Health Care Utilization

According to “Keeping America Healthy” (2013), “Medicaid provides coverage for individuals according to poverty guidelines who are unable to afford health care insurance because of limited income” (Eligibility). John Q. Qualifies for Medicaid but lives in a rural community with no public transportation to travel to access his benefits due to provider office hours and the distance he must travel to the location. John does own have a car. John is predisposed to heart disease through heredity and has been diagnosed with high blood pressure. According to “What Is High Blood Pressure? 2011),” blood pressure is when blood is forced against the artery walls to disperse oxygen and turbines carried in the blood to the body. Blood pressure is measured by two numbers; Systolic the top number or the higher of the two is measured when the heart beats pushing the blood against the walls of the arteries. Diastolic is the measure when the heart is at rest between beats. The normal measure for normal is 120/80. Persons with a measuring of 140/90 or higher is a person with High Blood Pressure or HIP” (What happens in the body when blood pressure is high? ).

HIP can lead to Hypertensive heart disease (“Hypertensive Heart Disease”, 2013). Regular doctor visits and prescribed medications to control blood pressure can offset the nest of Hypertensive Heart disease in patients with high blood pressure. Regular physician visits are required to keep check on John’s condition (“What Is High Blood pressure? ” 2011). The problems with health care utilization for John is that he lives in a rural community with limited providers, the distance of travel to reach locations, time needed to schedule appointments, and office hours of the available physician locations will not provide him with reasonable access.

Many Medicaid participants are faced with this same set of problems and have to adjust their lives to gain access o healthcare. Medicaid programs have benefits available to help participants conquer many obstacles. Patients need to inquire and learn what benefits are available to help. Utilizing social programs available in the community, and accessing information on Medicaid websites help to inform members of what is available for help. Medicaid programs have established grants for rural health clinics; John needs to find out if a clinic exits in his area.

These clinics provide information about benefits and do health screenings. The clinic can be a place where John can go to get blood erasure checks to make sure he is in target range regularly without having to travel too physician’s location for blood pressure checks. Rural health clinics provide education to patients and can issue devices such as blood pressure monitoring equipment and train patients to utilize self-check methods between physician visits. Government medical programs do provide for education and training to use medical devices like blood pressure monitors used at home for patient self-monitoring.

Missing time from work can be a problem. Most employers have paid time off that employees can access and schedule for personal situations. John can have his physician provide documentation of his appointments to submit to his employer and arrangements can be made for an adjustment in hours or to come into work on additional days if possible. Other options to John may be to use vacation time or sick time to cover missed time at work when he has to visit the doctor. According to “Medicaid. Ova; Keeping America Healthy” (2013), “Medicaid benefits cover inpatient hospital care, outpatient hospital services, and rural clinic services. These services give John comprehensive coverage to help with chronic illnesses like high loot pressure. He also

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has available prescription coverage for medications to help manage his blood pressure. Preventive services and diagnostic screenings are available for early detection and prevention” (Benefits). Medicaid and Medicare also pays for transportation to and from medical appointments for patients covered through the government programs.

John can research and locate Passport certified transportation providers in his area to reach his medical provider of choice. The Affordable Health Care Act of 2010 gave states the option to expand Medicaid in their states with federal funding. It also provides more insurance options for lower income residents to other insurance plans that may be more accessible for member access to services and providers. Starting in 2014 the act also makes John eligible for insurance through other carriers even though he has a preexisting illness (“Gpo. Ova”, 2010). John may need to make lifestyle changes to accommodate his illness. Eating a healthy diet and reducing sodium intake would be the first changes to make. John’s diet should consist of heart healthy foods, like Broccoli and other dark green vegetables. By exercising and keeping weight under control at an ideal weight or his height and age he will decrease the chances of heart problems and promote self-healing by keeping blood pressure numbers from getting higher increasing risk of other related illnesses.

John and many Americans face the dilemma of access to quality healthcare. John has a chronic illness that may lead to other related illnesses and continuous access to healthcare is crucial to his remaining healthy and productive enough to continue working. The government provides financial coverage because of his eligibility status as beneath poverty level income. Although he has uncial assistance, he still has problems with appointment times and transportation. These obstacles are mutable, but his illness is a predisposed health condition that is immutable.

Educating himself in what is covered by government assisted health plans and obtaining the needed medical care access would help John’s situation. He must also be responsible for his own well-being. Adapting his life, eating healthy, and exercising will not only deter worse health but also improve his high blood pressure.

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