healthcare delivery systems and organizations
healthcare delivery systems and organizations
To complete this assignment, you will need to access to the following databases: CINAHL, MEDLINE, Cochrane Library, and the Joanna Briggs Institute. I
know you can do this work, so don’t go short cut and mess it up. Research each heading and complete.
See the article I attached. Find more articles to complete to complete this work.
As a writer, you should first write a good introduction for each topic briefly say the story you about to tell, the subjects you going to talk about.
You then tall this story by each subject.
You summarize all the story for conclusion
Don’t do lazy work no beginning , no end. Don’t be repetitive to fill the page
Don’t copy old work
Don’t give me somebody’s work. I will know.
Grammer has got to improve. I end up deleting all work in the process of editing. Most time work below college level. I mean it. And sometimes it can be accepted at masters level.
1: Distinguish selected factors affecting U.S. healthcare delivery systems and organizations
Introduction: Find good article
1.
2.
3.
2: Examine factors affecting healthcare finance and payment systems
Introduction
1.
2.
3.
3: Evaluate selected healthcare policy models and frameworks
Intrduction: Find good article
Suptopics
1.
2.
3.
4
5
6
7
4: Formulate strategies for coalition building and health advocacy
Intrduction: Find good article
1.
2.
3.
5: Synthesize selected policy analyses affecting advanced practice nursing
Intrduction: Find good article
1.
2.
3.
Inclusion of all story work
Examples
Increased health insurance coverage
Payer pressures to reduce costs
• Medicare physician services payments are based on fee schedule (Resource Based Relative Value Scale, or RBRVS).
Change from “reasonable cost” to prospective payment system based on diagnosis related groups for hospital inpatient services begins under Medicare
Interview conducted and issues highlighted. Find issues in the policy or issues you can associate to the yellow highlighted in box
High staffing turnover
Diabetics patients are noncompliant with medication is more predominant
The facility denies any safety concerns
There is high staff turnover
No diabetics education protocol or policy in
place for the old and newly diagnosed diabetics
Facility denies and sentinel event
Yes
The relationship is good. Staff are not expected to take short cuts
Management is open for suggestions or improvements
Examples:
Staff members are not mistreated
Electronic health Record is not in use, No plans for one. Still using paper medical records
No further issues
Diabetic education for noncompliant diabetics patients
Very good role model
The nurse leader will be good preceptor
Transformational leadership
yes
Category
Points
%
Description
Introduction
Introduces the interview, purpose of the interview, and provides rationale for engaged interview process.
To determine existing practice problem within the organization
Description of Policy Issue
Please discuss the organizational assessment and how you decided upon this particular policy. Also include any subtopics regarding selected healthcare policy issue. Use examples from the interview that support your assertions and relevant examples from your practice situation.
Presentation of Policy Analysis
Include eight subtopics regarding selected healthcare policy analysis pathway. Summarize your subtopics using examples from the interview that support your assertions as well as relevant examples from your practice situation.
Conclusion
An effective conclusion identifies the main ideas and major conclusions from the body of your report. Minor details are left out. Summarize the benefits of the selected policy analysis to nursing practice.
Clarity of writing
Use of standard English grammar and sentence structure. No spelling errors or typographical errors. Organized around the required components using appropriate headers.
APA format
All information taken from another source, even if summarized, must be appropriately cited in the report (including citation of interview) and listed in the references using APA (6th ed.) format:
1. Document setup
2. Title and reference pages
3. Citations in the text and references.
Total:
250
100%
A quality report will meet or exceed all of the above requirements.
There are more than 9000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.”
Clayton M. Christensen
Health care financing in the United States is fragmented, complex, and the most costly in the world. The Affordable Care Act (ACA) of 2010 takes some steps to reshape how health care is paid for, but its primary purpose is to extend insurance coverage to approximately 30 million uninsured Americans through private insurance regulation, expansion of pubic insurance programs, and creation of health insurance marketplaces to foster competition in the private health insurance market. As the ACA is implemented, making health insurance more affordable and containing the rise in health care costs are significant ongoing policy challenges in system transformation. This chapter will provide an overview of the current system of health care financing in the United States, including the impact of the ACA.
Historical Perspectives on Health Care Financing
Understanding today’s complex and often confusing approaches to financing health care requires an examination of the nation’s values and historical context. Some dominant values underpin the U.S. political and economic systems. The United States has a long history of individualism, an emphasis on freedom to choose alternatives and an aversion to large-scale government intervention into the private realm. Compared with other developed nations with capitalist economies, social programs have been the exception rather than the rule and have been adopted primarily during times of great need or social and political upheaval. Examples of these exceptions include the passage of the Social Security Act of 1935 and the passage of Medicare and Medicaid in 1965.
Because health care in the United States had its origins in the private sector market, not government, and because of the growing political power of physicians, hospitals, and insurance companies, the degree to which government should be involved in health care remains controversial. Other developed capitalist countries, such as Canada, the United Kingdom, France, Germany, and Switzerland, view health care as a social good that should be available to all. In contrast, the United States has viewed health care as a market-based commodity, readily available to those who can pay for it but not available universally to all people. With its capitalist orientation and politically powerful financial stakeholders, the United States has been resistant to significant health care reform, especially as it relates to expanding access to affordable health insurance.
The debate over the role of government in social programs intensified in the decades after the Great Depression. Although the Social Security Act of 1935 brought sweeping social welfare legislation, providing for Social Security payments, workman’s compensation, welfare assistance for the poor, and certain public health, maternal, and child health services, it did not provide for health care insurance coverage for all Americans. Also, during the decade following the Great Depression, nonprofit Blue Cross and Blue Shield (BC/BS) emerged as a private 173insurance plan to cover hospital and physician care. The idea that people should pay for their medical care before they actually got sick, through insurance, ensured some level of security for both providers and consumers of medical services. The creation of insurance plans effectively defused a strong political movement toward legislating a broader, compulsory government-run health insurance plan at the time (Starr, 1982). After a failed attempt by President Truman in the late 1940s to provide Americans with a national health plan, no progress occurred on this issue until the 1960s, when Medicare and Medicaid were enacted.
BC/BS dominated the health insurance industry until the 1950s, when for-profit commercial insurance companies entered the market and were able to compete with BC/BS by holding down costs through their practice of excluding sick (with preexisting conditions) people from insurance coverage. Over time, the distinction between BC/BS and commercial insurance companies became increasingly blurred as BC/BS began to offer competitive for-profit plans (Kovner, Knickman, & Weisfeld, 2011. In the 1960s, the United States enjoyed relative prosperity, along with a burgeoning social conscience, and an appetite for change that led to a heightened concern for the poor and older adults and the impact of catastrophic illness. In response, Medicaid and Medicare, two separate but related programs, were created in 1965 by amendments to the Social Security Act. Medicare is a federal government-administered health insurance program for the disabled and those over 65 years (Kaiser Family Foundation [KFF], 2014c), and Medicaid, until recently, has been a state and federal government-administered health insurance program for low-income people, who are in certain categories, such as pregnant women with children.
