How do policymakers evaluate which health care services should be financed through government programs?

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With coinciding concerns about health care costs and the imperative to improve quality of care, health care providers and others face difficult decisions in the effort to achieve an appropriate balance. Such decisions often are addressed in the policy arena. How do policymakers evaluate which health care services should be financed through government programs? How do ethics-related questions and other considerations play into this evaluation process? Is it possible to contain costs and provide accessible, high-quality care to all, or is the tension between cost and care inherent in the U.S. health care delivery system? These questions are central to health care financing decisions in the United States.

For this Discussion, you will focus on the policy decision-making process that determines what types of care are covered by public and private insurers and the ethical aspects of such financial decisions.

To prepare:

  • Read the following case study, “Hard Economic and Finance Choices in US Healthcare” (Milstead):
    • Case Study 1: Hard Economic and Finance Choices in US Healthcare
      Applied economics is all about managing scarce resources. Economics is an amoral field of study: it is neither moral nor immoral. Morality and values are determined by individuals at the personal level and by group consensus or majority opinion at the national level. State and federal governments determine the ‘will of the people’ about how to use scarce resources for the good of a nation.

      The U.S. health care system is an exemplar of scarcity: primary care physicians, substance abuse treatment centers, trauma centers, registered nurses, and the money to pay for goods and services. Finance is all about how to pay for goods and services. The Medicare Payment Advisory Commission (MedPAC) is appointed by the Executive branch of the federal government to make decisions about what the Medicare program will and will not pay for. In this role, MedPAC makes decisions about medications, procedures and treatments. Examples of MedPAC decisions include coverage for left ventricular assistive devices as a destination therapy, coverage for bariatric surgery, and in 2010, coverage of the drug Provenge™. By law, MedPAC is not allowed to use price or cost of any treatment in its decision-making processes.

  • Review the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” in the Learning Resources.
  • Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process.
  • Reflect on how the Washington Post example illustrates the tension between cost and care. References:
    National Health Expenditures 2010 Highlights, Centers for Medicare & Medicaid Services (n.d.). Retrieved from https://www.cms.gov/NationalHealthExpendData/downloads/highlights.pdf. Milstead, J. A. (2013). Health policy and politics: A nurse’s guide (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers. Write your analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate your response with at least two outside resources. Use the following headings to answer the question:
    Healthcare Financing Analysis and Assessment of Ethical and Economic Challenges Presented in Washington Post How This Situations Affects Cost and Care

Competiveness and Performance Effectiveness for Health Care IT Systems

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Question description

Analysis Paper

Competiveness and Performance Effectiveness for Health Care IT Systems (Part I)

100 points

Write a six to eight (6-8) page paper in which you: address the following criteria:

  1. Define the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Make one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Support your response with related examples of such expertise in use.
  2. Suggest two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Provide a rationale to support your response.
  3. Determine two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Provide a rationale to support your response.
  • Suggest one (1) strategy for health care organizations to train providers in using technology in health care. Provide a rationale to support your response.
  • Use at least three (3) quality academic resources in this assignment. Note: Wikipedia and similar type Websites do not qualify as academic resources.
  1. Provide three (3) best practices for effective IT alignment and strategic planning initiatives. Justify your response.

Your assignment must follow these formatting guidelines:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; references must follow APA format.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

The specific course learning outcomes associated with this assignment are:

  • Apply strategic planning and management concepts and principles to health information and quality management activities;
  • Apply the principles of ethical decision-making for health information managers and quality managers;
  • Explain when and how principles of healthcare privacy and confidentiality guide health information managers’ actions;
  • Demonstrate principles of health care management, informatics and quality management via a business plan proposal for a new or existing health information product, quality improvement activity or service;
  • Assess the quality of healthcare outcomes and services utilizing quality management tools and survey assessments;
  • Describe the problems of maintaining security of health information systems, and list various techniques of maintaining administrative, financial and technical security of health records and information;
  • Use technology and information resources to research issues in health information systems.
  • Write clearly and concisely about health information systems using proper writing mechanics.

 

Grading for this assignment will be based on answer quality, logic / organization of the paper, and language and writing skills, using the following rubric.

Points: 100 Analysis Paper: Competiveness and Performance Effectiveness for Health Care IT Systems
Criteria Unacceptable

Below 60{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} F

 Meets Minimum Expectations

60-69{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} D

 Fair

70-79{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} C

 Proficient

80-89{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} B

 Exemplary

90-100{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} A
1. Define the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Make one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Support your response with related examples of such expertise in use.

Weight: 20{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Did not submit or incompletely defined the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Did not submit or incompletely made one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Did not submit or incompletely supported your response with related examples of such expertise in use. Insufficiently defined the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Insufficiently made one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Insufficiently supported your response with related examples of such expertise in use. Partially defined the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Partially made one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Partially supported your response with related examples of such expertise in use. Satisfactorily defined the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Satisfactorily made one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Satisfactorily supported your response with related examples of such expertise in use. Thoroughly defined the fundamental responsibilities and key characteristics of the Chief Information Officer (CIO) and Chief Technology Officer (CTO) within health care organizations. Thoroughly made one (1) recommendation where they can utilize their expertise to assist with employee and patient satisfaction. Thoroughly supported your response with related examples of such expertise in use.
2. Suggest two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Provide a rationale to support your response.

Weight: 15{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Did not submit or incompletely suggested two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Did not submit or incompletely provided a rationale to support your response. Insufficiently suggested two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Insufficiently provided a rationale to support your response. Partially suggested two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Partially provided a rationale to support your response. Satisfactorily suggested two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Satisfactorily provided a rationale to support your response. Thoroughly suggested two (2) developing technologies that health care systems should use in order to improve health care processes and thus increase the quality and lower the cost of health services. Thoroughly provided a rationale to support your response.
3. Determine two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Provide a rationale to support your response.

Weight: 15{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Did not submit or incompletely determined two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Did not submit or incompletely provided a rationale to support your response. Insufficiently determined two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Insufficiently provided a rationale to support your response. Partially determined two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Partially provided a rationale to support your response. Satisfactorily determined two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Satisfactorily provided a rationale to support your response. Thoroughly determined two (2) significant methods that health care systems should use in order to prevent misuse of information and protect data privacy and thus achieve a high level of security of health information. Thoroughly provided a rationale to support your response.
4. Suggest one (1) strategy for health care organizations to train providers in using technology in health care. Provide a rationale to support your response.

Weight: 15{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Did not submit or incompletely suggested one (1) strategy for health care organizations to train providers in using technology in health care. Did not submit or incompletely provided a rationale to support your response. Insufficiently suggested one (1) strategy for health care organizations to train providers in using technology in health care. Insufficiently provided a rationale to support your response. Partially suggested one (1) strategy for health care organizations to train providers in using technology in health care. Partially provided a rationale to support your response. Satisfactorily suggested one (1) strategy for health care organizations to train providers in using technology in health care. Satisfactorily provided a rationale to support your response. Thoroughly suggested one (1) strategy for health care organizations to train providers in using technology in health care. Thoroughly provided a rationale to support your response.
5. Provide three (3) best practices for effective IT alignment and strategic planning initiatives. Justify your response. Weight: 10{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} Did not submit or incompletely provided three (3) best practices for effective IT alignment and strategic planning initiatives. Did not submit or incompletely justified your response. Insufficiently provided three (3) best practices for effective IT alignment and strategic planning initiatives. Insufficiently justified your response. Partially provided three (3) best practices for effective IT alignment and strategic planning initiatives. Partially justified your response. Satisfactorily provided three (3) best practices for effective IT alignment and strategic planning initiatives. Satisfactorily justified your response. Thoroughly provided three (3) best practices for effective IT alignment and strategic planning initiatives. Thoroughly justified your response.
6. References

Weight: 5{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 No references provided Does not meet the required number of references, and / or references are of poor quality. Meets the required number of references; some or all references poor quality choices. Meets number of required references; all references high quality choices. Exceeds number of required references; all references high quality choices.
7. Writing Mechanics, Grammar, and Formatting

Weight: 5{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Serious and persistent errors in grammar, spelling, punctuation, or formatting. Numerous errors in grammar, spelling, and punctuation. Partially free of errors in grammar, spelling, punctuation, or formatting. Mostly free of errors in grammar, spelling, punctuation, or formatting. Error free or almost error free grammar, spelling, punctuation, or formatting.
8. Appropriate use of APA in-text citations and reference section

Weight: 5{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Lack of in-text citations and / or lack of reference section. In-text citations and references are given, but not in APA format. In-text citations and references are provided, but they are only partially formatted correctly in APA style. Most in-text citations and references are provided, and they are generally formatted correctly in APA style. In-text citations and references are error free or almost error free and consistently formatted correctly in APA style.
9. Information Literacy / Integration of Sources

Weight: 5{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Serious errors in the integration of sources, such as intentional or accidental plagiarism, or failure to use in-text citations. Sources are rarely integrated using effective techniques of quoting, paraphrasing, and summarizing. Sources are partially integrated using effective techniques of quoting, paraphrasing, and summarizing. Sources are mostly integrated using effective techniques of quoting, paraphrasing, and summarizing. Sources are consistently integrated using effective techniques of quoting, paraphrasing, and summarizing.
10. Clarity and Coherence of Writing

Weight: 5{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

 Information is confusing to the reader and fails to include reasons and evidence that logically support ideas. Information is somewhat confusing with not enough reasons and evidence that logically support ideas. Information is partially clear with minimal reasons and evidence that logically support ideas. Information is mostly clear and generally supported with reasons and evidence that logically support ideas. Information is provided in a clear, coherent, and consistent manner with reasons and evidence that logically support ideas.

Consider the support capabilities of a typical health care operation and where employees may access data of various types related to patient needs. What might be accessed, and what controls may be needed to protect patient data?

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Question description

You have been asked by your health care organization to provide a detailed report on the benefits of implementing a new health information technology system to comply with the current mandates. Develop a report of 10–12 pages detailing how information technology systems can be used to analyze organizational data for a health care organization. This should include types of systems where data may be retrieved and how IT and various applications can be used to aggregate and analyze the data to understand issues, identify root causes, and document progress related to implemented changes, patient progress, quality assurance, and compliance. Make sure to address the following questions:

  • With plenty of data stored on computer systems, data should not be a problem, but access to the data and sharing of information may have implications under federal regulations. What precautions might you suggest when handling health care data? Be sure to apply current trends in health care from proven sources and models.
  • Consider the support capabilities of a typical health care operation and where employees may access data of various types related to patient needs. What might be accessed, and what controls may be needed to protect patient data?
  • From a departmental perspective, consider the role of the health information manager (HIM). What qualifications and experience would be needed for your specific health care setting? What functions and role would the HIM have in regard to this organization’s medical records?
  • As technology advances, what compliance issues and regulations do health care managers at this organization need to be on top of? Consider the impact of falling behind the technology curve not only in terms of productivity but regulatory compliance. What role do the Affordable Care and Patient Protection Acts have on the implementation and use of technology and electronic health records (EHRs) at this setting?
  • paper must be 11 pages

Discuss the ethical and legal issues that may be found in the health care organization

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Question description

  • Identify the market sector your organization falls into (mass market or niche services). How does the population health approach to health care rather than the curative approach affect service delivery and management in your organization?
  • Assess common health care leadership issues (e.g., organizational climate, teamwork, coaching, and so on) and their impact on stakeholders.
  • Discuss the ethical and legal issues that may be found in the health care organization of your choice.
  • Provide at least 3 suggestions to minimize negative outcomes and maximize the positive outcomes of leadership intervention in areas such as staffing, financing, competition, regulations, and public image.
    • Identify the market sector your organization falls into (mass market or niche services). How does the population health approach to health care rather than the curative approach affect service delivery and management in your organization?
    • Assess common health care leadership issues (e.g., organizational climate, teamwork, coaching, and so on) and their impact on stakeholders.
    • Discuss the ethical and legal issues that may be found in the health care organization of your choice.
    • Provide at least 3 suggestions to minimize negative outcomes and maximize the positive outcomes of leadership intervention in areas such as staffing, financing, competition, regulations, and public image.