Assignment: Evaluate selected healthcare policy models and frameworks

Assignment: Evaluate selected healthcare policy models and frameworks

Assignment: Evaluate selected healthcare policy models and frameworks

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

Assignment: Evaluate selected healthcare policy models and frameworks

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.

Assignment: Evaluate selected healthcare policy models and frameworks

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 insurance 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.

Government Programs

Current Public/Federal Funding for Health Care in the United States

In the United States, no single public entity oversees or controls the entire health care system, making the payment for and delivery of health care complex, inefficient, and expensive. Instead, the system is composed of many public and private programs that form interrelated parts at the federal, state, and local levels. The public funding systems, which include Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), the U.S. Department of Veterans Affairs (VA), and the Defense Health Program (TRICARE) for military personnel, their families, military retirees, and some others, continue to represent a larger and larger proportion of health care spending. Other examples of federal programs are the Indian Health Service, which covers American Indians and Alaskan Natives, and the Federal Employees Health Benefits (FEHB) Program, which covers all federal employees unless excluded by law or regulation.

Federal health expenditures for these programs totaled $731.6 billion or 26% of all health care expenditures in 2012 (Martin et al., 2014). Medicare outlays were $572.5 billion in 2012 and accounted for 20% of all national health care expenditures with Medicare Advantage (a Medicare-managed care program provided by insurance plans that can be chosen by beneficiaries instead of the traditional Medicare program) growing most rapidly (Martin et al., 2014). Medicaid outlays in 2012 were $412.2 billion and accounted for 15% of total national health care expenditures, and its spending growth also decelerated that year (Martin et al., 2014).