Author: Irene Dankwa-Mullan
Publisher: John Wiley & Sons
ISBN: 1119374812
Category : Science
Languages : en
Pages : 548
Book Description
Integrates the various disciplines of the science of health disparities in one comprehensive volume The Science of Health Disparities Research is an indispensable source of up-to-date information on clinical and translational health disparities science. Building upon the advances in health disparities research over the past decade, this authoritative volume informs policies and practices addressing the diseases, disorders, and gaps in health outcomes that are more prevalent in minority populations and socially disadvantaged communities. Contributions by recognized scholars and leaders in the field—featuring contemporary research, conceptual models, and a broad range of scientific perspectives—provide an interdisciplinary approach to reducing inequalities in population health, encouraging community engagement in the research process, and promoting social justice. In-depth chapters help readers better understand the specifics of minority health and health disparities while demonstrating the importance of advancing theory, refining measurement, improving investigative methods, and diversifying scientific research. In 26 chapters, the book examines topics including the etiology of health disparities research, the determinants of population health, research ethics, and research in African American, Asians, Latino, American Indian, and other vulnerable populations. Providing a unified framework on the principles and applications of the science of health disparities research, this important volume: Defines the field of health disparities science and suggests new directions in scholarship and research Explains basic definitions, principles, and concepts for identifying, understanding and addressing health disparities Provides guidance on both conducting health disparities research and translating the results Examines how social, historical and contemporary injustices may influence the health of racial and ethnic minorities Illustrates the increasing national and global importance of addressing health disparities Discusses population health training, capacity-building, and the transdisciplinary tools needed to advance health equity A significant contribution to the field, The Science of Health Disparities Research is an essential resource for students and basic and clinical researchers in genetics, population genetics, and public health, health care policymakers, and epidemiologists, medical students, and clinicians, particularly those working with minority, vulnerable, or underserved populations.
The Science of Health Disparities Research
Author: Irene Dankwa-Mullan
Publisher: John Wiley & Sons
ISBN: 1119374812
Category : Science
Languages : en
Pages : 548
Book Description
Integrates the various disciplines of the science of health disparities in one comprehensive volume The Science of Health Disparities Research is an indispensable source of up-to-date information on clinical and translational health disparities science. Building upon the advances in health disparities research over the past decade, this authoritative volume informs policies and practices addressing the diseases, disorders, and gaps in health outcomes that are more prevalent in minority populations and socially disadvantaged communities. Contributions by recognized scholars and leaders in the field—featuring contemporary research, conceptual models, and a broad range of scientific perspectives—provide an interdisciplinary approach to reducing inequalities in population health, encouraging community engagement in the research process, and promoting social justice. In-depth chapters help readers better understand the specifics of minority health and health disparities while demonstrating the importance of advancing theory, refining measurement, improving investigative methods, and diversifying scientific research. In 26 chapters, the book examines topics including the etiology of health disparities research, the determinants of population health, research ethics, and research in African American, Asians, Latino, American Indian, and other vulnerable populations. Providing a unified framework on the principles and applications of the science of health disparities research, this important volume: Defines the field of health disparities science and suggests new directions in scholarship and research Explains basic definitions, principles, and concepts for identifying, understanding and addressing health disparities Provides guidance on both conducting health disparities research and translating the results Examines how social, historical and contemporary injustices may influence the health of racial and ethnic minorities Illustrates the increasing national and global importance of addressing health disparities Discusses population health training, capacity-building, and the transdisciplinary tools needed to advance health equity A significant contribution to the field, The Science of Health Disparities Research is an essential resource for students and basic and clinical researchers in genetics, population genetics, and public health, health care policymakers, and epidemiologists, medical students, and clinicians, particularly those working with minority, vulnerable, or underserved populations.
Publisher: John Wiley & Sons
ISBN: 1119374812
Category : Science
Languages : en
Pages : 548
Book Description
Integrates the various disciplines of the science of health disparities in one comprehensive volume The Science of Health Disparities Research is an indispensable source of up-to-date information on clinical and translational health disparities science. Building upon the advances in health disparities research over the past decade, this authoritative volume informs policies and practices addressing the diseases, disorders, and gaps in health outcomes that are more prevalent in minority populations and socially disadvantaged communities. Contributions by recognized scholars and leaders in the field—featuring contemporary research, conceptual models, and a broad range of scientific perspectives—provide an interdisciplinary approach to reducing inequalities in population health, encouraging community engagement in the research process, and promoting social justice. In-depth chapters help readers better understand the specifics of minority health and health disparities while demonstrating the importance of advancing theory, refining measurement, improving investigative methods, and diversifying scientific research. In 26 chapters, the book examines topics including the etiology of health disparities research, the determinants of population health, research ethics, and research in African American, Asians, Latino, American Indian, and other vulnerable populations. Providing a unified framework on the principles and applications of the science of health disparities research, this important volume: Defines the field of health disparities science and suggests new directions in scholarship and research Explains basic definitions, principles, and concepts for identifying, understanding and addressing health disparities Provides guidance on both conducting health disparities research and translating the results Examines how social, historical and contemporary injustices may influence the health of racial and ethnic minorities Illustrates the increasing national and global importance of addressing health disparities Discusses population health training, capacity-building, and the transdisciplinary tools needed to advance health equity A significant contribution to the field, The Science of Health Disparities Research is an essential resource for students and basic and clinical researchers in genetics, population genetics, and public health, health care policymakers, and epidemiologists, medical students, and clinicians, particularly those working with minority, vulnerable, or underserved populations.
Medical Fees
Author: James B. Davis
Publisher:
ISBN: 9781936977383
Category : Medical fees
Languages : en
Pages : 730
Book Description
Publisher:
ISBN: 9781936977383
Category : Medical fees
Languages : en
Pages : 730
Book Description
Service Design and Service Thinking in Healthcare and Hospital Management
Author: Mario A. Pfannstiel
Publisher: Springer
ISBN: 3030007499
Category : Medical
Languages : en
Pages : 535
Book Description
This book examines the nature of service design and service thinking in healthcare and hospital management. By adopting both a service-based provider perspective and a consumer-oriented perspective, the book highlights various healthcare services, methods and tools that are desirable for customers and effective for healthcare providers. In addition, readers will learn about new research directions, as well as strategies and innovations to develop service solutions that are affordable, sustainable, and consumer-oriented. Lastly, the book discusses policy options to improve the service delivery process and customer satisfaction in the healthcare and hospital sector. The contributors cover various aspects and fields of application of service design and service thinking, including service design processes, tools and methods; service blueprints and service delivery; creation and implementation of services; interaction design and user experience; design of service touchpoints and service interfaces; service excellence and service innovation. The book will appeal to all scholars and practitioners in the hospital and healthcare sector who are interested in organizational development, service business model innovation, customer involvement and perceptions, and service experience.
Publisher: Springer
ISBN: 3030007499
Category : Medical
Languages : en
Pages : 535
Book Description
This book examines the nature of service design and service thinking in healthcare and hospital management. By adopting both a service-based provider perspective and a consumer-oriented perspective, the book highlights various healthcare services, methods and tools that are desirable for customers and effective for healthcare providers. In addition, readers will learn about new research directions, as well as strategies and innovations to develop service solutions that are affordable, sustainable, and consumer-oriented. Lastly, the book discusses policy options to improve the service delivery process and customer satisfaction in the healthcare and hospital sector. The contributors cover various aspects and fields of application of service design and service thinking, including service design processes, tools and methods; service blueprints and service delivery; creation and implementation of services; interaction design and user experience; design of service touchpoints and service interfaces; service excellence and service innovation. The book will appeal to all scholars and practitioners in the hospital and healthcare sector who are interested in organizational development, service business model innovation, customer involvement and perceptions, and service experience.
Alzheimer's In America
Author: Maria Shriver
Publisher: Free Press
ISBN: 9781451639872
Category : Health & Fitness
Languages : en
Pages : 0
Book Description
The Shriver Report: A Woman’s Nation Takes on Alzheimer’s will be the first comprehensive multi-disciplinary look at these questions at this transformational moment. The Report will digest the current trends in thinking about Alzheimer’s, examine cutting-edge medical research, look at societal impacts, and include a groundbreaking and comprehensive national poll. It will feature original photography and personal essays by men and women – some from the public arena with names you know, some from everyday America – sharing their personal struggles with the disease as patients, caregivers and family members.
Publisher: Free Press
ISBN: 9781451639872
Category : Health & Fitness
Languages : en
Pages : 0
Book Description
The Shriver Report: A Woman’s Nation Takes on Alzheimer’s will be the first comprehensive multi-disciplinary look at these questions at this transformational moment. The Report will digest the current trends in thinking about Alzheimer’s, examine cutting-edge medical research, look at societal impacts, and include a groundbreaking and comprehensive national poll. It will feature original photography and personal essays by men and women – some from the public arena with names you know, some from everyday America – sharing their personal struggles with the disease as patients, caregivers and family members.
Fiscal Sustainability of Health Systems Bridging Health and Finance Perspectives
Author: OECD
Publisher: OECD Publishing
ISBN: 9264233385
Category :
Languages : en
Pages : 264
Book Description
The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to ...
Publisher: OECD Publishing
ISBN: 9264233385
Category :
Languages : en
Pages : 264
Book Description
The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to ...
Patient Protection and Affordable Care ACT - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
ISBN: 9781722602420
Category :
Languages : en
Pages : 78
Book Description
Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
Publisher: Createspace Independent Publishing Platform
ISBN: 9781722602420
Category :
Languages : en
Pages : 78
Book Description
Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
ISBN: 9781722371326
Category :
Languages : en
Pages : 184
Book Description
Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care. This book contains: - The complete text of the Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
Publisher: Createspace Independent Publishing Platform
ISBN: 9781722371326
Category :
Languages : en
Pages : 184
Book Description
Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care. This book contains: - The complete text of the Medicare Program - Home Health Prospective Payment System Rate Update for Calendar Year 2011 - Changes in Certification Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
Estimated Financial Effects of the 'Patient Protection and Affordable Care Act,' as Amended
Author: Richard S. Foster
Publisher: DIANE Publishing
ISBN: 143793353X
Category : Health & Fitness
Languages : en
Pages : 34
Book Description
This memorandum summarizes the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary¿s estimates of the financial and coverage effects through FY 2019 of selected provisions of the ¿Patient Protection and Affordable Care Act¿ (PPACA) (P.L. 111-149) as enacted on March 23, 2010, and amended by the ¿Health Care and Education Reconciliation Act of 2010¿ (P.L. 111-152) as enacted on March 30, 2010. Included are the estimated net Federal expenditures in support of expanded health insurance coverage, the associated numbers of people by insured status, the changes in Medicare and Medicaid expenditures and revenues, and the overall impact on total national health expenditures. Charts and tables.
Publisher: DIANE Publishing
ISBN: 143793353X
Category : Health & Fitness
Languages : en
Pages : 34
Book Description
This memorandum summarizes the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary¿s estimates of the financial and coverage effects through FY 2019 of selected provisions of the ¿Patient Protection and Affordable Care Act¿ (PPACA) (P.L. 111-149) as enacted on March 23, 2010, and amended by the ¿Health Care and Education Reconciliation Act of 2010¿ (P.L. 111-152) as enacted on March 30, 2010. Included are the estimated net Federal expenditures in support of expanded health insurance coverage, the associated numbers of people by insured status, the changes in Medicare and Medicaid expenditures and revenues, and the overall impact on total national health expenditures. Charts and tables.
Patient Protection and Affordable Care Act
Author: John E. Dicken
Publisher:
ISBN: 9781457869044
Category :
Languages : en
Pages : 48
Book Description
The Patient Protection and Affordable Care Act (PPACA) resulted in significant changes to the private individual and small group health insurance markets in 2014 that expanded the availability and affordability of coverage. However, some of these provisions reduced issuers' ability to mitigate the risk of high-cost-enrollees. To limit these risks, PPACA required the establishment of three risk mitigation programs. This report describes: (1) the factors that guided the Centers for Medicare & Medicaid Services's (CMS's) design of these programs; (2) the data collection systems CMS developed for these programs; (3) CMS's plans to monitor and evaluate the programs; and (4) issuer experiences with the programs. Tables and figures. This is a print on demand report.
Publisher:
ISBN: 9781457869044
Category :
Languages : en
Pages : 48
Book Description
The Patient Protection and Affordable Care Act (PPACA) resulted in significant changes to the private individual and small group health insurance markets in 2014 that expanded the availability and affordability of coverage. However, some of these provisions reduced issuers' ability to mitigate the risk of high-cost-enrollees. To limit these risks, PPACA required the establishment of three risk mitigation programs. This report describes: (1) the factors that guided the Centers for Medicare & Medicaid Services's (CMS's) design of these programs; (2) the data collection systems CMS developed for these programs; (3) CMS's plans to monitor and evaluate the programs; and (4) issuer experiences with the programs. Tables and figures. This is a print on demand report.
Code of Federal Regulations, Title 42, Public Health, Pt. 400-413, Revised As of October 1 2015
Author: Centers for Medicare and Medicaid Services (U.S.)
Publisher: Office of the Federal Register
ISBN: 9780160930416
Category :
Languages : en
Pages : 932
Book Description
This print ISBN represents the official U.S. Federal Government edition. 42 CFR Parts 400 to 413 continues coverage on the United States Department of Health and Human Services. In this volume, you will find rules, processes, procedures, and regulations pertaining to the Centers for Medicare and Medicaid Services to include Federal health insurance for the aged and disabled, hospital insurance eligibility and entitlement, supplemental insurance eligibility and entitlement, premiums for supplemental medical insurance, hospital insurance benefits, exclusions and limitations for medicare and medicare payments, prospective payment systems for inpatient hospital services, and more. Other related products: Health Insurance Claims Forms (CMS-1500) Single Sheets (Revised 2012) can be found at this link:https://bookstore.gpo.gov/products/sku/017-060-00663-3?ctid=1623 Health Insurance Claim Forms (CMS-1500) 2-Part Snapout (Package of 100) (2012) can be found here: https://bookstore.gpo.gov/products/sku/017-060-00661-7?ctid=1623Health Insurance Claim Forms (CMS-1500) 2 Part Continuation (Package of 1400) (2012) can be found here: https://bookstore.gpo.gov/products/sku/017-060-00662-5?ctid=1623Health Insurance Claim Forms (CMS-1500) 1-part Continuation (2012) (Package of 2500) can be found here: https://bookstore.gpo.gov/products/sku/017-060-00664-1?ctid=1623TeamSTEPPS 2.0 Pocket Guide: Team Strategies & Tools to Enhance Performance and Patient Safety (Package of 10) can be found here: https://bookstore.gpo.gov/products/sku/017-033-00510-9Income, Poverty, and Health Insurance Coverage in the United States, 2012 can be found at this link:https://bookstore.gpo.gov/products/sku/803-005-30092-7Health, United States, 2014, With Special Feature on Adults Ages 55 to 64; Health Statistics 2014 in Brief can be found here: https://bookstore.gpo.gov/products/sku/017-022-01622-2Keywords: 42 CFR Parts 400 to 413; 42 CFR Parts 400-413; CFR 42 Parts 400-413; cfr 42 parts 400-413; Medicare; Medicaid; Insurance; medicare insurance; medicare hospital benefits; smi; supplemental medical insurance; supplemental medical insurance (smi); medicare hospital insurance benefits; skilled nursing facilities determined payment rates; centers for medicare and medicaid services; medicare; medicaid; public health programs; in-patient hospital services; payment rates for skilled nursing facilities; supplemental medical insurance benefits; hospital insurance; aged; disabled; handicapped; physically challenged; medical; insurance; healthcare; health care; health billing payments; CMS; cms;
Publisher: Office of the Federal Register
ISBN: 9780160930416
Category :
Languages : en
Pages : 932
Book Description
This print ISBN represents the official U.S. Federal Government edition. 42 CFR Parts 400 to 413 continues coverage on the United States Department of Health and Human Services. In this volume, you will find rules, processes, procedures, and regulations pertaining to the Centers for Medicare and Medicaid Services to include Federal health insurance for the aged and disabled, hospital insurance eligibility and entitlement, supplemental insurance eligibility and entitlement, premiums for supplemental medical insurance, hospital insurance benefits, exclusions and limitations for medicare and medicare payments, prospective payment systems for inpatient hospital services, and more. Other related products: Health Insurance Claims Forms (CMS-1500) Single Sheets (Revised 2012) can be found at this link:https://bookstore.gpo.gov/products/sku/017-060-00663-3?ctid=1623 Health Insurance Claim Forms (CMS-1500) 2-Part Snapout (Package of 100) (2012) can be found here: https://bookstore.gpo.gov/products/sku/017-060-00661-7?ctid=1623Health Insurance Claim Forms (CMS-1500) 2 Part Continuation (Package of 1400) (2012) can be found here: https://bookstore.gpo.gov/products/sku/017-060-00662-5?ctid=1623Health Insurance Claim Forms (CMS-1500) 1-part Continuation (2012) (Package of 2500) can be found here: https://bookstore.gpo.gov/products/sku/017-060-00664-1?ctid=1623TeamSTEPPS 2.0 Pocket Guide: Team Strategies & Tools to Enhance Performance and Patient Safety (Package of 10) can be found here: https://bookstore.gpo.gov/products/sku/017-033-00510-9Income, Poverty, and Health Insurance Coverage in the United States, 2012 can be found at this link:https://bookstore.gpo.gov/products/sku/803-005-30092-7Health, United States, 2014, With Special Feature on Adults Ages 55 to 64; Health Statistics 2014 in Brief can be found here: https://bookstore.gpo.gov/products/sku/017-022-01622-2Keywords: 42 CFR Parts 400 to 413; 42 CFR Parts 400-413; CFR 42 Parts 400-413; cfr 42 parts 400-413; Medicare; Medicaid; Insurance; medicare insurance; medicare hospital benefits; smi; supplemental medical insurance; supplemental medical insurance (smi); medicare hospital insurance benefits; skilled nursing facilities determined payment rates; centers for medicare and medicaid services; medicare; medicaid; public health programs; in-patient hospital services; payment rates for skilled nursing facilities; supplemental medical insurance benefits; hospital insurance; aged; disabled; handicapped; physically challenged; medical; insurance; healthcare; health care; health billing payments; CMS; cms;