Walden MMHA6050 All Modules Discussions Latest 2019 November

MMHA6050 Topics in U.S. Health Delivery

Module 1 Discussion

Historical Developments in Health Care Delivery

Post your responses to the Discussion based on the course requirements. Your Discussion postings should be written in standard edited English. Initial postings must be 250–350 words.

Every American presidential administration following the end of World War II has, to some extent, proposed or supported changes to the healthcare system in this country… We have not yet arrived at the destination of a more accessible, cost efficient and high quality health care system, but that destination is surely worth the difficult journey.

—Jerry Taylor, JD, 2014

The U.S. health care delivery system is often described as a kaleidoscope, puzzle, or patchwork quilt to emphasize that health care delivery in this country involves multiple, loosely coordinated components, and does not function through one integrated system (Shi & Singh, 2019). The organization of this “system” has a significant impact on the delivery of services. As a health care administrator, it is important to understand how the health care industry has been shaped over time and the various factors that influence health care delivery today.

To prepare for this Discussion, select one legislative act from the list below:

1937 Social Security Act

1946 Hill-Burton Act

1965 Social Security Amendments (Medicare/Medicaid)

1973 Health Maintenance Act (Managed Care)

1983 Introduction of Diagnostic Related Groups (DRGs) by Medicare

1986 Emergency Medical Treatment and Active Labor Act (EMTALA)

1986 Consolidated Omnibus Budget Reconciliation Act (COBRA)

1996 Balanced Budget Amendment

1996 Health Insurance Portability and Accountability Act (HIPAA)

2006 Medicare Part D Drug Benefit

2006 Massachusetts (Chapter 58) and Vermont (No. 191) legislation to expand health coverage for state residents

2010 Patient Protection and Affordable Care Act (PPACA)

Review the information about your selected legislation in this module’s Learning Resources, including the chapters of the Shi and Singh text (2015). Conduct additional research using resources available in the Walden Library and on credible websites. As you research each legislative act, identify historical events or circumstances that brought about the need for that legislation, and examine the positive and/or negative consequences that followed the implementation of each act.

Post by Day 3 of Module  1 a substantive and cohesive response to the following:

Analyze the historical events or circumstances that created a need for the legislative act you have selected.

Describe the legislative act and analyze how it has influenced the U.S. health care system.

Evaluate positive and/or negative consequences that arose following implementation of the act you have chosen.

Support your posting and subsequent responses to your colleagues’ postings by identifying and explaining key points and/or examples presented in the Learning Resources and other credible sources.

Read a selection of your colleagues’ postings.

Respond by Day 5 of Module  1 to at least two of your colleagues’ postings, selecting those that address at least one act that you did not focus on in your posting. Analyze and compare the historical events and consequences you and your colleague describe, explaining how this enhances your understanding of the historical background of health care delivery and/or posing questions for further investigation. If you are an international student, you may share historical events that have influenced health care delivery in your country.

Continue this Discussion until the end of the module, Day 7 of Module  1.

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MMHA6050 Topics in U.S. Health Delivery

Module 2 Discussion

DQ1 Discussion 1: Case Study Analyses

Post your responses to the Discussion based on the course requirements. Your Discussion postings should be written in standard edited English. Initial postings must be 250–350 words.

A person’s health may be greatly impacted by his or her access to timely, appropriate care. Yet, in the United States, there are marked differences in the quality of services that are available and in each individual’s use of those services. The cost of health care, for instance, can influence a person’s decision to visit the doctor or fill a prescription. What other factors impact health care-related decisions? In this Discussion, you will examine two case studies that illustrate dilemmas related to cost, quality, and access to health care, and consider the potential influence these dilemmas can have on a person’s health, financial standing, and quality of life.

Read the Module 2 Discussion 1 Case Studies, found in this module’s Learning Resources. Review the information presented in the Learning Resources, including Chapter 12 in the Shi and Singh (2019) textbook and the websites and articles. Analyze the circumstances presented in the two case studies, and consider the following questions:

Which barriers in the U.S. health care delivery system related to cost, quality, and/or access are evident in each scenario?

How does the use of health insurance influence concerns or decisions related to cost, quality, and/or access to health care for each person?

What are the possible health care outcomes in each scenario?

Post by Day 3 of Week 2 a substantive and cohesive response to the following:

Analyze at least two barriers in the U.S. health care delivery system related to cost, quality, and/or access that are evident in each person’s scenario.

Analyze how health insurance may influence concerns or decisions related to cost, quality, and/or access to health care for each person.

Explain potential health care outcomes for each scenario.

Reminder: Use and identify sources to support your posting and responses.

Read a selection of your colleagues’ postings.

Respond by Day 5 of Week 2 to at least two of your colleagues’ postings, analyzing how you think the patient’s situation and the specified barrier would be impacted if prevention were a higher priority in the United States. If you are an international student, you may share examples from your own country that relate to the topics addressed in this Discussion.

Continue engaging in the Discussion through Day 7 of Week 2, evaluating potential solutions to the barriers you and your colleagues have identified.

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DQ2 Discussion 2: Cost, Quality, and Access Challenges in Health Care Delivery

Post your responses to the Discussion based on the course requirements. Your Discussion postings should be written in standard edited English. Initial postings must be 250–350 words.

In Discussion 1, you analyzed case studies that demonstrate the different experiences patients may have related to cost, quality, and access to health services. As a health care administrator, you must be prepared to address these issues at the team, department, and/or organizational level. How will you support your organization to contain costs, while providing appropriate access to care that meets quality standards?

Consider the following example:

According to a 2013 article in Kaiser Health News, Gallup Indian Medical Center in New Mexico, a busy federal government hospital on the border of the Navajo Reservation that sees a complex population of patients, learned it would be paid 1.14 percent less for each Medicare patient as a penalty for poor quality scores. Those who gained financially from the Medicare reimbursement policy change included large teaching hospitals and specialty hospitals. For instance, a physician-owned hospital focused on cardiovascular care in Arkansas received one of the largest bonuses (Rau, 2014).

This example highlights some of the complexities surrounding cost, quality, and access that health care administrators frequently encounter. Review the health care challenges related to cost, quality, and access discussed in the Learning Resources. In addition, think about similar examples you have noticed in current news or in the literature.

Identify a specific example related to health care, economics, policy, or other pertinent topics that is presented in the Learning Resources or another credible source. If you are an international student, you may select an example from your own country. You will use this example as the focus of your initial posting for this Discussion.

To prepare for this Discussion, analyze your selected example and consider how it illustrates concerns related to cost, quality, and/or access. Also consider potential implications of this issue for the management and leadership of health services organizations.

Post by Day 3 of Week 3 a substantive and cohesive response to the following:

Provide a description of the example you selected.

Analyze how this example illustrates concerns related to cost, quality, and/or access to health care.

Evaluate one or more potential implications of the issue(s) described in your example for the management and leadership of health services organizations.

Reminder: Use clearly identified sources to support your posting and responses.

Read a selection of your colleagues’ postings.

Respond by Day 5 of Week 3 to at least two of your colleagues’ postings, addressing the example he or she identified by offering a differing viewpoint, deepening the analysis, and/or making a connection to a related issue. Compare the key players/institutions that are involved in addressing this issue at the organizational, local, state, and/or national level.

Continue engaging in the Discussion until the end of the module, Day 7 of Week 3.

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MMHA6050 Topics in U.S. Health Delivery

Module 3 Discussion

The Patient’s Experience of Health Care Delivery

Post your responses to the Discussion based on the course requirements. Your Discussion postings should be written in standard edited English. Initial postings must be 250–350 words.

In an ideal health care delivery system, all patients would have access to affordable, high-quality health services that are well coordinated to ensure the continuity and comprehensiveness of care. In reality, patients may have vastly different experiences based on their health problem or injury, the organizations that provide services close to where they live, and how the health services they need are financed.

Consider, for example, a 56-year-old man who has a hemorrhagic stroke in a rural area of Alaska. What services will he need through the duration of his recovery experience? Where will he receive care? How will he pay for the services he needs? Now think about how his situation might compare to a 56-year-old man who had a stroke and lived in Houston, Texas. How might the two patients’ experiences compare in terms of care coordination and the continuity and comprehensiveness of services they receive?

This Discussion, which relates to your PowerPoint Assignment for this module, provides a forum for you and your colleagues to evaluate experiences patients may have with health care delivery.

For this Discussion, be prepared to describe one of the organizations/agencies you featured in your PowerPoint Assignment and discuss care coordination. As indicated in the Assignment instructions, if you are an international student, you may choose a geographic area in the United States or use your own location as the patient’s location. In addition, develop a brief description of your hypothetical patient (presented in the PowerPoint Assignment) that includes the patient’s primary diagnosis and location.

Note: You are encouraged to apply insights from your scholarly discussion with colleagues in this Discussion forum to strengthen the description and analysis in your PowerPoint presentation for the Assignment.

Post by Day 3 of Week 5 a substantive and cohesive response to the following:

Describe one organization/agency that would be involved in care delivery for your hypothetical patient. Provide specific details related to:

The geographic location in which it is located

The primary diagnosis of your hypothetical patient

Types of patients typically treated at this facility

Administration

Departments

Payment sources the organization accepts

Performance improvement efforts

Briefly identify other organizations/agencies with which your selected organization is likely to coordinate in order to provide optimal care.

Read a selection of your colleagues’ postings.

Respond by Day 5 of Week 5 to at least two of your colleagues’ postings, addressing the example he or she identified. Keep expanding and/or deepening the discussion by adding insights related to the continuity of services and the coordination of care needed by various patients. Discuss gaps in services or difficulties patients may experience.

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MMHA6050 Topics in U.S. Health Delivery

Module 4 Discussion

Vertical and Horizontal Integration of Health Systems in Various Regions

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. Initial postings must be 250–350 words (not including references).

A 58-year-old man needs to have his blood tested on a regular basis so his physician can monitor the effects of the anticoagulant (blood thinner) medication he is currently taking. He usually has his blood drawn at his local lab in San Francisco, California. While traveling on business in Portland, Oregon, he is able to have his blood drawn on the specified day at another Labcorp location. Labcorp operates an extensive network of 1,700 laboratories across the United States, so lab results can be communicated to the patient’s physician from any location.

Geisinger Health System serves an area with 2.6 million people in northeastern and central Pennsylvania. As an integrated health system, it provides coordinated care to meet the wide-ranging needs of patients. The advanced use of information technology has been critical for facilitating communication, reducing duplication of services, and improving the patient experience along the care continuum. Consisting of numerous clinical facilities and a health insurance company, Geisinger Health System offers an innovative approach to care delivery that it hopes will become a national model.

Integration is an organizing principle for care delivery intended to promote better health outcomes and greater clinical and financial accountability. Labcorp’s horizontal integration is a growth strategy that reduces competition from other companies. Geisinger’s vertical integration is a diversification strategy that links a continuum of services to increase the comprehensiveness of care.

In Module 3, you examined the varied services a patient may need and researched health care organizations that provide those services in your geographic area. In this Discussion, you will examine how integration affects the delivery of care in your community.

To prepare for this Discussion, review the information related to horizontal and vertical integration in the Learning Resources, including the information in the Shi and Singh (2015) textbook and the journal articles.

Next, research integrated health systems in your geographic area. If you find that one or more of the settings you identified for your Module 3 Assignment are part of an integrated system, you may further research the setting(s) for this Discussion.

Select one vertically integrated health system and one horizontally integrated health system in your geographic area on which to focus for this Discussion.

Continue researching these two health systems, noting important information about each health system, including its size, settings/locations, and the services it provides. Investigate how the integration of each system has affected, or is expected to affect, issues related to cost, quality, and access to health care services in your area. Consider implications of integration for the management of the organization, as well as the patient/consumer experience.

If you are an international student, you may examine a specific geographic area in the United States or research two integrated health systems identified in the Learning Resources that are not the same ones you address in your Assignment.

Note: In the Assignment for this module, you are required to select and analyze one vertically integrated health system and one horizontally integrated health system from a provided list. Do not select the same health systems for this Discussion.

Post by Day 5 of Week 6 a substantive and cohesive response to the following:

Analyze one vertically integrated health system in your area and share details about its size, settings/locations, and the services it provides.

Analyze one horizontally integrated health system in your area and share details about its size, settings/locations, and the services it provides.

Assess the impact of integration on issues related to cost and access to care, including implications for the management of the organization and the patient/consumer experience.

Reminder: Use and cite sources to support your posting and responses in the Discussion.

Read a selection of your colleagues’ postings.

Respond by Day 7 of Week 6 to at least two of your colleagues, comparing the impact of integration on the delivery of care in various health systems and regions.

Keep expanding and/or deepening the discussion by adding insights related to the advantages and challenges of vertical and horizontal integration for health care delivery.

Post again by Day 3 of Week 7, discussing how integration of the two health systems you selected likely affects the patient/consumer experience in your community. Provide specific examples to illustrate benefits, concerns, and/or questions patients/consumers may experience.

Continue engaging in the Discussion until the end of the module, Day 7 of Week 7.

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MMHA6050 Topics in U.S. Health Delivery

Module 5 Discussion

DQ1 Discussion 1: Comparison of State and National Data

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. Initial postings must be 250–350 words (not including references).

Cassandra’s father has recently been diagnosed with Type 2 diabetes. Although she already knows that diabetes is a major health problem in the United States, she is surprised to discover that it is one of the leading causes of death. As she researches diabetes, she is even more surprised to learn that the prevalence of diabetes is significantly higher in the state of Tennessee, where she and her family live, than in most other states. Although the data she looks at sometimes vary depending on the source, comparing data from her state with national data gives her a better understanding of the impact of this disease. As Cassandra examines genetic, lifestyle, and environmental risk factors for the disease, she uncovers compelling distinctions between Type 1 diabetes and Type 2 diabetes that heighten her interest in addressing this health problem through her work as a health care administrator and as an advocate for improving health outcomes, not only for her father, but also for others who suffer from complications of Type 2 diabetes.

In this Discussion, you will research one of the leading causes of death in the United States, comparing data from your state with national data and examining risk factors associated with the health problem.

To prepare for this Discussion, examine the leading causes of death in the United States using the following websites from this module’s Learning Resources:

CDC: Leading Causes of Death

Medical News Today: What Are the Top 10 Leading Causes of Death in the US?

Select one leading cause of death on which to focus for this Discussion.

Using credible websites, research how your state’s data compare to national data related to this health condition. For example, you may search for information on the following websites, found in this module’s Learning Resources:

Centers for Disease Control and Prevention (CDC)

United Health Foundation: America’s Health Rankings

Trust for America’s Health

Robert Wood Johnson Foundation

Ensure that you examine comparable data from reliable sources. For instance, look at state and national prevalence rates from the same year and, ideally, from the same source.

Review the information on determinants of health (also referred to as risk factors) presented in Chapter 2 of the Shi and Singh (2015) textbook. In addition, conduct research using the Walden library and credible websites to identify and analyze the causes of your selected health problem and associated lifestyle, genetic, and environmental risk factors.

If you are an international student, you may research a leading cause of death in your country and compare data from your local community with national data.

Post by Day 3 of Week 8 a substantive and cohesive response to the following:

Describe one of the leading causes of death.

Compare your state’s data with national data related to this health problem. Identify your sources of data.

Describe the causes of this health problem and associated lifestyle, genetic, and environmental risk factors/determinants.

Reminder: Use and cite sources to support your posting and responses.

Read a selection of your colleagues’ postings.

Respond by Day 5 of Week 8 to at least two of your colleagues’ postings, explaining how the analysis informs your understanding of death and disease and its impact on health care delivery in various locations.

Continue engaging in the Discussion through Day 7 of Week 8.

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DQ2 Discussion 2: International Comparison of Health System Characteristics

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this module’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. Initial postings must be 250–350 words (not including references).

How does the U.S. health care delivery system compare with other countries’ health care delivery systems? What is the relationship of a country’s economic resources to health outcomes? How does the funding of services influence access to care? How does government involvement in health care delivery inform the patient/consumer experience?

There are no simple answers to the questions above. Yet, health care administrators must engage in thoughtful, ongoing inquiry into questions such as these in order to gain a well-rounded perspective on health care delivery. In your Assignment for this module, you will analyze and compare data to deepen your understanding of the U.S. health care delivery system, as well as other health care delivery systems around the world. Your examination of data can provide valuable insights, but it is also important to consider the context surrounding health care expenditures and outcomes. In this Discussion, you will examine health system characteristics, such as government involvement and funding of health care delivery in the United States and other nations.

For this Discussion and the Assignment, select two countries to compare with the United States in terms of health care (i.e., compare the same countries in both the Discussion and Assignment). One country must be a developed country, and the other must be considered a developing (low- or middle-income) country: as much as possible, select countries that are of similar size. To identify the development level of countries, use the following resources found in this module’s Learning Resources:

The International Statistical Institute: Developing Countries

World Bank: Country and Lending Groups

Next, review the information in the Learning Resources related to health system characteristics, particularly Chapter 1 in the Shi and Singh textbook. Research the characteristics of the U.S. health care delivery system and the systems of your selected countries using the Walden Library and credible websites, such as the Organisation for Economic Co-operation and Development (OECD) site, found in this module’s Learning Resources.

Consider the following questions as you research each country:

How is the health system organized? Is there a central governing agency?

How does an individual gain access to needed services, including specialized care?

How are health care services paid for? For example, does the country have a national health system with tax-funded coverage, a health insurance system with a single payer, a health insurance system with multiple insurers, or something else?

What benefits do people in this country experience because of the health system’s characteristics? For instance, are people guaranteed access to health care services? Do patients receive well-coordinated care because their health information is readily available to providers through an integrated technology system? Do they have a great deal of choice when selecting physicians?

What challenges do people in this country encounter? For instance, is there typically a long wait to see a specialist? Do patients encounter adverse effects because medical supplies are not readily available? Are health care services prohibitively expensive for most people?

Post by Day 3 of Week 9 a substantive and cohesive response to the following:

Analyze two or more defining characteristics of the U.S. health care system.

Explain how these characteristics compare to the characteristics of the health care systems of your selected countries. (Be sure to identify the countries in your posting.)

Evaluate potential benefits and challenges for people in your selected countries based on the health system characteristics you have identified.

Reminder: Use and cite sources to support your posting and responses.

Read a selection of your colleagues’ postings. Begin engaging with at least two of your colleagues. (Try to select individuals who chose different countries than you did.)

Respond by Day 5 of Week 9 to at least two of your colleagues’ postings, analyzing the characteristics your colleagues described and comparing them with the ones you identified for your selected countries. Describe any themes or trends you notice or pose meaningful questions for further investigation.

Continue engaging in the Discussion until the end of the module, Day 7 of Week 9.

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MMHA6050 Topics in U.S. Health Delivery

Module 6 Discussion

DQ1 Health Care Trends

Health care administrators must proactively plan for changes that alter the health care environment. Trends that affect health care delivery are varied and arise from many different sources, such as the emergence of new technologies, changing patient and workforce demographics, economic fluctuations, and policy developments. In this Discussion, you and your colleagues will investigate trends that are likely to play a pivotal role in the ongoing transformation of health care delivery.

Choose one of the following topics on which to focus for this Discussion:

Prevention and wellness

Aging population

Consumerism

Accountability and governance

Transparency

Cost containment

Technology

Collaboration

Medical tourism

Review the information provided on the websites included in the Learning Resources, and conduct additional research using the Walden Library and credible websites to assess current trends related to your selected topic.

DQ2 Health Care Reform

Federal, state, and local health care policies are continually instituted or amended to address emerging issues and trends and to rectify problems in health care delivery. For instance, reform may be required to address cost containment challenges or disparities in access to health care services.

Identify an issue currently in the news that relates to federal, state, or local reform.

Research the issue in a variety of news sources, such as government sites (e.g., the National Institutes of Health and the National Institute of Mental Health) and online newspapers. Do not use blogs or other informal sources.

Select one article or news item on which to focus for this Discussion.

Reflect on the information in the article/news item and consider how it relates to your understanding of the U.S. health care delivery system. Review the information in the Learning Resources and conduct additional research using the Walden Library and credible websites to assess this issue and associated reform efforts.

Analyze the social, economic, and political circumstances surrounding this instance of health care reform, and evaluate what this development might mean for your work in health care administration.

By Day 3 of Week 11

Post a cohesive response to the following:

Summarize the article/news item you selected, noting key areas for discussion.

Analyze how the issue and associated reform addressed in the article/news item you selected relates to at least one trend presented in the Learning Resources