Candyce S. Berger
The U.S. health care system is a pluralistic, market-based approach that incorporates various public and private payers and providers. Passage of Medicare and Medicaid, combined with rapid advances in technology and an aging population, has contributed to rising health care costs that typically increase faster than general inflation. This entry will review health care financing, exploring where the money is spent, who pays for health care, what the reimbursement mechanisms for providers are, and some issues central to the discussion of reform of health care financing. To effectively advocate health care reform, social workers must understand health care financing.
Victoria M. Rizzo and Rebekah Kukowski
In 1965, Titles XVIII and XIX of the Social Security Act were passed, creating Medicare and Medicaid and laying the foundation for US healthcare policy. Medicare was originally created to meet the specific medical needs of adults age 65 and older. Currently, individuals with end-stage renal disease, amyotrophic lateral sclerosis (ALS), and other disabilities may also receive Medicare, regardless of age. Medicaid was established to provide a basic level of medical care to specific categories of people who are poor, including pregnant women, children, and the aged. As part of the Affordable Care Act (ACA), states are provided with the opportunity to expand Medicaid to close the coverage gap for public health insurance. This entry provides explanations of Medicaid and Medicare and associated social healthcare programs in the United States. An overview of significant programming developments and current issues of legislative consideration are also provided.
Jennifer L. Magnabosco
Throughout history, measuring outcomes has been a goal and priority in the human services. This entry chronicles the history of outcomes measurement in the human services in the United States and discusses present-day outcome measurement activities as well as trends and some of the key areas for outcomes measurement in several human service domains.
Rosalyn M. Bertram
This entry presents frameworks for implementing effective services. When service organizations understand and work through implementation frameworks, programs can achieve targeted fidelity and client outcomes in a sustainable manner while enhancing practitioner competence and confidence, and improving organizational culture and climate. These frameworks should be but are not yet infused throughout social work curricula. They provide a practical and conceptual bridge for supporting effective delivery of evidence-based or empirically informed practices.