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Credentials from the Heathcare Financial Management Association

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1. A broad term commonly used for medical professionals who are not nurses and not physicians is allied health personnel. Dental Hygienist is a very well respected allied health profession. Describe the field, and be sure to include training, professional role, and other aspects to this profession.

2. The general public typically uses the terms licensure, certification, and registration interchangeably when referring to medical professionals. However, each term has a specific and important meaning with regard to regulating medical occupations. Explain the meaning of these terms, and relate the important differences among them.

3. Health insurance is a concept developed in the United States and now appearing in many other nations of the world. Its history and development is an interesting story. Briefly trace the history of health insurance in America, from the beginnings with Blue Cross up to the Managed Care era.

4. It is abundantly clear that Americans spend more per capita on health care than any other nation on earth. What are the key drivers of our large health care expenditures in the U.S.? Cite at least five key drivers, and explain the impact of each on total medical spending.

5. An interesting and innovative approach to care of American seniors is adult day care. What exactly is adult day care, where is it provided, and what role is it filling today in our communities? Would you personally utilize this service for a senior family member? Why, or why not?

6. Hospice provides tremendous support for patients and families at time of true need, near the end of a family member's life. But Hospice continues to be poorly utilized in many parts of America. How would you describe the role of Hospice? What can be done to improve the utilization of Hospice services when the need exists?

7. Case Study
Please visit the following site http://www.hfma.org/

Part 1: What is the process for earning credentials from HFMA in the field of health care finance? What kinds of professional roles would individuals earning these credentials typically be able to achieve? Why would one be interested in pursuing a career in medical finance?

Part 2: What types of resources does this organization provide to its members and others in the health care community? As a health care manager, what HFMA resources would one see his or herself utilizing for their facility and career?

Book: Sultz, H., & Young, K. (2011). Health care USA: Understanding its organization and delivery (7th ed.). Burlington, MA: Jones & Bartlett Learning.
http://books.google.com/books/about/Health_Care_USA.html?id=r1ASWbMugj4C

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The credentials from the healthcare financial management associations are determined.

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Part 1: Allied Health and Dental Hygienists
Allied health professionals(AHPs): Comprise health care professionals including but not limited to: Dental hygienists, dietitians, art therapists, medical technologists, medical sonographers, occupational therapists, radiographers, physical therapists, speech and language pathologists, respiratory therapists(HLWIKI, 2013). AHPs must be proficient in using information technologies and be very versed and knowledgeable in evidence -based healthcare. They are also involved in, but not limited to the delivery of health care for the identification, evaluation and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management. Additionally, the concept (AHP) applies to a major component of health professionals that make up at least 60% of the workforce in hospitals and clinics. (HLWIKI, 2013).
AHPs are central to the health care delivery around the world and are found working in concert with physicians, nurses and pharmacists in delivery patient care (HLWIKI, 2013). Medicine, dentistry and nursing are typically professionals with their own separate designations and are usually separated from the allied health categories. They usually have very important and special skills that they bring to the health care team. Such skills include but are not limited to: interpersonal, communication and counseling skills; computer literacy skills; the ability to document healthcare information; interviewing skills; proficiency in basic health informatics; database management and research (HLWIKI, 2013). Additionally, AHPs must undergo rigorous and adhere to national training and continuing educational standards (HLWIKI, 2013). As well, they typically have their own professional scope of practice, and tend to establish their credentials through diploma programs, certificate programs as well as continuing education mentioned earlier.
Dental Hygienists
When a patient goes for a dental checkup, he or she is likely to spend more of that appointment time with a dental hygienist, who is a licensed allied healthcare professional provides preventative oral care. Dental hygienists also clean patients' teeth and check for signs of disease and damage, and teach patients how to maintain good oral health. The services dental hygienists can provide or do, it depends on the State and country they live, as regions and countries have different rules (Department of labor (DOL), 2013). Dental hygienists usually work under a dentist's supervision, and most work part-time , and approximately 40% of them work full time and often in multiple dental practices. In 2010, Dental hygienists held approximately 182,000 jobs in total (DOL, 2013).
Salary and Job Description
Dental hygienists can usually make an average yearly salary of approximately $70, 000 and/or approximately $35 hourly wages as reported in 2011(DOL, 2013). On a typical day a dental hygienist may perform, but not limited to the following:
• Perform, and develop dental x-rays;
• Perform dental cleanings and keep patients' records and track care and treatment ;
• Teach patients how to take care of their teeth and prepare diagnostic tests that dentists will administer
• Assist the dentist by working chair-side apply sealants and fluoride to patients' teeth
Some state may even allow dental hygienists to: help prepare patients for dental procedures or surgery by administering anesthetics remove sutures apply filling materials, temporary fillings, and periodontal dressings smooth and polish metal restorations (DOL, 2013).

Educational Requirements and Work Outlook for DHs
In order to work as a dental hygienist, an individual must graduate from an accredited dental hygiene school with usually an associate degree (more common), a certificate, a bachelor's degree and some even have master's degrees. (DOL, 2013). After graduation, a dental hygienist needs a license from the dental board in the region, country, province or state in which he or she wants to practice. Additionally, in order to get licensed, he/she must pass a written as well as a clinical exam. As things differ at times depending on location, the individual state dental boards should be consulted to learn about specific requirements (DOL, 2013).
Those who are compassionate, with manual dexterity and good interpersonal skills, tend to be best suited for this profession. It also helps to be detail oriented and have the stamina necessary to spend a lot of time reaching over while treating patients (DOL, 2013). Overall, the future looks bright for dental hygienists. For example, The US Bureau of Labor Statistics projects that employment in the field will grow much faster than the average for all occupations through 2020. Additionally, it is predicted that the profession will grow faster overall, than other occupations that, also require post-secondary training or an associate degree (DOL, 2013).
References
Bureau of Labor Statistics (BLS). U.S. Department of Labor (DOL) (2013). Occupational outlook handbook: 2012-13. Dental hygienists. Retrieved from http://www.bls.gov/ooh/healthcare/dental- hygienists.htm

HLWIKI (2013). Allied health professionals. Retrieved from http://hlwiki.slais.ubc.ca/index.php/Allied_health_professionals
Part 2: Licensure, Certification, and Registration
The general public typically uses the terms licensure, certification, and registration interchangeably when referring to medical professionals. Each term however, has a specific and important meaning with regard to regulating medical occupations with significant differences as well. The reality is all three terms are all completely blurred. For example, "registered nurses" are in fact related to licensure, since we refer to them as "registered nurses. However, they cannot be registered nurses without being licensed. If we say certified teachers, this also is licensure-related, since one cannot teach in a public school without meeting certain licensure requirements. As such, in reality-especially the term "certification" is often blurred with licensure, and so is registration.
Licensure
Licensure: Is a process by which a governmental agency grants time-limited permission to those individuals so they can be involved and engage in a given occupation after verifying that he or she has met certain predetermined and standardized criteria such as required education, experience, and examinations and so on. The goal of licensure is to ensure that the licensees have the minimal degree of competency necessary to ensure that the public's health, safety, and/or welfare are protected (Marberry, Quist, & Decka, 2011). To summarize, in order to become licensed, one usually has to meet eligibility requirements and pass an assessment that covers a broad range of knowledge and skills, especially and usually at the entry level, other criteria include but not limited to:
• Continuing requirements and education that must be met to maintain the license (CEUs, retests, physical exams, etc.);
• These are usually granted at the state level, and if the individual works in multiple jurisdictions or State, then they must be licensed in each jurisdiction and area, since licensing requirements vary from jurisdiction to jurisdiction;
• Professional associations do not usually grant licensure. However, they can take part in other related licensure activities, such as advocating for the license and collaborating with agencies responsible for the development and administration of licensing; and
• In most cases, the terms "licensure" and "registration" are especially used interchangeably. An example of this credential would be a registered architect or licensed interior designer (Marberry, Quist, & Decka, 2011).
Certification
Certification: Is a private regulation and a voluntary process by which non-governmental agencies grant a time-limited (upon expiration date) recognition to an individual, following verification of the fact that they have met a set or predetermined and standardized criteria. Usually, in order to become certified, individuals must meet eligibility requirements as well as pass standard required assessments (Marberry, Quist, & Decka, 2011). Other notables including but are not limited to:
• Certification is usually/mostly voluntary and the individual does not need to be certified in order to engage in that given health (or other) occupation;
• Traditionally, certification has been an association activity in which a group of professionals simply determines the need to publicly state their standards through assessment of competence, quality, or other specialized knowledge;
• The certification assessment can and may also cover a broad area of knowledge and skills at entry, specialty, or even advanced levels; and
• Certified professionals must usually engage in continuing education and have ongoing requirements, such retesting, to maintain the certification (Marberry, Quist, & Decka, 2011).
Additionally, it is essential that a certificate program is not confused with certification. As such, examples of certification programs are those offered by AAHID, ACHA, American College of Healthcare Executives (ACHE), EDAC, and GBCI (LEED), American Association of Certified Health Education Specialists (AACHES), and so on. While it offers credentials for individuals for example, GBCI actually uses the term "certification" for its building credential program, which does not fit the traditional definitions mentioned earlier (Marberry, Quist, & Decka, 2011).
Certificate
Certificate: Is another voluntary process by which an individual or organization acquires a document that serves as proof, evidence, or as written testimony, of status, qualifications, privileges, or the truth of something( Marberry, Quist, & Decka, 2011). Other characteristics include but are not limited to the following facts:
• Typically (in most cases) certificates are issued by an institution that is not authorized to grant diplomas, or to a student that are not qualifying for a diploma;
• Represents a 'one-time recognition' that does not expire or have ongoing requirements such as continuing education/credits etc;
• Unlike certification or even accreditation, a certificate belongs to the individual and not the organization (Marberry, Quist, & Decka, 2011).

Registration
Registration: Is a process by which a state, region, or an association maintains a list of individuals who have informed the governing body that they perform professional services for the public, in a specific and particular field. There are certain advantages and disadvantages of this process which also differentiates it from the other processes (ISA, 2013). As such, characteristics of registration include the following:
• Becoming registered usually involves notifying the state or association that an individual or a company, exist;

• There are usually no eligibility criteria for registration, and there is traditionally no examination that must be passed to become registered;

• Registration is only applicable within a given state and a lack of eligibility criteria and periodic examination does not guarantee continued job proficiency;

• Employers and clients have little to no means of evaluating an employee's or organization's proficiency prior to the work being performed (ISA, 2013).

References
ISA (2013). Registration, licensure, certification: Which is right for you? Retrieved from http://www.isa.org/Content/NavigationMenu/Products_and_Services/Certification3/Certified_A utomation_Professional1/CAP_Newsletter/200406CAPNewsletter.pdf
Marberry, S., Quist, C., & D. Decka (2011). Accreditation, certification, licensure, registration. Retrieved from http://www.healthcaredesignmagazine.com/article/accreditation-certification -lregistration?page=3
Part 3: Health insurance
Health Insurance is a concept that was developed in the United States and has appeared now in many other nations of the world. Its history and development is an interesting story. The history of health insurance in America can be traced from the beginnings with Blue Cross up to the Managed Care era. In fact, flaws in the U.S.' health care system date back to the Great Depression, since it was during the Depression that hospitals banded together and offered prepaid coverage to Americans. Prepaid hospital coverage was a way for hospitals to avoid the financial failure that the banks endured. The concept worked very well-and so well in fact that doctors came on board and Blue Cross Blue Shield followed years later(WPRI, 2006).
To that end, prepaid, employer-provided insurance quickly dominated the American health care landscape, and subsequent action by the federal government in the 1950s to provide a tax deduction for health insurance premiums helped solidify the approach even more. In the 1960s, the federal government created two programs that were patterned after the Blue Cross' Model (WPRI, 2006). The two programs, Medicare and Medicaid seemed ...

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