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Reflection Paper

Making Managed Care Work – A Case Study

1-2 pages

Reflection Questions:

Question

Points

Grade

Briefly describe the organization, setting, situation, who is involved, who decides what, etc.

Why was it important to find out what the gaps in services?

What is the main theme of the article?

The organization was successful because they took steps to be prepare, what might have happened if they did not take steps prepare and understand the needs?

As an administrator, is there anything you would have done differently?  Why or why not?

Assignment:

Complete ALL of the bullet points below:

Compare and contrast each of the three questions related to Managed Care Organizations, Medicare, and Medicaid with one another and explain how they were similar and different to each other.

• Managed care organizations emphasize physicians’ responsibilities      to control patient access to expensive hospitalization and specialty care,      a principle dubbed “gatekeeping.” Some argue that      “gatekeeping” is unethical because it introduces financial      factors into treatment decisions. Others say it improves quality by      promoting the use of the most appropriate levels of care.
• Medicare is an area that often gets overlooked and is      seen as a burden financially. Discuss alternatives to ease the drain on      Medicare resources.
• Medicaid is shouldering an ever-increasing burden of      cost for long-term care for the elderly, with enormous impacts on state      budgets throughout the nation. Discuss alternatives to ease this drain on      Medicaid resources.

Please submit one APA formatted table, (minimum 750 words) that highlights the above content make sure to include a title and reference page. The assignment should have a minimum of two (2) scholarly sources, in addition to the textbook.

Based on the feedback offered by the provider, identify the best approach for teaching. Prepare a presentation based on the Teaching Work Plan and present the information to your community.

Options for Delivery

Select one of the following options for delivery and prepare the applicable presentation:

1. PowerPoint presentation – no more than 30 minutes
2. Pamphlet presentation – 1 to 2 pages  
3. Poster presentation

Community Setting (HOSPITAL)

General Requirements

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 guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

I need a response for this assignment  today

2 references

 I feel that narrative family therapy can be largely beneficial for families and couples as family narrative therapy takes on the perspective that different people organize and compartmentalize their life events through different stories of events that occurred (Miller & Madigan, 2011). Many people will discuss their reasoning for coming to therapy, or the main problem that has sent the to therapy, from their perspective, by telling stories or narratives of what occurred in their lives (Miller & Madigan, 2011). Their stories thus create a larger picture of differing life events through a series of different time frames, which have thus created their problem or current predicament from their point of view (Miller & Madigan, 2011). Therefore family narrative therapy links together all of these stories, ideas and thus problems allowing the therapist to see the larger perspective of the family as an entire unit, and the involved limitations of their point of views (Miller & Madigan, 2011). 

Due to the fact that this patient is very resistive to therapy, as well as uncooperative in coming to therapy. It may be beneficial for him to attend groups with other men in order to realize that he is not alone in his situation. Another helpful form of therapy that may allow him to become more proactive could be motivational interviewing (Wheeler, 2014). Motivational interviewing therapy may aid in open communication that can allow the patient to speak out as to what reasons he may not be attending therapy (Wheeler, 2014). By asking open ended questions that are not accusatory, this can allow the patient to express concerns, problems while helping the therapist to receive an understanding of what can remotivate the patient to become more proactive (Wheeler, 2014). It is also vital in motivational interviewing that the therapist practice evocation, where the patient feels accepted and that they have help in pulling out all the qualities within them in order to be successful (Wheeler, 2014). These strategies can help the patient to become more proactive and cooperative with therapy, as well as aid the therapist in understanding why the patient has not been participating In doing so, the therapist can aid this family unit in getting back on track.

References:

Miller, A., & Madigan, S. (2011). Madigan on Narrative Family Therapy. Instructor’s Manual for Narrative Family Therapy. https://www.psychotherapy.net/data/uploads/5113d78866002.pdf.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-base

DNT 200 — NUTRITION FOR HEALTH SCIENCE 

STUDY GUIDE 7: VITAMINS 

Directions. Using Chapters 10 and 11, and the DRI tables (pp. A, B) of your textbook as a reference, answer the following questions. Please include the questions with your answers. Be sure to put your name on your document. Your answers should be thoughtful, complete, and in Standard English. Credit will not be given for answers copied from online sources. 

Research  the health-illness continuum and its relevance to patient care. In a  750-1,000 word paper, discuss the relevance of the continuum to patient  care and present a perspective of your current state of health in  relation to the wellness spectrum. Include the following:

1. Examine  the health-illness continuum and discuss why this perspective is  important to consider in relation to health and the human experience  when caring for patients.
2. Explain  how understanding the health-illness continuum enables you, as a health  care provider, to better promote the value and dignity of individuals  or groups and to serve others in ways that promote human flourishing.
3. Reflect  on your overall state of health. Discuss what behaviors support or  detract from your health and well-being. Explain where you currently  fall on the health-illness continuum.
4. Discuss  the options and resources available to you to help you move toward  wellness on the health-illness spectrum. Describe how these would assist  in moving you toward wellness (managing a chronic disease, recovering  from an illness, self-actualization, etc.).

Prepare  this assignment according to the guidelines found in the APA Style  Guide, located in the Student Success Center. An abstract is not  required.

This  assignment uses a rubric. Please review the rubric prior to beginning  the assignment to become familiar with the expectations for successful  completion. 

Please refer below for Instructions

The purpose of this assignment is to give you an idea of how challenging it is when health care is a scarce resource. There will never be enough money for everyone to have every health care service they may need or want. Who makes these decisions? Perhaps a government agency, perhaps an insurance company. It is easy to blame a nameless, faceless business for denying care. But what if it was you? What if you worked in that field and the burden to allocate too few resources to too many needy patients sat on your shoulders? Might you have a completely different perspective? How do payors determine what to cover? The answer is simple and complex at the same time. Payers generally do not cover anything experimental. They have clear policies for what specific plans cover. They often require preauthorization to ensure that the test/procedure is truly necessary and that it is supported by best practice showing improved quality outcomes.

In this case you are not working for an insurance company. You are a senior executive in a hospital. The hospital sets aside charity care monies each year to assist needy patients. There are always more needy patients than there are funds. When the funds are gone, they are gone. This year, you are tasked with distribution of the money.

None of the patients have insurance or any significant funds. You have 1 million dollars. It cannot be used for more than one patient.

The patients are as follows:

1.  Patient A is a 70 y/o retired business executive who needs a $500,000 heart transplant and $500,000 in post care surgery (i.e. medications, rehab, follow- ups, etc.)

2.  Patient B is a toddler with cerebral palsy (affect a person’s ability to move and maintain balance and posture) who needs $500,000 for ongoing care. With expert care the expected lifespan is teenage.

3.  Patient C is a 32 year old mother of 2 who needs a $750,000 bone marrow transplant and $500,000 in post care surgery (i.e. medications, rehab, follow- ups, etc.).

4.  Patient D is a 38 y/o athlete who needs a hepatitis C drug that costs $30,000/ month. The patient could live a normal life span as long as the drug is provided.

5.  Patient E is a micro-premature baby who is costing $10,000 day with a 20% chance of survival. The hospital stay is expected to be 12 months minimum, not including any needed surgical procedures, and not including likely life-long health care needs if he survives.

Determine the distribution of health care funds

Include the following aspects in the assignment:

Ø  Which patient should receive the funding and why?

Ø  If the funds were available to be shared among the patients, would you have chosen differently?

Ø  How did you feel having to make a choice?

Ø  Discuss if this exercise has changed your view of the challenges behind paying for health care

Read chapters 16 and 17 of the class textbook and review the PowerPoint presentations located in the PowerPoint folder. Once done answer the following questions.

1. Identify and discuss the incidence and prevalence of intimate partner violence (IVP).

2. Explains the effects of IPV in adults and children.

3. How do you think the values of different skate-holders such as the alcohol industry, local communities, local law enforcement, public health organizations, nurse researchers, nurse clinician in alcohol treatment facilities, and college students would affect the identification of “social harms” associated with alcohol abuse and misuse?

4. Do you think the general public’s perception of the social harms associated with alcohol, tobacco, ad cannabis has changed? Why?

APA style (intext and citations)

Plagiarism FREE

 A minimum of 3 evidence-based references no older than 5 years must be used.   

Review American Institute for Healthcare management – Publications -Healthcare Economics. 

https://www.amihm.org/category/healthcare-economies/

Write a 250-300 words reflection on “Supply and Demand” from the website. What have you learned new? How can you use that for “your” business?  In this case, my business would be in-house detox. Detoxing individuals with issues with alcohol, opioids, etc.

Make sure all reference sources are within 5 years.

APA format.

Plagiarism receipt requires

Please do not have it Turnitin