Category: Health Care and Life Sciences : Health Care

Evolution of Laws
MMA was signed by President Bush in 2003. The MMA brought about sweeping changes that increased enrollment and improved access to Medicare Plans. Similarly, the PPACA was signed into law by President Obama in 2010. The law is expected to significantly increase access to Medicaid for the uninsured, low-income families, and individuals. Medicaid managed care has been implemented by most states, mainly because of rising costs, plan quality, access to providers, and the decrease in state revenues and federal matching funding. Medicare has explored managed care for the same reasons: to reduce costs, improve quality and improve access to providers. Using the South University Online Library or the Internet, research the following two topics and write a paper evaluating the impact of these policies on Medicare and Medicaid managed care.
You need to research on the following two topics:
Medicare and managed care
Medicaid and managed care
Based on your research, answer the following questions:
Write a summary for each topic tying together the information learned about that topic.
Analyze the challenges Medicaid faces in terms of improving access to care, quality of care, and reducing the cost of care.
Analyze the challenges Medicare faces in terms of improving access to care, quality of care, and reducing the cost of care.
Draw conclusions about the future of managed care in each program—will it grow or decline? What will be the challenges for success?
Select at least four reputable articles per topic that address the challenges facing Medicare and Medicaid managed care.
As in all assignments, cite your sources in your work and provide references for the citations in APA format.

The goal of protecting patient information privacy often conflicts with the goal of providing the improved healthcare that EMRs can support. Provisions in HIPAA provide some confidentiality protection, but not enough. Potential for a major privacy breach lies in the system of primary or secondary users.
Please review:
Rodriguez, L. (2011). Privacy, security, and electronic health records. Retrieved from https://www.healthit.gov/buzz-blog/privacy-and-security-of-ehrs/privacy-security-electronic-health-records/.
What privacy and security issues are hindering the adoption of EMR systems?
In your opinion, which of these issues is the most important to address first?

Current Trends and Issues in Managed Care
Compensation and reimbursement models are another method of controlling access, cost, and quality in a managed care environment. An MCO doesn’t have direct control over physicians or hospitals but through contractual agreements that set incentives for meeting agreed-upon standards, it can exert influence.
This week, you are required to write an essay on the following topics:
Managed care hospital reimbursement
Managed care provider reimbursement
Using  the Internet, review at least two articles for each topic and write a review for each source of information. Use the following guidelines for developing your essay:
Write a summary for each topic tying together the information learned about that topic.
Analyze the market forces that would favor using one reimbursement method over another.
Evaluate the key differences between different types of payment methodologies from the provider and hospital point of view.
Evaluate the advantages and disadvantages of the payment methodologies reviewed from the provider and hospital point of view.
Evaluate new payment methodologies resulting from the Patient Protection and Affordable Care Act (PPACA) and discuss future changes in reimbursement methodologies.
Compare and contrast each article to the information discussed in the course textbook.

https://www.healthit.gov/playbook/
This week you will work on the system implementation phase of the final project, which requires completion of the following steps:
Site preparation: What are the physical locations where workstations, printers, servers, and other hardware will be installed?
User preparation: How will you provide users enough information about the system being installed to gain their confidence?
Installing hardware and software:  How will you place and connect the hardware? How will you go about installing, configuring, customizing, and testing specific software?
Please review: How to implement EHRs
As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Illegal Billing Practices
Reimbursement procedures are complex and detailed, especially those associated with government programs such as Medicare. Part of the regulatory requirements of Medicare is to prevent illegal billing practices such as churning, upcoding, and unbundling. For the Week 4 discussion, address the following, keeping in mind the above information:
Review the latest enforcement actions on this website(https://oig.hhs.gov/). Identify a case where at least one of the following illegal actions was used—churning, upcoding, and unbundling.
What are some of the specific examples of actions taken against providers engaged in these practices?
To support your work, refer to the readings and relevant outside research. As in all assignments, cite your sources in your work and provide references for the citations in APA format

Current Trends and Issues in Managed Care
Compensation and reimbursement models are another method of controlling access, cost, and quality in a managed care environment. An MCO doesn’t have direct control over physicians or hospitals but through contractual agreements that set incentives for meeting agreed-upon standards, it can exert influence.
This week, you are required to write an essay on the following topics:
Managed care hospital reimbursement
Managed care provider reimbursement
Using r the Internet, review at least two articles for each topic and write a review for each source of information. Use the following guidelines for developing your essay:
Write a summary for each topic tying together the information learned about that topic.
Analyze the market forces that would favor using one reimbursement method over another.
Evaluate the key differences between different types of payment methodologies from the provider and hospital point of view.
Evaluate the advantages and disadvantages of the payment methodologies reviewed from the provider and hospital point of view.
Evaluate new payment methodologies resulting from the Patient Protection and Affordable Care Act (PPACA) and discuss future changes in reimbursement methodologies.
Compare and contrast each article

This week there are three tasks to do. First, you will work on the user training phase of the system implementation, considering the following in 3-5 pages:
Planning for training
Contents of training
Methods of training
Location of training
Schedule of training
Resources needed
Training the trainer
Conducting the training
Additional periodic ongoing trainings
Computer-assisted training
Second, this week is final phase of the system implementation that results in the acceptance, rejection, or modification of the project, and release, suspension, or deduction of the contracted amount to the vendor(s)—system maintenance. Complete this section in 2-3 pages.
Ensure that all hardware work together.
Ensure that every function of every application of the computer system works and the system meets the functional requirements and the RFP specifications.
Ensure that data between different systems interfaces and is transferred smoothly and in correct format.
Ensure correct transference of data from old to new system (conversion testing).
Ensure that the system can work under maximum load (volume/stress testing).
Verify that the system works as expected in a live environment.
Third, combine your earlier Final Project papers into a single cohesive document with appropriate transitions and editing.
As in all assignments, cite your sources in your work and provide references for the citations in APA format.

You are the manager of a busy hospital unit.  Your unit has been tasked with selecting and implementing upgraded technology on your hospital unit.  As the unit manger, address the following in your selection of technology and implementation plan:
    Examine the features of the new technology that are important in reducing or preventing errors and adverse events on your unit.  Discuss in detail the intended uses and benefits of these tools and technology.
    Discuss, in a strategic plan of action, the steps and measures you will take to implement the new technology on your unit. Be sure to discuss the individuals responsible for implementing and overseeing each step of the process.
    Analyze the challenges that are anticipated with implementing the new technology and create a plan to mitigate these challenges.
Your well-written paper should meet the following requirements:
    Four-to-five pages in length, not including the title or reference pages.
    Formatted per APA 7th edition and Saudi Electronic University standards.
    Provide support for your work with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but two must be external. The Saudi Digital Library is a good place to find these references.
    Provide full APA references for the sources used on a reference page, along with appropriate in-text citations.
    Utilize headings to organize the content in your work.

Discuss the information listed below by providing a sufficient analysis on the subject matter. The explosion in access to information fostered by technology and social networking has not been accompanied by a corresponding level of fidelity of that information.  Various sources state that vaccines are harmful, attribute certain outbreaks to a sinister plot to elimination certain populations, or promote folk or fad remedies.  [See, for example, Hall, H. (2018).  Modern Reflexology: Still As Bogus As Pre-Modern Reflexology.  Science-Based Medicine.  https://sciencebasedmedicine.org/modern-reflexology-still-as-bogus-as-pre-modern-reflexology/.]
As a leader in healthcare, what organizational strategy can you implement to counter this potentially harmful trend?
How would your strategy circumvent these potentially harmful trends? Include at least one (1) example.
What measurements could be conducted to determine the success of your proposed strategy?

Provide an assessment of at least one (1) healthcare trend from the last three (3) years that could influence an organization’s strategic plan in terms of the following factors:
Sustainability
Success
Financial Outcomes
Consumerism
Organizational Significance
Include at least one example that describes each factor that you identified as part of the assessment.