Value Driven Healthcare.docx
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This document describes a two-part assignment related to value-driven healthcare. For part one, students are asked to describe their process for choosing a primary care physician based on factors like price and quality. For part two, students must get pricing information for an MRI from multiple facilities and reflect on their experience researching costs and the relationship to price transparency. The paper summarizing both parts should be 10-12 pages long with 10 references cited in APA format no older than 5 years.
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Correspondence PortfolioFor this assignment, you will use the .docx
Correspondence Portfolio
For this assignment, you will use the attached scenarios to prepare three separate pieces of correspondence.
In each piece of correspondence, you will be graded on your ability to demonstrate the following business writing techniques
effectively, thoroughly, and consistently.
You must use these techniques
throughout
your documents—not just a few times.
You Viewpoint
* Focus on the reader’s benefits, choices, and points of interest, not on yourself
* Don’t make assumptions about a reader’s beliefs or feelings
* Don’t talk about your own feelings
* Use
you
more often than
I
in positive situations
* Avoid
you
in negative situations
* Emphasize what the reader wants to know through organization and content
Positive Emphasis
* Emphasize positive information through detail and placement
* Avoid negative words
* Focus on what the reader can do, not on limitations
* Justify negative information (give a reason or link it to a benefit)
* Omit unimportant negatives
* When appropriate, de-emphasize negative information and present it compactly
Audience Analysis
* Brainstorm
all
of your potential audiences, but focus on your primary audience
* Gather and analyze relevant information about your audience
* Use your analysis to plan strategy, organization, content, and tone
Reader Benefits
* Identify the feelings, fears, and needs that may motivate your readers
* Identify the features of your product/service/plan/information that could benefit your audience
* Use strong, vivid details to develop reader benefits
* Use intrinsic benefits
* Use benefits you can develop fully
* Use you viewpoint when presenting benefits
You will also be graded on your ability to use proper memo and letter formats as described in the
Business Writer’s Handbook
and to effectively implement techniques pertaining to positive/informative, negative, and persuasive messages.
For each piece of correspondence,
make sure all necessary information is included and unnecessary information is excluded.
(Not every piece of information in the scenarios needs to go in the message.
Pick what’s most important to your audience!)
You must also be meticulous in proofreading for grammar and spelling errors.
Remember, although these assignments contain “real world” scenarios, I will be grading you on your ability to demonstrate your knowledge and mastery of course concepts.
That might mean writing more, or going into more depth, than you would if you were actually in these scenarios.
You may add information to your documents that is not contained in the scenario, but you cannot change any of the information in the scenario.
I will grade this assignment based on 1) your mastery of the course techniques and message types outlined above, 2) your adherence to proper memo and letter formatting, 3) the clarity and correctness of your writing.
Make sure you fully understand the scenarios before you start writing—read them carefully more than once and l.
1Health Insurance MatrixAs you learn about health care del.docx
1
Health Insurance Matrix
As you learn about health care delivery in the United States, it is necessary to understand the various models of health insurance to develop important foundational knowledge as you progress through the course and for your role as a future health care worker. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers. Fill in the following matrix. Each box must contain responses between 50 and 100 words and use complete sentences.
Model
Describe the model
How is the care paid or financed when this model is used?
What is the structure behind this model? Is it a gatekeeper, open-access, or combination of both?
What are the benefits for providers in using this model?
What are the challenges for providers in using this model?
Health Maintenance Organization (HMO)
Preferred Provider Model
Point-of-Service Model
Provider Sponsored Organization
High Deductible Health Plans and Savings Options
Cite your sources below.
References
H 235: Health Care Services
Textbook: Niles, N. J. (2014). Basics of the US health care system (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Shi, L., & Singh, D.A. (2015) Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Instructions: Please ensure to substantiate your response with scholarly sources and/or also a personal account of your own experience in the work place or personal life. Cite and reference work! QUESTIONS 1 – 11 USE TEXBOOK ABOVE & FOR QUESTIONS 1, 4 & 5 PLEASE SEE ATTACHED DOCUMENTS.
1. Read Chapter 8 Healthcare Financing and discuss what you found the most or least interesting. See Chapter 8 attached. Must be 200 word count.
1. Glenn: This chapter covers the different types and costs of health care. According to our reading, the cost of health care increases about 6% annually, and the new concentration of the health care industry is controlling overall cost. In the past, health care spending was not controlled, so providers could submit a claim for reimbursement and be automatically reimbursed with no penalty or incentive to control spending. I am sure that many claims were summited that were grossly over estimated, leading to higher health care costs for insurance companies and the consumers. I thought that the portion CDHPs was interesting. CDHPs allow consumers to control health care costs by giving them the opportunity to save money for health care, by letting consumers bank tax free money from paychecks to use towards medical expenses. I wish the data was more up to date, because I seem to remember reading somewhere in the Los Angeles Times that health care costs were due to increase well above the average annual increase in 2015. I know that a lot of those costs get passed on to the consumer, and it would be interesting to see just how much of tha ...
Hello, I need assistance with the following I need assistance.docx
Hello, I need assistance with the following:
I need assistance with the following, would you be able to assist?
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals var.
Recommended
Correspondence PortfolioFor this assignment, you will use the .docx
Correspondence Portfolio
For this assignment, you will use the attached scenarios to prepare three separate pieces of correspondence.
In each piece of correspondence, you will be graded on your ability to demonstrate the following business writing techniques
effectively, thoroughly, and consistently.
You must use these techniques
throughout
your documents—not just a few times.
You Viewpoint
* Focus on the reader’s benefits, choices, and points of interest, not on yourself
* Don’t make assumptions about a reader’s beliefs or feelings
* Don’t talk about your own feelings
* Use
you
more often than
I
in positive situations
* Avoid
you
in negative situations
* Emphasize what the reader wants to know through organization and content
Positive Emphasis
* Emphasize positive information through detail and placement
* Avoid negative words
* Focus on what the reader can do, not on limitations
* Justify negative information (give a reason or link it to a benefit)
* Omit unimportant negatives
* When appropriate, de-emphasize negative information and present it compactly
Audience Analysis
* Brainstorm
all
of your potential audiences, but focus on your primary audience
* Gather and analyze relevant information about your audience
* Use your analysis to plan strategy, organization, content, and tone
Reader Benefits
* Identify the feelings, fears, and needs that may motivate your readers
* Identify the features of your product/service/plan/information that could benefit your audience
* Use strong, vivid details to develop reader benefits
* Use intrinsic benefits
* Use benefits you can develop fully
* Use you viewpoint when presenting benefits
You will also be graded on your ability to use proper memo and letter formats as described in the
Business Writer’s Handbook
and to effectively implement techniques pertaining to positive/informative, negative, and persuasive messages.
For each piece of correspondence,
make sure all necessary information is included and unnecessary information is excluded.
(Not every piece of information in the scenarios needs to go in the message.
Pick what’s most important to your audience!)
You must also be meticulous in proofreading for grammar and spelling errors.
Remember, although these assignments contain “real world” scenarios, I will be grading you on your ability to demonstrate your knowledge and mastery of course concepts.
That might mean writing more, or going into more depth, than you would if you were actually in these scenarios.
You may add information to your documents that is not contained in the scenario, but you cannot change any of the information in the scenario.
I will grade this assignment based on 1) your mastery of the course techniques and message types outlined above, 2) your adherence to proper memo and letter formatting, 3) the clarity and correctness of your writing.
Make sure you fully understand the scenarios before you start writing—read them carefully more than once and l.
1Health Insurance MatrixAs you learn about health care del.docx
1
Health Insurance Matrix
As you learn about health care delivery in the United States, it is necessary to understand the various models of health insurance to develop important foundational knowledge as you progress through the course and for your role as a future health care worker. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers. Fill in the following matrix. Each box must contain responses between 50 and 100 words and use complete sentences.
Model
Describe the model
How is the care paid or financed when this model is used?
What is the structure behind this model? Is it a gatekeeper, open-access, or combination of both?
What are the benefits for providers in using this model?
What are the challenges for providers in using this model?
Health Maintenance Organization (HMO)
Preferred Provider Model
Point-of-Service Model
Provider Sponsored Organization
High Deductible Health Plans and Savings Options
Cite your sources below.
References
H 235: Health Care Services
Textbook: Niles, N. J. (2014). Basics of the US health care system (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Shi, L., & Singh, D.A. (2015) Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Instructions: Please ensure to substantiate your response with scholarly sources and/or also a personal account of your own experience in the work place or personal life. Cite and reference work! QUESTIONS 1 – 11 USE TEXBOOK ABOVE & FOR QUESTIONS 1, 4 & 5 PLEASE SEE ATTACHED DOCUMENTS.
1. Read Chapter 8 Healthcare Financing and discuss what you found the most or least interesting. See Chapter 8 attached. Must be 200 word count.
1. Glenn: This chapter covers the different types and costs of health care. According to our reading, the cost of health care increases about 6% annually, and the new concentration of the health care industry is controlling overall cost. In the past, health care spending was not controlled, so providers could submit a claim for reimbursement and be automatically reimbursed with no penalty or incentive to control spending. I am sure that many claims were summited that were grossly over estimated, leading to higher health care costs for insurance companies and the consumers. I thought that the portion CDHPs was interesting. CDHPs allow consumers to control health care costs by giving them the opportunity to save money for health care, by letting consumers bank tax free money from paychecks to use towards medical expenses. I wish the data was more up to date, because I seem to remember reading somewhere in the Los Angeles Times that health care costs were due to increase well above the average annual increase in 2015. I know that a lot of those costs get passed on to the consumer, and it would be interesting to see just how much of tha ...
Hello, I need assistance with the following I need assistance.docx
Hello, I need assistance with the following:
I need assistance with the following, would you be able to assist?
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals var.
Could you also please incorporate law review articles in your refe.docx
Could you also please incorporate law review articles in your references. The reference list should contain 8-10 respectable sources such as reliable publications and .edu, .gov websites; Wikipedia cannot be used.
Introduction
· Advertising as a tool for representing company’s personality;
· Legal regulations of advertising then and now (a brief history of governmental regulations of advertising);
· If there is a strict set of regulations and laws why advertising scandals even occur? (ambiguity)
The main topic of the paper is to showcase the role of language in advertising and describe the potential legal consequences that may occur when using language incorrectly.
Arguments (paragraphs):
1. Consumers often confuse legality with ethics; not all ethical issues can be regulated legally
· Discuss the concepts of puffery, reasonable consumer, misleading advertising deceptive advertising;
· Commercial exaggeration is legal and it is not possible to legislate against emotional appeals;
· Consumers sometimes take company’s tagline or claim too literally;
2. Governmental and industry self-regulative laws are very complex and can be misinterpreted by the company
· Discuss FTC and advertising standards;
· Failure to define correctly product’s or service’s category sometimes lead to legal issues;
· A high lack of clarity for digital advertising since many laws were written prior to the spread of computers and Internet;
3. A very minor number of marketers and advertisers resort to violation of industry self-regulations and use of unethical tactics.
· Tough competition puts pressure on companies and forces them to create eccentric campaigns to break through the clutter;
· Industry is actively fighting the advertising fraud;
For the following court cases examples it is needed to refer to the actual court documents in addition to the articles:
Discuss the following court cases and incorporate in the context of the essay.
4. Whole Foods sued over false advertising of sugar in goods
http://www.foxnews.com/food-drink/2015/07/14/whole-foods-sued-over-false-advertising-sugar-in-goods.html
5. Red Bull Will Pay $10 To Customers Disappointed The Drink Didn’t Actually Give Them 'Wings' http://www.businessinsider.com/red-bull-settles-false-advertising-lawsuit-for-13-million-2014-10?r=UK&IR=T
6.Naked Juice Class Action Lawsuit Settlement Over Health Claims Means $9 Million For Consumers
http://www.huffingtonpost.com/2013/08/28/naked-juice-class-action-lawsuit_n_3830437.html
Conclusion
Running head: Critical thinking
Critical thinking 2
Critical thinking
Dennis Byrd
UOPX
Critical Thinking and Decision Making
Bridget Peaco
4/3/2017
Critical thinking is one of the most powerful tools which is used in evaluation and objective analysis of a scenario so as to form a judgment. It utilizes intellectual concepts, skillful conceptualization, synthesis, application, assessment and evaluation of issues before making a decision. A good example from by expe.
Healthcare ReimbursementI need help on the following assignment C.docx
Healthcare Reimbursement
I need help on the following assignment: Create a white paper. I have coompleted the first part and can provide it to you for help on the second part of the paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an i.
NHS-FPX6008 - Economics and Decision Making in Health CareAssess (2).docx
NHS-FPX6008 - Economics and Decision Making in Health Care
Assessment 4 Instructions: Lobbying for Change
Top of Form
Bottom of Form
Write a letter to an official in your state or local government. (Choose the individual in the level of government that will best address your issue). The purpose of this letter is to advocate for action with regards to your chosen health care environment issue.
Introduction
Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
As health care leaders, it is important to understand strategies for advocating and lobbying elected officials. This can lead to the development of policies or laws that can help drive improved equity and outcomes for all participants in the health care environment as well as a more sustainable financial future.
Background and Context
As a master's-level health care practitioner, you may be expected to implement plans to ensure that initiatives designed to take advantage of economic opportunities for the organization are rolled out successfully and can be sustained over multiple years. Additionally, it is important to be able to envision how an initiative could be implemented in different contexts and for different purposes to ensure the investment remains a viable and positive asset to your organization or care setting.
As a master's-level practitioner, you will often be challenged to influence the health care environment in a variety of ways. This influence can occur on a micro-level (implementing change on your unit, institution, community, or local organizations) or at a macro level (implementing change via state or federal regulations and policy). One way you can influence the health care environment is by lobbying an elected official at the local, state, or national level to adopt policies or legislation that would support positive economic and health outcomes for patients, practitioners, and organizations within the health care environment.
Instructions
For this assessment, you will develop a letter to an official in your state or local government (choose the individual in the level of government that will best address your issue). The purpose of this letter is to advocate for action with regards to your chosen health care environment issue. Remember, when writing the letter, you must use your personal address and telephone number unless you are exclusively representing a group or your organization.
Be sure to address each main point. Review the assessment instructions and scoring guide, including performance-level descriptions for each criterion, to ensure you understand the work you will be asked to complete and how it will be assessed. In addition, note the requirements for document format and length and for supporting evidence.
Overall, your assessment submission will be assessed on the following criteria:
· Summarize the health care economic i.
I need the follwoing assignmentThe project is the creation of a w.docx
I need the follwoing assignment:
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus.
Becker’s Hospital Review
has an excellent .
Running Head HEALTHCARE FACILITY PROPOSAL .docx
Running Head: HEALTHCARE FACILITY PROPOSAL 1
HEALTHCARE FACILITY PROPOSAL 5
Healthcare Facility Proposal
Name:
04/06/2019
Healthcare Facility Proposal
The provision of outpatient healthcare services in the United States is quickly growing as more investments into this sector come in. There is a great shift in healthcare services from inpatient to outpatient medical services. Among the outpatient healthcare services is the establishment of an outpatient pharmacy. I propose that a pharmacy should be established in the state of Florida, where I come from. The pharmacy should be big enough to possible serve the most people possible. The pharmacy would be open for service to the general public under the directions of the state’s hospital.
A pharmacy would be the best idea for one to put up in my state. The pharmacies are not just outlets for collection of drugs, as some may be made to believe. There is much more in store for the patient when he/she decides to get the services from a pharmacy. Pharmacies offer medicinal and health information and advice to the patients, given that the pharmacists are well trained in the medical and anatomical fields and they understand much on the expected effects of drugs on the body. Pharmacists also offer quick solutions to common weather-related infections such as common cold and influenza, thereby reducing congestion in hospitals. Expectant women and newborn babies and their mothers often require specialized attention in terms of medication and diet. The pharmacists are also well trained to handle such cases and give them the relevant medicinal and nutritional advice that they may need in their pursuit for health.
It is common nowadays for people to suffer from psychological disorders and other emotional distresses. Such patients can also get their services at the pharmacies. These disorders are just as dangerous and as prevalent as other physical diseases and disorders, and are sometimes caused by the effects of chemical imbalances in the body. The pharmacist is well trained to understand the possible imbalances that are likely to induce such mental disorders in the patients, and they therefore give forth the best medication and advice to the patients on how to overcome the disorders. The pharmacists are also well trained to offer therapy sessions to the patients, or they could have the psychiatrists and other experts in those fields at the pharmacies for these therapy sessions (Harding & Taylor, 2016). This helps to rationalize therapy sessions and reduce the costs related to therapy sessions.
Other services delivered at the pharmacies include immunizations to the new-born babies and the little children. This helps reduce the susceptibility of these children to common diseases that attack the infants’ immune system and could bring forth life-threatening diseases to them. Pha ...
In this assignment, you will demonstrate your mastery of the followi.docx
In this assignment, you will demonstrate your mastery of the following course outcomes:
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements Analyze organizational strategies for negotiating healthcare contracts with managed care organizations Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives
Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There are several ways to accomplish this. Choose one of the following:
If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses. Conduct research through articles or get information from professional organizations.
Below is an example of how to begin framing your analysis.
A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what happens in an emergency area. The patient could be asked to change into a hospital gown (think about the costs of the gown and other supplies provided). If the patient is displaying signs of vomiting, plastic bags will be provided and possibly antinausea medication. Lab work and possibly x-rays would be done. The patient could be sent to surgery, sent home, or admitted as an inpatient. If he or she is admitted as an inpatient, meals will be provided and more tests will be ordered by the physician—again, more costs and charges for the patient bill. Throughout the course, you will be gathering additional information th.
You are a corporate compliance officer for a hospital. You are al.docx
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
Assignment 1 Grading Criteria
Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity.
Explained the steps to take to determine who is involved in the complaint.
Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation.
Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview.
Identified the criteria to determine if the allegations are substantiated or unsubstantiated.
Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary.
Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted.
Written Components:
Style:
Tone, audience, and word choice
Organization:
Introduction, transitions, and conclusion
Usage and Mechanics:
Grammar, spelling, and sentence structure
APA Elements:
I.
Dis 1Reply PostSpecifically, address your classmates’ recom.docx
Dis 1:
Reply Post
Specifically, address your classmates’ recommended solutions of the other scenarios other than your own. Would you propose the same solution? Why or why not?
1. Scenario 3
There’s a patient at the Pain management clinic for chronic pain. The patient arrived at the clinic for her treatment and overhead staff say, “she is only a drug seeker and is not really in pain”. The patient was upset and decided to write the clinic administrator about her experience and unacceptable behavior the clinic staff engaged in. These types of behavior can be legally, ethically and financially impactful which should never be tolerated.
These types of conversations can be detrimental to the patient and clinic and need to be addressed in a timely manner. Decision making by the administer needs to be established in this process.
· You must define the problem
· Generate solutions
· Propose the solutions in detail and operational
· Evaluate and implement
This model decision makers conceptualize a real situation to help strengthen the code of ethic obtains a tangible solution (Szymaniec-Micka, 2017).
As the administrator I would gather all the facts and have a private conversation with the staff members involved. I would provide a copy of code of ethics, mission and vision for our clinic. Health care managers and staff must demonstrate high ethical conduct that is in line with the core values (Walston, 2017). This type of behavior is unacceptable, not tolerated, and does not demonstrate appropriate ethical conduct. If this were the first time the staff member exhibited tis behavior it would be used as an opportunity to have a conversation and provide constructive feedback. If this type of behavior becomes a pattern, the assistance of human resources would be needed. As the leader this is an opportunity to start a conversation and implement education for the department. The conversation would be centered around the topics of inclusion, diversity, acceptable behaviors and value-based education. I would implement annual education sessions and signing the code of ethics policy as a reminder of accepted behaviors.
As the administrator, I would initially address the patient with an apology and explain that these conversations are not acceptable or tolerated. I would assure the patient that this behavior is not in line with our mission, vision or code of conduct. I would assur her the staff members would be addressed and that education for our clinic would be implement based on our core values to ensure these types of conversations do not happen again. Lastly, I will ask the patient if she has any other feedback regarding her experiences in the clinic and follow up appropriately.
2.
Scenario 3:
At the Pain Management Clinic (PMC) there is a patient that comes in for recurring chronic pain management and overheard a staff member say, “she is only a drug seeker and is not really in pain”, which lead to the patient writing the administrato.
Preparing for a Service Planning Conference or Disposition Plannin.docx
Preparing for a Service Planning Conference or Disposition Planning Meeting
Introduction
After you have completed your assessment on each new client and done a tentative plan with the person, your agency might hold a meeting in which more specific plans are made for the individual’s care or services. In some agencies this is done informally. In small agencies, particularly, individual case managers may make those decisions by themselves, referring people to other services in systems that will have more formal case management.
In some places, children who come into the system are presented by their case manager to a “children’s panel” consisting of child psychologists, child psychiatrists, social workers, pediatricians, and others who serve children. Many other places use panels of professionals for creating plans for clients from different populations; in this situation, the case manager presents the case to representatives of any number of agencies serving or specializing in that population. Together the group decides what combination of services would best suit people in their current situation and gives a diagnosis, if appropriate.
If a person has both a substance abuse (SA) problem and a mental health problem and the agencies that address these two problems are not combined, representatives from each of the agencies working with the client should meet together to decide what should be done. In the past a client could be turned down for mental health services because he was drinking and turned down for SA services because he was suicidal. That kind of “turf” exclusion at the expense of the client is no longer tolerated by funding sources that expect people to be served.
In these meetings, decisions regarding the service an individual will receive are made with others who have experience and come, perhaps, from different disciplines. When the meeting is over, a formal plan will be drawn up.
What You Will Need to Bring to the Meeting
You should consider bringing three items to these planning meetings.
1. Tentative service plan:You have already developed a tentative service plan with the individual. Bring this tentative plan to the service planning conference.
2. Human service directory:As you work within the same social service system, you will come to know, without consulting a directory, which agencies are reliable and which services are used most often by your agency when referring people. As you begin your career, you need to know what human service organizations are available in your community. If there is a directory, bring that to the meeting so that you can work with your peers to find the best placement for your client. A good place to look is the local phone book, where social services are usually listed together. You might copy these pages and bring them to the meeting.
3. DSM Handbook:The DSM is a large volume containing considerable information. If you are working in an area that is likely to use the DSM to give diagnoses, you m.
What I need help on the most would be the following sections1. .docx
What I need help on the most would be the following sections:
1. data management,
2. data analysis,
3. discussion.
Just those parts would be only about 3 to 4 pages double space of writing. The document titled treatment satisfaction final draft has all the work I have done so far. I have highlighted and sort of color-coordinated the sections of the paper that you will need to do.
Here are some specifics you need to know:
I had to pick 4 variable (3 independent 1 Dependent variables) which was pulled from the same Data which is called Cathy's data ( is attached to the homeworkmarket post )
My picks were:
· Treatment Satisfaction (TS)
· Desire for Help(DH)
· Treatment Readiness(TR)
· Treatment participation(TP)
Each indicator had there own data sets which were:
TS
Cest 007 Time schedule is convenient
Cest 0011 Program expects responsibility/self
Cest 020 Program organized /run well
Cest 030 Satisfied with program
Cest 080 Staff efficient with Job
Cest 115 Personal Counseling
Cest 112 Location is convenient
DH
Cest 003
Cest 032
Cest 039
Cest 065
Cest 86
Cest 116
TR
Cest006 TR Need to stay in treatment
Cest 013 TR Solve Problems in treatment
Cest 014 TR Treatment is not helping ( this one had to be removed because it failed reliability test)
Cest 054 TR Treatment gives you hope
Cest 056 TR Want to be in drug treatment
TP
Cest 019
Cest 026
Cest 031
Cest 035
Cest 037
Cest 066
Cest 067
Cest 077
Cest 083
Cest 104
Cest 127
The example paper is exactly how the paper needs to read so really you would need to just copy and paste most of it and plug in my variables and maybe change some words around so that it will fit my data set.
when it comes to interpreting the data for the finding section my professor has a specific way which she wants it to be written. I will give you some homework examples that we have done to give you an idea for the univariate and bivariate analysis but for the Mutlvariates you have to go off the final paper example because i do not have HW examples for them.
Data Management:
For the Data management just simply give a detailed summary of what methods/steps i used. Use Appendix A for your reference. To make it easy for you i made a table of contents
page 6: Ran Frequencies
Page 23: Computations
page 30: Factor Analysis
Page 44: Reliability Analysis
Page 53: Computation
Try to word it like it is for the example paper
Data Analysis:
For Data Analysis use Appendix B info I highlighted or colored the different tables so you could easily find them.
Lastly, I have attached Cathy's Data set for you in case you wanted to go in replicate my steps so you could get a better understanding of the data
Discussion section is the conclusion
Final ProjectComment by Davis-Ganao, Jessica S: Better title needed
Institution
Dr. Ganao
Introduction
The reason for this study is to understand counselor relationships based on key elements. The study seeks to find how well a counselor rapport hel ...
A guide-to-pricing-techniques
This field guide serves as a quick reference for pricing professionals in findings some minute ideas for pricing research solutions.
A guide-to-pricing-techniques
A Field Guide to pricing serves as a quick reference for pricing research professionals.
Compare and contrast conflict visions in healthcare
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CHAPTER1097THE DEMAND FOR HEALTHCARE PRODUCTSLearnin
CHAPTER
109
7THE DEMAND FOR HEALTHCARE PRODUCTS
Learning Objectives
After reading this chapter, students will be able to
• calculate sales and revenue using simple models,
• discuss the importance of demand in management decision making,
• articulate why consumer demand is an important topic in healthcare,
• apply demand theory to anticipate the effects of a policy change,
• use standard terminology to describe the demand for healthcare
products, and
• discuss the factors that influence demand.
Key Concepts
• The demand for healthcare products is complex.
• When a product’s price rises, the quantity demanded usually falls.
• The amount a consumer pays directly is called the out-of-pocket price
of that good or service.
• Because of insurance, the total price and the out-of-pocket price can
differ markedly.
• Multiple factors can shift demand: changes in consumer income,
insurance coverage, health status, prices of other goods and services,
and tastes.
• Demand forecasts are essential to management.
7.1 Introduction
Demand is one of the central ideas of economics. It underpins many of the
contributions of economics to public and private decision making. Analyses
of demand tell us that human wants are seldom absolute. More often they
demand
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product that will
be purchased at
different prices
when all other
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EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 6/1/2022 6:17 PM via UNIVERSITY OF MARYLAND GLOBAL
CAMPUS
AN: 2144510 ; Robert Lee.; Economics for Healthcare Managers, Fourth Edition
Account: s4264928
E c o n o m i c s f o r H e a l t h c a r e M a n a g e r s110
are conditioned by questions: “Is it really worth it?” “Is its value greater than
its cost?” These questions are central to understanding healthcare economics.
Demand forecasts are essential to management. Most managerial deci-
sions are based on revenue projections. Revenue projections in turn depend
on estimates of sales volume, given prices that managers set. A volume esti-
mate is an application of demand theory. Understanding the relationship
between price and quantity must be part of every manager’s tool kit. On
an even more fundamental level, demand forecasts help managers decide
whether to produce a certain product at all and how much to charge. For
example, if you conclude that the direct costs of providing therapeutic mas-
sage are $48 and that you will need to charge at least $75 to have an attrac-
tive profit margin, will you have enough customers to make this service a
sensible addition to your product line? Demand analyses are desig ...
Proven Strategies for Tackling Health Care Cost
This session will motivate you to be more proactive in considering major strategies to reduce health care costs.
More Related Content
Similar to Value Driven Healthcare.docx
Could you also please incorporate law review articles in your refe.docx
Could you also please incorporate law review articles in your references. The reference list should contain 8-10 respectable sources such as reliable publications and .edu, .gov websites; Wikipedia cannot be used.
Introduction
· Advertising as a tool for representing company’s personality;
· Legal regulations of advertising then and now (a brief history of governmental regulations of advertising);
· If there is a strict set of regulations and laws why advertising scandals even occur? (ambiguity)
The main topic of the paper is to showcase the role of language in advertising and describe the potential legal consequences that may occur when using language incorrectly.
Arguments (paragraphs):
1. Consumers often confuse legality with ethics; not all ethical issues can be regulated legally
· Discuss the concepts of puffery, reasonable consumer, misleading advertising deceptive advertising;
· Commercial exaggeration is legal and it is not possible to legislate against emotional appeals;
· Consumers sometimes take company’s tagline or claim too literally;
2. Governmental and industry self-regulative laws are very complex and can be misinterpreted by the company
· Discuss FTC and advertising standards;
· Failure to define correctly product’s or service’s category sometimes lead to legal issues;
· A high lack of clarity for digital advertising since many laws were written prior to the spread of computers and Internet;
3. A very minor number of marketers and advertisers resort to violation of industry self-regulations and use of unethical tactics.
· Tough competition puts pressure on companies and forces them to create eccentric campaigns to break through the clutter;
· Industry is actively fighting the advertising fraud;
For the following court cases examples it is needed to refer to the actual court documents in addition to the articles:
Discuss the following court cases and incorporate in the context of the essay.
4. Whole Foods sued over false advertising of sugar in goods
http://www.foxnews.com/food-drink/2015/07/14/whole-foods-sued-over-false-advertising-sugar-in-goods.html
5. Red Bull Will Pay $10 To Customers Disappointed The Drink Didn’t Actually Give Them 'Wings' http://www.businessinsider.com/red-bull-settles-false-advertising-lawsuit-for-13-million-2014-10?r=UK&IR=T
6.Naked Juice Class Action Lawsuit Settlement Over Health Claims Means $9 Million For Consumers
http://www.huffingtonpost.com/2013/08/28/naked-juice-class-action-lawsuit_n_3830437.html
Conclusion
Running head: Critical thinking
Critical thinking 2
Critical thinking
Dennis Byrd
UOPX
Critical Thinking and Decision Making
Bridget Peaco
4/3/2017
Critical thinking is one of the most powerful tools which is used in evaluation and objective analysis of a scenario so as to form a judgment. It utilizes intellectual concepts, skillful conceptualization, synthesis, application, assessment and evaluation of issues before making a decision. A good example from by expe.
Healthcare ReimbursementI need help on the following assignment C.docx
Healthcare Reimbursement
I need help on the following assignment: Create a white paper. I have coompleted the first part and can provide it to you for help on the second part of the paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an i.
NHS-FPX6008 - Economics and Decision Making in Health CareAssess (2).docx
NHS-FPX6008 - Economics and Decision Making in Health Care
Assessment 4 Instructions: Lobbying for Change
Top of Form
Bottom of Form
Write a letter to an official in your state or local government. (Choose the individual in the level of government that will best address your issue). The purpose of this letter is to advocate for action with regards to your chosen health care environment issue.
Introduction
Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
As health care leaders, it is important to understand strategies for advocating and lobbying elected officials. This can lead to the development of policies or laws that can help drive improved equity and outcomes for all participants in the health care environment as well as a more sustainable financial future.
Background and Context
As a master's-level health care practitioner, you may be expected to implement plans to ensure that initiatives designed to take advantage of economic opportunities for the organization are rolled out successfully and can be sustained over multiple years. Additionally, it is important to be able to envision how an initiative could be implemented in different contexts and for different purposes to ensure the investment remains a viable and positive asset to your organization or care setting.
As a master's-level practitioner, you will often be challenged to influence the health care environment in a variety of ways. This influence can occur on a micro-level (implementing change on your unit, institution, community, or local organizations) or at a macro level (implementing change via state or federal regulations and policy). One way you can influence the health care environment is by lobbying an elected official at the local, state, or national level to adopt policies or legislation that would support positive economic and health outcomes for patients, practitioners, and organizations within the health care environment.
Instructions
For this assessment, you will develop a letter to an official in your state or local government (choose the individual in the level of government that will best address your issue). The purpose of this letter is to advocate for action with regards to your chosen health care environment issue. Remember, when writing the letter, you must use your personal address and telephone number unless you are exclusively representing a group or your organization.
Be sure to address each main point. Review the assessment instructions and scoring guide, including performance-level descriptions for each criterion, to ensure you understand the work you will be asked to complete and how it will be assessed. In addition, note the requirements for document format and length and for supporting evidence.
Overall, your assessment submission will be assessed on the following criteria:
· Summarize the health care economic i.
I need the follwoing assignmentThe project is the creation of a w.docx
I need the follwoing assignment:
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus.
Becker’s Hospital Review
has an excellent .
Running Head HEALTHCARE FACILITY PROPOSAL .docx
Running Head: HEALTHCARE FACILITY PROPOSAL 1
HEALTHCARE FACILITY PROPOSAL 5
Healthcare Facility Proposal
Name:
04/06/2019
Healthcare Facility Proposal
The provision of outpatient healthcare services in the United States is quickly growing as more investments into this sector come in. There is a great shift in healthcare services from inpatient to outpatient medical services. Among the outpatient healthcare services is the establishment of an outpatient pharmacy. I propose that a pharmacy should be established in the state of Florida, where I come from. The pharmacy should be big enough to possible serve the most people possible. The pharmacy would be open for service to the general public under the directions of the state’s hospital.
A pharmacy would be the best idea for one to put up in my state. The pharmacies are not just outlets for collection of drugs, as some may be made to believe. There is much more in store for the patient when he/she decides to get the services from a pharmacy. Pharmacies offer medicinal and health information and advice to the patients, given that the pharmacists are well trained in the medical and anatomical fields and they understand much on the expected effects of drugs on the body. Pharmacists also offer quick solutions to common weather-related infections such as common cold and influenza, thereby reducing congestion in hospitals. Expectant women and newborn babies and their mothers often require specialized attention in terms of medication and diet. The pharmacists are also well trained to handle such cases and give them the relevant medicinal and nutritional advice that they may need in their pursuit for health.
It is common nowadays for people to suffer from psychological disorders and other emotional distresses. Such patients can also get their services at the pharmacies. These disorders are just as dangerous and as prevalent as other physical diseases and disorders, and are sometimes caused by the effects of chemical imbalances in the body. The pharmacist is well trained to understand the possible imbalances that are likely to induce such mental disorders in the patients, and they therefore give forth the best medication and advice to the patients on how to overcome the disorders. The pharmacists are also well trained to offer therapy sessions to the patients, or they could have the psychiatrists and other experts in those fields at the pharmacies for these therapy sessions (Harding & Taylor, 2016). This helps to rationalize therapy sessions and reduce the costs related to therapy sessions.
Other services delivered at the pharmacies include immunizations to the new-born babies and the little children. This helps reduce the susceptibility of these children to common diseases that attack the infants’ immune system and could bring forth life-threatening diseases to them. Pha ...
In this assignment, you will demonstrate your mastery of the followi.docx
In this assignment, you will demonstrate your mastery of the following course outcomes:
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements Analyze organizational strategies for negotiating healthcare contracts with managed care organizations Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives
Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There are several ways to accomplish this. Choose one of the following:
If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses. Conduct research through articles or get information from professional organizations.
Below is an example of how to begin framing your analysis.
A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what happens in an emergency area. The patient could be asked to change into a hospital gown (think about the costs of the gown and other supplies provided). If the patient is displaying signs of vomiting, plastic bags will be provided and possibly antinausea medication. Lab work and possibly x-rays would be done. The patient could be sent to surgery, sent home, or admitted as an inpatient. If he or she is admitted as an inpatient, meals will be provided and more tests will be ordered by the physician—again, more costs and charges for the patient bill. Throughout the course, you will be gathering additional information th.
You are a corporate compliance officer for a hospital. You are al.docx
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
Assignment 1 Grading Criteria
Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity.
Explained the steps to take to determine who is involved in the complaint.
Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation.
Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview.
Identified the criteria to determine if the allegations are substantiated or unsubstantiated.
Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary.
Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted.
Written Components:
Style:
Tone, audience, and word choice
Organization:
Introduction, transitions, and conclusion
Usage and Mechanics:
Grammar, spelling, and sentence structure
APA Elements:
I.
Dis 1Reply PostSpecifically, address your classmates’ recom.docx
Dis 1:
Reply Post
Specifically, address your classmates’ recommended solutions of the other scenarios other than your own. Would you propose the same solution? Why or why not?
1. Scenario 3
There’s a patient at the Pain management clinic for chronic pain. The patient arrived at the clinic for her treatment and overhead staff say, “she is only a drug seeker and is not really in pain”. The patient was upset and decided to write the clinic administrator about her experience and unacceptable behavior the clinic staff engaged in. These types of behavior can be legally, ethically and financially impactful which should never be tolerated.
These types of conversations can be detrimental to the patient and clinic and need to be addressed in a timely manner. Decision making by the administer needs to be established in this process.
· You must define the problem
· Generate solutions
· Propose the solutions in detail and operational
· Evaluate and implement
This model decision makers conceptualize a real situation to help strengthen the code of ethic obtains a tangible solution (Szymaniec-Micka, 2017).
As the administrator I would gather all the facts and have a private conversation with the staff members involved. I would provide a copy of code of ethics, mission and vision for our clinic. Health care managers and staff must demonstrate high ethical conduct that is in line with the core values (Walston, 2017). This type of behavior is unacceptable, not tolerated, and does not demonstrate appropriate ethical conduct. If this were the first time the staff member exhibited tis behavior it would be used as an opportunity to have a conversation and provide constructive feedback. If this type of behavior becomes a pattern, the assistance of human resources would be needed. As the leader this is an opportunity to start a conversation and implement education for the department. The conversation would be centered around the topics of inclusion, diversity, acceptable behaviors and value-based education. I would implement annual education sessions and signing the code of ethics policy as a reminder of accepted behaviors.
As the administrator, I would initially address the patient with an apology and explain that these conversations are not acceptable or tolerated. I would assure the patient that this behavior is not in line with our mission, vision or code of conduct. I would assur her the staff members would be addressed and that education for our clinic would be implement based on our core values to ensure these types of conversations do not happen again. Lastly, I will ask the patient if she has any other feedback regarding her experiences in the clinic and follow up appropriately.
2.
Scenario 3:
At the Pain Management Clinic (PMC) there is a patient that comes in for recurring chronic pain management and overheard a staff member say, “she is only a drug seeker and is not really in pain”, which lead to the patient writing the administrato.
Preparing for a Service Planning Conference or Disposition Plannin.docx
Preparing for a Service Planning Conference or Disposition Planning Meeting
Introduction
After you have completed your assessment on each new client and done a tentative plan with the person, your agency might hold a meeting in which more specific plans are made for the individual’s care or services. In some agencies this is done informally. In small agencies, particularly, individual case managers may make those decisions by themselves, referring people to other services in systems that will have more formal case management.
In some places, children who come into the system are presented by their case manager to a “children’s panel” consisting of child psychologists, child psychiatrists, social workers, pediatricians, and others who serve children. Many other places use panels of professionals for creating plans for clients from different populations; in this situation, the case manager presents the case to representatives of any number of agencies serving or specializing in that population. Together the group decides what combination of services would best suit people in their current situation and gives a diagnosis, if appropriate.
If a person has both a substance abuse (SA) problem and a mental health problem and the agencies that address these two problems are not combined, representatives from each of the agencies working with the client should meet together to decide what should be done. In the past a client could be turned down for mental health services because he was drinking and turned down for SA services because he was suicidal. That kind of “turf” exclusion at the expense of the client is no longer tolerated by funding sources that expect people to be served.
In these meetings, decisions regarding the service an individual will receive are made with others who have experience and come, perhaps, from different disciplines. When the meeting is over, a formal plan will be drawn up.
What You Will Need to Bring to the Meeting
You should consider bringing three items to these planning meetings.
1. Tentative service plan:You have already developed a tentative service plan with the individual. Bring this tentative plan to the service planning conference.
2. Human service directory:As you work within the same social service system, you will come to know, without consulting a directory, which agencies are reliable and which services are used most often by your agency when referring people. As you begin your career, you need to know what human service organizations are available in your community. If there is a directory, bring that to the meeting so that you can work with your peers to find the best placement for your client. A good place to look is the local phone book, where social services are usually listed together. You might copy these pages and bring them to the meeting.
3. DSM Handbook:The DSM is a large volume containing considerable information. If you are working in an area that is likely to use the DSM to give diagnoses, you m.
What I need help on the most would be the following sections1. .docx
What I need help on the most would be the following sections:
1. data management,
2. data analysis,
3. discussion.
Just those parts would be only about 3 to 4 pages double space of writing. The document titled treatment satisfaction final draft has all the work I have done so far. I have highlighted and sort of color-coordinated the sections of the paper that you will need to do.
Here are some specifics you need to know:
I had to pick 4 variable (3 independent 1 Dependent variables) which was pulled from the same Data which is called Cathy's data ( is attached to the homeworkmarket post )
My picks were:
· Treatment Satisfaction (TS)
· Desire for Help(DH)
· Treatment Readiness(TR)
· Treatment participation(TP)
Each indicator had there own data sets which were:
TS
Cest 007 Time schedule is convenient
Cest 0011 Program expects responsibility/self
Cest 020 Program organized /run well
Cest 030 Satisfied with program
Cest 080 Staff efficient with Job
Cest 115 Personal Counseling
Cest 112 Location is convenient
DH
Cest 003
Cest 032
Cest 039
Cest 065
Cest 86
Cest 116
TR
Cest006 TR Need to stay in treatment
Cest 013 TR Solve Problems in treatment
Cest 014 TR Treatment is not helping ( this one had to be removed because it failed reliability test)
Cest 054 TR Treatment gives you hope
Cest 056 TR Want to be in drug treatment
TP
Cest 019
Cest 026
Cest 031
Cest 035
Cest 037
Cest 066
Cest 067
Cest 077
Cest 083
Cest 104
Cest 127
The example paper is exactly how the paper needs to read so really you would need to just copy and paste most of it and plug in my variables and maybe change some words around so that it will fit my data set.
when it comes to interpreting the data for the finding section my professor has a specific way which she wants it to be written. I will give you some homework examples that we have done to give you an idea for the univariate and bivariate analysis but for the Mutlvariates you have to go off the final paper example because i do not have HW examples for them.
Data Management:
For the Data management just simply give a detailed summary of what methods/steps i used. Use Appendix A for your reference. To make it easy for you i made a table of contents
page 6: Ran Frequencies
Page 23: Computations
page 30: Factor Analysis
Page 44: Reliability Analysis
Page 53: Computation
Try to word it like it is for the example paper
Data Analysis:
For Data Analysis use Appendix B info I highlighted or colored the different tables so you could easily find them.
Lastly, I have attached Cathy's Data set for you in case you wanted to go in replicate my steps so you could get a better understanding of the data
Discussion section is the conclusion
Final ProjectComment by Davis-Ganao, Jessica S: Better title needed
Institution
Dr. Ganao
Introduction
The reason for this study is to understand counselor relationships based on key elements. The study seeks to find how well a counselor rapport hel ...
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Compare and contrast conflict visions in healthcare
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CHAPTER1097THE DEMAND FOR HEALTHCARE PRODUCTSLearnin
CHAPTER
109
7THE DEMAND FOR HEALTHCARE PRODUCTS
Learning Objectives
After reading this chapter, students will be able to
• calculate sales and revenue using simple models,
• discuss the importance of demand in management decision making,
• articulate why consumer demand is an important topic in healthcare,
• apply demand theory to anticipate the effects of a policy change,
• use standard terminology to describe the demand for healthcare
products, and
• discuss the factors that influence demand.
Key Concepts
• The demand for healthcare products is complex.
• When a product’s price rises, the quantity demanded usually falls.
• The amount a consumer pays directly is called the out-of-pocket price
of that good or service.
• Because of insurance, the total price and the out-of-pocket price can
differ markedly.
• Multiple factors can shift demand: changes in consumer income,
insurance coverage, health status, prices of other goods and services,
and tastes.
• Demand forecasts are essential to management.
7.1 Introduction
Demand is one of the central ideas of economics. It underpins many of the
contributions of economics to public and private decision making. Analyses
of demand tell us that human wants are seldom absolute. More often they
demand
The amounts of a
product that will
be purchased at
different prices
when all other
factors are held
constant.
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EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 6/1/2022 6:17 PM via UNIVERSITY OF MARYLAND GLOBAL
CAMPUS
AN: 2144510 ; Robert Lee.; Economics for Healthcare Managers, Fourth Edition
Account: s4264928
E c o n o m i c s f o r H e a l t h c a r e M a n a g e r s110
are conditioned by questions: “Is it really worth it?” “Is its value greater than
its cost?” These questions are central to understanding healthcare economics.
Demand forecasts are essential to management. Most managerial deci-
sions are based on revenue projections. Revenue projections in turn depend
on estimates of sales volume, given prices that managers set. A volume esti-
mate is an application of demand theory. Understanding the relationship
between price and quantity must be part of every manager’s tool kit. On
an even more fundamental level, demand forecasts help managers decide
whether to produce a certain product at all and how much to charge. For
example, if you conclude that the direct costs of providing therapeutic mas-
sage are $48 and that you will need to charge at least $75 to have an attrac-
tive profit margin, will you have enough customers to make this service a
sensible addition to your product line? Demand analyses are desig ...
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- 1. Value Driven Healthcare Description Part 1.Search for a new primary care physician where you live. Describe in depth how you made your physician choice. What impact did price have on your decision making? What were the key factors that factored in your decision making? Summarize your decision making process. Part 2. Search for pricing for an MRI for a 13 year old female patient complaining of headaches. Determine the cost of this procedure to you, and what the cost is to the insurance provider. Do a price comparison against three other facilities offering the same service. Provide a chart that summarizes the price differences. Reflect on your experience and summarize the following: 1. How long did this take? How comfortable would you be if you actually had to purchase these services in determining the value for services? Ie. How do you know what you received was worth the money you paid? Comment on your experiences in finding the information and the relationship to price transparency. Your paper should include the following: 10-12 pages in length, not including the title and reference pages. 10 references cited in the assignment. Remember, you must support your thinking/opinions and prior knowledge with references; all facts must be supported; in-text references used throughout the assignment must be included in an APA- formatted reference list. –( References should be current not more than 5 years old.)#Driven #Healthcare