Assignment: Regulatory Government Agencies
Assignment: Regulatory Government Agencies
Topic 5 DQ 1
The Healthcare system is in dire need of restructuring in its payment systems. Healthcare services that provide optimal benefits to patients encounter significant shortages. Today, the healthcare system lacks a sophisticated system that integrates Medicaid and Medicare. This is due to a lack of proper planning, which has resulted in inefficiency in healthcare. As such, future healthcare leaders must address various issues. One of the issues is the adoption of innovative payment. The diverse patient needs and the fact that the baby boomer generation is facing retirement are likely to increase the spending on Medicare & Medicaid by all levels of government. The increased spending is likely to affect the whole healthcare system. As such, there is a need to ensure Medicare payments are based on value (Pittman et al., 2021). Future healthcare leaders should consider fee-for-service and value-based payments. Future healthcare leaders should also be ready to take financial accountability for the quality of care and the cost of the whole care process of an individual patient or the population.
Adherence to MCO standards can play a vital role in future healthcare. The MCO regulatory orders are likely to play a crucial role in enabling healthcare organizations to deliver quality, safe, and affordable care (Vickery et al., 2020). The MCO regulatory statutes require healthcare settings to provide safe and quality care and also ensure that cost of healthcare is affordable. MCO standards will play a crucial of removing wasteful utilization of healthcare costs and deter preventable harm, leading to a controlled cost of healthcare. The ACA and CMS laws also require MCOs to adopt detailed plans and programs to enhance billing processes to discover and prevent any fraud, abuse, or waste in healthcare. This trend is likely to ensure efficiency in the future healthcare system.
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Pittman, P., Rambur, B., Birch, S., Chan, G. K., Cooke, C., Cummins, M., … & Trautman, D. (2021). Value-Based Payment: What Does It Mean for Nurses?. Nursing administration quarterly, 45(3), 179-186. https://doi.org/10.1097/NAQ.0000000000000482
Vickery, K. D., Shippee, N. D., Menk, J., Owen, R., Vock, D. M., Bodurtha, P., … & Linzer, M. (2020). Integrated, accountable care for Medicaid expansion enrollees: A comparative evaluation of Hennepin Health. Medical Care Research and Review, 77(1), 46-59. https://journals.sagepub.com/doi/full/10.1177/1077558718769481
Help me study for my Nursing class. I’m stuck and don’t understand.
PART A- Discussion Questions due by Wednesday
DQ 1 – WATCH VIDEO Plus add x1 reference
Health care organizations continually face challenges from various regulatory and government agencies while also being bound by Managed Care Organization (MCO) standards. View the video located in the study materials entitled “College of Nursing and Health Care Professions: Do We Know What Our Future Is?” for insight into the challenges of health care reform. Based on the video, describe two key reform factors that you believe will need to be addressed by future health care workers or leaders and explain why. (Note: You can download slides from this video for ease of review in developing your forum response). Additionally, what role does adherence to MCO standards play in your future health care vision? (250 words response plus x1 peer reviewed source to support response )
Watch the video “College of Nursing and Health Care Professionals: Do We Know What Our Future Is?”
DQ2- Research with x2 sources- peer reviewed articles
The Affordable Care Act (ACA) identifies requirements related to provider compliance with fraud, waste, and abuse laws that have been enacted to protect consumers. (250 words response) Research three of these requirements and describe the corresponding measures that your health care organization has initiated, or could initiate, to comply with the ACA. Support your analysis with a minimum of two peer-reviewed articles.
PART B -Assignments Due by Fr
Assignment #1 – Paper
Title: Reflective Analysis- Risk Management & The Role of Managed Care
The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 250‐500-word response that addresses the following:
1.What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
2.What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
3.What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?
Required sources from: textbook (Read Chapters 18, 19, and 26 in Legal and Ethical Essentials of Health Care Administration.And you are required to support your analysis with a minimum of two peer‐reviewed references.
Prepare this assignment according to the guidelines found in the APA Style. An abstract is not required.
This assignment uses a rubric (see attached doc titled Assignment Paper Rubrics). Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Assignment #2 – PowerPoint presentation
The purpose of this assignment is to create an educational risk management presentation.
SEE ATTACHED DOCUMENT WITH PART 1 OUTLINE AND INSTRUCTOR FEEDBACK AT THE BOTTOM OF THAT OUTLINE COLORED IN BLUE.
USE POWERPOINT TEMPLATE SENT AS SEPARATE ATTACHMENT
Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.
Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide. However, you may include supplementary images, graphs, and data where relevant.
To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:
You are required to support your statements with a minimum of six citations from appropriate credible sources.(same as outline in part 1)
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting
This assignment uses a rubric (see attached doc titled-“PowerPoint Rubic”) for Rubics. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Assignment: Regulatory Government Agencies
Assignment: Regulatory Government Agencies
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
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