be confused with nada, the third-person present indicative form of nadar, to swim: Nada todas las maà ±anas en la piscina. (She swims every morning in the swimming pool.)El atleta nada a casi nueve kilà ³metros por hora. (The athlete swims at almost nine kilometers an hour.)Nada en agua frà ­a como si nada. (She swims in cold water as if it were nothing.) Key Takeaways Nada is the Spanish word for nothing.Because of the ways negatives are used in Spanish, nada is sometimes translated as anything.Nada is sometimes used as a word of emphasis.