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Discussion Topic- Concepts of Managed Care Health insurance companies cover services they define as medically necessary. Medical necessity is a decision made by a health plan as to whether the treatment, test, or procedure is necessary for a patient’s health or to treat a medical problem. Third-party payers (aka Insurance companies or health plans) often require documentation to illustrate medical necessity for treatment before payment will be made. For your main Discussion post, evaluate and examine medical necessity from a provider’s (doctor, hospital, clinic, etc.) point of a view and from a payer’s /health plan’s (Aetna, Cigna, Affinity, Healthfirst, etc.) point of view. Research then discuss the role evidence-based clinical criteria and guidelines play with regard to medical necessity. At least 250 words Chapter 5 Required Textbooks:Kongstvedt, P., Health Insurance and Managed Care: What They Are and How TheyWork, 5th. Edition. Sudbury, MA: Jones and Bartlett.ISBN- 978-1-284-15209-8 or EBook-ISBN-978-1-284-09487-9 .

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Unintended Consequences of Health Care Reform The PPACA of 2010 fostered new provisions for health care and the structure of health care delivery. The individual mandate to obtain insurance is one provocative provision. While this provision attempts to increase access to health care, it raises questions on how the existing system could sustain the potentially large influx of newly insured individuals. Another provision calls for new models of health care provider organizations to ensure delivery efficiency and continuity of care. In this week’s media presentation, Dr. Kathleen White discusses the accountable care organization, which comprises a group of providers coordinating care across a variety of institutional settings. Yet becoming an accountable care organization may present a number of challenges. This week’s Discussion builds on Week 1, continuing the examination of those societal and organizational contexts that influence health care reform. The unintended consequences of reform policy on the health care system are also considered. To prepare: Review this week’s media presentation and the other Learning Resources focusing on how reform may lead to improved quality, greater access, and reduced cost of care. Also think about the unintended consequences that may arise as a result. Consider the information presented about the individual mandate and accountable care organizations. What are some questions or concerns you might have regarding the individual mandate? What are the pros and cons associated with becoming an accountable care organization? With posting instructions in mind, select either the individual mandate or accountable care organizations as the focus of your Discussion this week. By tomorrow Wednesday 03/07/18 BY 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below: Post a cohesive response that addresses the following: 1) In the first line of your posting, identify the topic you have selected—either the individual mandate or accountable care organizations. With regard to this topic, describe one or more positive results that could be achieved, and one or more unintended consequence(s) that organizations or individuals may experience. 2) Briefly evaluate issues on the topic that may be a consideration for the organization you work in and the nursing profession ( I WORK I A HOSPITAL SETTING). Required Readings Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical. Chapter 5, “How Health Care is Organized – I: Primary, Secondary, and Tertiary Care” Chapter 6, “How Health Care is Organized – II: Health Delivery Systems” McClellan, M. (2010). Accountable care organizations in the era of health care reform. American Health & Drug Benefits, 3 ...

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Legal and Ethical Issues Related to Psychiatric Emergencies The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare. In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments. To Prepare · Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events. The Assignment In 2–3 pages, address the following: · Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released. · Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. · Explain the difference between capacity and competency in mental health contexts. · Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source. · Identify one evidence-based suicide risk assessment that you could use to screen patients. · Identify one evidence-based violence risk assessment that you could use to screen patients. Attach copies of or links to the suicide and violence risk assessments you selected. NOTE: MY STATE IS ILLINOIS 2 Final Project : Policy Research and Organizational Analysis Report Precious Teasley Southern New Hampshire University IHP-620-Q1591 Economic Principles- healthcare 22TW1 Dr. Scott October 20, 2022 Introduction The purpose of this report is to focus on economic principles and how they apply to the field of healthcare. Healthcare facilities need to make economic decisions because they need financial resources to run. They need economic consultants that will help in making strategic economic decisions that will guide healthcare facilities on where and how to spend their money (Hicks, 2020). This ensures that they are wise in their undertakings. This report focuses on Jackson Memorial Hospital, a facility that has more than 1,500 li.

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Headnote Governments with universal healthcare systems are increasingly bemoaning the costs of their systems and the need to contain these costs if affordable healthcare services are to be sustained into the future. In a bid to reduce the costs of healthcare, politicians and bureaucrats have championed the need for reform. Although avoiding the language of rationing, the kinds of 'reforms' being championed (eg. greater government regulation of universal health coverage, reducing reimbursement for medical costs, cutting funding to public hospitals) seem however, to be more concerned with restricting universal healthcare coverage, rather than reforming it. The rhetoric of healthcare reforms has also had a political ideological objective shifting the provision of and accountability for public healthcare services to private sector providers. This objective has been pursued despite experts warning that such a shift will ultimately lead (and in some cases has already led) to inequities and unjust disparities in access to healthcare and related health outcomes, especially in vulnerable populations who cannot afford private health insurance. Australia has not been immune from ideologically driven machinations about the sustainability of its universal healthcare scheme, ie. Medicare. Despite health expenditure in Australia reportedly reaching a record low for the period 2012-2013, there has been a political campaign of spreading false and misleading information about Medicare's sustainability (Keast 2015).This misinformation has included 'blaming' vulnerable populations (eg. an ageing demographic, the 'undeserving poor') for their allegedly disproportionate over-utilisation of public healthcare services and the need to curb this costly 'wanton' demand. What has been overlooked in this situation, however, is that a key driver of the spiraling costs of healthcare is not the over-utilisation of services by people in need, but rather 'the use of wasteful tests and treatments' prescribed by doctors (Tilburt & Cassel, 2013) together with the rising costs of drugs (driven by the business behaviours of the pharmaceutical industry) and medical technology, particularly in hospitals. Also overlooked is the problem of language and the tendency to treat the terms 'healthcare', 'hospital care', and 'medical care' as being synonymous, when they are not. Failure to distinguish what each of these terms refers to unnecessarily muddles debate about what healthcare reforms are needed as well as where and how these should occur. Question of nursing ethics The ethics of healthcare rationing has been the subject of debate for decades. This debate has primarily rested on the issue of whether it is ever acceptable to ration healthcare and, if so, on what grounds. It has also prompted unresolved controversies about the interests of individuals versus the collective interests of society in accessing limited healthcare resources and how best to balance these competing inter.

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CHAPTER 6 Measuring Consumer Satisfaction Shulamit L. Bernard and Lucy A. Savitz “The key to customer feedback is to ask about the few aspects of the customer experience that matter the most … and do something about them!” —Davis Balestracci (2009) Measures of consumer satisfaction can serve an important role in monitoring quality and improving health care. Oftentimes overshadowed by measures of clinical process and outcomes in monitoring health care quality, consumer satisfaction has emerged as an important indicator of quality (see Chapter 5). At one time relegated to service improvement efforts by hospitals, measures of patient—or consumer—satisfaction are recognized as the provider’s best source of information about “communication, education, and pain-management process, and they (patients) are the only source of information about whether they were treated with dignity and respect” (Cleary, 2003, p. 33). Consumers’ experiences can stimulate important insights into how a provider is operating and suggest changes that may “close the chasm between the care provided and that care that should be provided” (Cleary, 2003, p. 33). Furthermore, the marketplace in which the providers operate is demanding that data on patient satisfaction be used to empower consumers and foster provider accountability and consumer choice. Measuring consumer satisfaction provides a comprehensive, systematic, and patient-centered approach for analysis, implementation, monitoring, and improving both the perceived and the clinical quality aspects of care (Ford et al., 1997). This chapter provides an overview of key issues and methods related to measuring consumer satisfaction. The rationale for measurement is discussed and followed by a series of issues: measurement, data capture, timing, and functional responsibility. An example applying patient satisfaction measures as part of the Balanced Scorecard (a measurement system that adds customer and other dimensions to the customary financial measures [Kaplan and Norton, 1996]) is presented. We conclude with a brief overview of the special issue of case-mix adjustment of reported consumer satisfaction measures. DEFINING CONSUMER SATISFACTION Obtaining the views of customers has been a key feature of many modern business practices for many years, and the health care sector has adopted this same view, considering the patient as a consumer, which has led to the application of methods for assessing patient views (Wensing and Elwyn, 2002). The idea of patients as consumers stems from a market perspective on health care in which the providers are assumed to be responsive to competition and in which competition can drive increased quality and lower cost. In the context of satisfaction measures, patients are considered as parties to an exchange of goods and/or services. Health consumers’ views can be divided into three types: measures of preferences, evaluations by users, and reports of health care. Preferences are ideas about wh ...

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Discussion Board #45050 unread replies.5050 replies.Discus.docx

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Discussion: Ethics in Cross-Cultural Research While many psychologists may be familiar with ethical considerations in their own culture, such as the use of Institutional Review Boards (IRBs) to review research, or the existence of professional documents such as American Psychological Association’s (APA) code of ethics, when conducting research outside of their majority home culture, they may be at a loss. For instance, the psychologist may not be aware of different rules and regulations for research in different nations, or about various spoken and unspoken cultural beliefs about morals and ethics and the role and purpose of research, such as differing understandings and beliefs about what merits co-authorship or what constitutes privacy and confidentiality. Familiarizing yourself with such ethical considerations will be important for you to understand in your future professional practice. For this Discussion, you will examine ethical issues related to cross-cultural research and the necessary course of action. To Prepare: Consider the following: Professor Plum wants to investigate cross-cultural differences in attitudes towards different foods. He is very interested in nation “X”. However, he has never been there nor does he know the language or culture or the political situation. He also does not know if there are any psychologists living in that nation. Understanding attitudes about foods in this nation may help with people with eating disorders in Professor Plum’s country and eventually may help people with eating disorders in many nations. As you consider Professor Plum’s research, think about the impact of his plans on human subject protection. Also, consider the ethical implications of the aims of his research purposes and his ability to gain information that will accurately represent those from whom he collects data. Before Professor Plum begins his research, post and explain some of the potential ethical issues he will need to consider (i.e., impact on human subject protection) and why this is an important consideration. Further explain two ethical issues and suggest what courses of action might be appropriate. Learning Resources Required Readings Haffejee, S., & Theron, L. (2018). Contextual risks and resilience enablers in South Africa: The case of Precious. In G. Rich & S. Sirikantraporn (Eds.), Human strengths and resilience: Developmental, cross-cultural, and international perspectives (pp. 87–104).Lanham, MD: Lexington Books. Credit Line: Human Strengths and Resilience: Developmental, Cross-Cultural, and International Perspectives, by Rich, G.; Sirikantraporn, S. Copyright 2018 by Lexington Books. Reprinted by permission of Lexington Books via the Copyright Clearance Center. Ice, G.H., Dufour, D. L., & Stevens, N. J. (2015). Disasters in field research: Preparing for and coping with unexpected events. New York, NY: Rowman & Littlefield. Credit Line: Disasters in Field Research: Preparing for and Cop.

Discussion Ethics in Cross-Cultural ResearchWhile many psyc.docx

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Discussion 2 Locate current or proposed legislation, city rules, or ordinances that have the potential to affect the environment in your area. Summarize the legislation and draw conclusions about the impact legislation will have on environmental practices. GUIDELINES Visit the website of a legislative body that has the ability to create rules, codes, or ordinances that impact the environment. Examples of these types of agencies include: Green Dallas, Fort Worth Environmental Management Department, Texas House of Representatives Committee on Environmental Regulation, U.S. House of Representatives Committee on Natural Resources, U.S. Senate Committee on Environment and Public Works and U.S. Environmental Protection Agency (EPA). Select one piece of legislation (or rule, or ordinance), either proposed or actual, and summarize it for the class. Ideally, you should select legislation that will directly impact your community. · Review the discussion board prior to selecting a proposal or prior to posting your message to the discussion board in order to avoid duplicating resources. · List the title of the legislative bill, rule, or ordinance. Include the title of the legislative body that drafted, proposed, or authorized the legislation. · Summarize the environmental legislation in one or two paragraphs. Identify key concepts included in the legislation. · In your opinion, what is the potential or realized impact of this legislation on the community? · Do you agree or disagree with the legislation? Support your answer. · Your original post should consist of complete sentences and should be at least two complete paragraphs but no more than three paragraphs. .

Discussion 2Locate current or proposed legislation, city rul.docx

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Discussion 2: Advantages and Disadvantages of Different Methods in Cross-Cultural Research In cross-cultural psychology research, a broad range of techniques is utilized to determine the best way to access critical data. Each technique has its advantages and disadvantages. For example, laboratory experiments may offer great control and ability to examine issues of cause and effect, but may not always reflect actual real-world conditions, especially in cross cultural situations. As an additional example, long term field work and interviews conducted by living in a given cultural setting for a year or two, may offer the possibility of many nuanced observations, yet such qualitative work will not lead to statistical or experimental designs. Each method tends to have pros and cons, rather than one method being the "right" one for every situation. For this Discussion, you will explore the advantages and disadvantages of using different research methods in cross-cultural research. Post and explain one advantage and one disadvantage of quantitative research for cross-cultural psychology. Then, describe one advantage and one disadvantage of qualitative research for cross-cultural psychology. Use examples from the studies provided to support your thinking. Learning Resources Required Readings Karasz, A., & Singelis, T. M. (2009). Qualitative and mixed methods research in cross-cultural psychology: Introduction to the special issue. Journal of Cross-Cultural Psychology, 40 (6), 909–916 Leech, N. L., & Onwuegbuzie, A. J. (2009). A typology of mixed methods research designs. Quality and Quantity, 43 (2), 265–275. doi:10.1007/s11135-007-9105-3 Malda, M., Van de Vijver, F. J. R., Srinivasan, K., Transler, C., Sukumar, P., & Rao, K. (2008). Adapting a cognitive test for a different culture: An illustration of qualitative procedures. Psychology Science Quarterly, 50 (4), 451–468. Miller, K. E., Omidian, P., Quraishy, A. S., Quraishy, N., Nasiry, M. N., Nasiry, S.,... & Yaqubi, A. A. (2006). The Afghan symptom checklist: A culturally grounded approach to mental health assessment in a conflict zone. American Journal of Orthopsychiatry, 76 (4), 423–433. Rich, G., Sirikantraporn, S., & Jean-Charles, W. (2018). The concept of posttraumatic growth in an adult sample from Port-Au-Prince, Haiti: A mixed methods study. In G. Rich & S. Sirikantraporn (Eds.), Human strengths and resilience: Developmental, cross-cultural, and international Perspectives (pp. 21–38).Lanham, MD: Lexington Books. Credit Line: International Differences in Well-Being, by Diener, J.; Helliwell, J. ; Kahneman, D. Copyright 2010 by Oxford University Press. Reprinted by permission of Oxford University Press via the Copyright Clearance Center. Van de Vijver, F. J. R. (2009). Types of comparative studies in cross-cultural psychology. Online readings in psychology and culture, 2 (2), pp.1–12. Credit Line: Fons J. R. van de Vijver. (2009). Types of Comparative Studies in Cross.

Discussion 2 Advantages and Disadvantages of Different Methods .docx

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Intermediate Accounting II Discussion Question: Imagine you are the senior accountant in the Fixed Assets department at your organization, and management is undecided as to whether it should construct its fixed assets or purchase such assets from an outside source. You are responsible for preparing a report to management, highlighting the advantages and disadvantages of self-constructed assets. Suggest to management two (2) advantages of purchasing the assets from an outside organization, as opposed to constructing the assets internally. Justify your response. Imagine that management is considering a nonreciprocal transfer of an old asset. Determine the key arguments for and against the accounting treatment of a nonreciprocal transfer. Select a position for or against the accounting treatment, and explain the method that reflects the best accounting practice. .

Intermediate Accounting II Discussion QuestionImagine you are t.docx

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Interaction Paper 1 Instructions For this Interaction Paper, you will choose a topic from the list below and write a 7–8-page paper based on methods of conflict resolution. You will be required to show your understanding of issues that cause conflict and the methods/resources being used today towards specific resolution. Special permission to choose and write on a topic not included on the list may be secured from the instructor. Area 1 Topics Area 1 topics are about conflict and are theoretical in nature. Your interaction paper should: Clearly define your purpose and clarify a specific question to answer. Your purpose should be general in nature and serve to prompt a more specific question that you will attempt to answer. For example, using the “Hillary Clinton as Peace Maker” topic, the purpose might be to explore how world leaders act as intermediaries to achieve diplomacy. The specific question could be, “How has Hillary Clinton made attempts to maintain peace between the U.S. and hostile countries like North Korea and Iran?” Specify a method for how you will accomplish your purpose and answer your question. This step is a preview of your research, and you will briefly indicate the tools you used to conduct your study. You may use any number of methods: surveying literature or journal articles, conducting surveys, studying historical cases, etc. Demonstrate your research. In this section, you will provide the details of your research process. Your input here should comprise the majority of your content. Draw some conclusions you reached. In this section, you will answer the question you posed in Step 1. Summarize the results of your research. Give recommendations for further study. Choose your topic from the list below: · The Biblical mandate for resolving conflict · Interpersonal Conflict and the Scriptures · Examples of IP conflict between man and God and man and man in Scripture. · The importance and significance of “forgiveness” in resolving conflict. · Techniques that may be used for international conflict reconciliation · Jimmy Carter as Peace Maker · Condoleezza Rice as Conflict Resolver · Bill Clinton as Conflict Resolver · President Obama as Conflict Resolver · Negotiation · Kissinger as Effective Negotiator · Hillary Clinton as Conflict Resolver · Mediation and conflict resolution in job disputes · Barriers to Conflict Resolution · Peacekeeping and Conflict Resolution · Business Management Methods of Handling Conflict. · The Functions of Conflict · Dealing with Racism as conflict · Dealing with Gender as conflict · Dealing with Multicultural conflicts · Forgiveness and Reconciliation in Conflict · Social-Psychological Perspectives of Conflict · Conflict Climates · Stress and Conflict Affects · Anger and Conflict Affects · Confrontation and Conflict · Listening and Conflict · The Church as a Stimulus for Peacemaking · .

Interaction Paper 1 InstructionsFor this Interaction Paper, yo.docx

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"Interface Design Models" Please respond to the following: Evaluate interface design models and describe design issues across human-computer interaction environments associated with these models. Support your response. Building an interface can be broken down into the phases of design and development. Analyze the activities that take place in both phases, and explain why certain activities should be included in design but not in development. .

Interface Design Models Please respond to the followingEvaluate.docx

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