number one : Reducing the Price of Health Care
The focus in health care reform is cost control in light of annual double-digit inflation since the late 1990s and the consumption of nearly 17% of the gross domestic product (GDP) in 2009 (more than any other country in the world). The debate is over how to reduce the rate of spending for health care while preserving quality and access to care for patients. Research at least 2 methods of reducing the percentage of the GDP spent on health care. You will need to be able to describe how you would do this in specific terms. This can be a number of approaches, such as the following:
- Completely dismantle the current system and start over-A monumental task
- Revise the current payment system to reflect current economic constraints
- Cut Medicare and Medicaid
- Insurance reform
- National health insurance based on the Massachusetts Model
- Malpractice reform
- Legislation such as the Balanced Budget Act of 1997, the Medicare Modernization Act of 2003, the Affordable Care Act (2010), and others
Provide the following elements in your paper:
- Describe the model you are supporting to best control costs without compromising the quality and access to health care, and explain how the model works.
- Analyze the method that you are supporting, detailing the strengths and weaknesses from all stakeholder group (e.g., patient, provider, and third-party payer) perspectives.
- Provide an example of the model in real time or as a scenario.
- Summarize the anticipated results in terms of costs and benefits.
For assistance with your assignment, please use your text, Web resources, and all course materials.
number two : Quandaries in Health Care
Declining Trust in the Health Care System (The Trust Crisis)
Health reform is mired in the morass of multitiered payment systems and multiple modes of access, limited by the ability to seek and to pay. Increasingly, patients are interacting with multiple entities within the system, causing more and more confusion on the part of the patient. According to recent research, patients' trust in the system, providers, and insurers continues to decline. This may result in a decline in individual health and an increase in costs for health care.
Investigate the declining trust in the health care system from an ethical and moral position. You may use the four principles plus attention to scope model of Beauchamp and Childress or any other ethical model that you choose to address this.
Complete the following:
- State what model you will use to investigate this issue.
- Identify 2 or more legal issues contributing to this problem.
- Identify 2 or more economic and financial issues contributing to this problem.
- Analyze the impact of various issues that are contributing to this problem, and rank them in order from greatest to least impact.
- Propose at least 1 modification that would increase trust in the health care system with rationale.
For assistance with your assignment, please use your text, Web resources, and all course materials.
number three : Analyzing Health Care Decision Making
A number of quantitative methods are utilized to make decisions and recommendations in health care. Quantitative methods are used to analyze and predict the demand for patient services, to determine capital expenditures for facility and technology enhancements, and to guide the manager in implementing quality controls. Whether or not you are familiar with quantitative methodologies, as a manager, you are responsible for the outcomes of implementing the decision based on the method used.
Your agency or institution has noted a negative trend in profitability for a diagnostic imaging cost center over the past 4 quarters.
As a manager, you need to make some recommendations to take to your board of directors to reverse the negative trend. Your first priority is to find a quantitative method to help you in making decisions. Complete the following:
- Choose a quantitative method (e.g., the decision tree model).
- Describe the model that you are using.
- Outline at least 4 proposed solutions to your board of directors, and analyze the strengths and weaknesses of each with regard to return on investment, break-even analysis, improvement in patient demand, improved patient safety and quality, and so forth.
- Summarize how the decision-making method helped you make objective recommendations to your board of directors.
For assistance with your assignment, please use your text, Web resources, and all course materials.
number four : Managed Care Organizations and Information Technology
The most important function of information technology (IT) for the managed care organization (MCO) is to support the business of the MCO. How the IT department aligns with the operational dynamics of the MCO is a vital management consideration. A well-functioning IT department will help the MCO reduce risk (e.g., costs). The IT department should design, implement, and operate the systems that run the MCO. Efficiency is the hallmark of a good system.
Your task as the manager of the MCO is to determine what the IT department in your organization should consist of, what its function will be, and what critical elements will be turned over to the IT department. Complete the following:
- Describe the key elements of an information system for an MCO. What elements are different than for a physician office or group?
- Describe the technology that you think the MCO would need to operate fully.
- Propose a specific electronic health record (EHR) or electronic medical record (EMR) program that is Health Insurance Portability and Accountability Act (HIPAA) compliant. Describe the essential functions, costs, and projected savings for the MCO.
- Evaluate the strengths and weaknesses of insourcing versus outsourcing your IT needs, and make a final recommendation based on that evaluation.