SNHU Healthcare Delivery Systems Essay

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HCM 340 Final Project Guidelines and Rubric Overview The 2000 Institute of Medicine (IOM) report To Err is Human was a call to arms for the U.S. healthcare delivery system. It emphasized the need to explore the processes, structure, and outcomes related to the quality of care provided to individuals in our society. For your final project, you will research a gap in access to quality, equity, or efficiency of care (including existing initiatives in place to address the gap and economic and regulatory factors that are currently in place to address the gap). Access to care includes access to health insurance coverage, access to services and providers, and timeliness of the care received. All three of these components impact quality of care. Access can also include affordability. The quality of the care people receive in the healthcare system should not vary based upon their socioeconomic status. For your final project, you will select a healthcare delivery process gap and the population affected from the list below. Then, you will develop a healthcare delivery systems research paper. • • • Option One: A gap in quality related to care coordination for individuals with chronic illnesses Option Two: A gap in equity related to mental health access for veterans Option Three: A gap in efficiency related to rising cost of pharmaceuticals for the aging population This assessment addresses the following course outcomes: • • • • Draw connections between current healthcare delivery systems and the context in which they were developed Describe the impact of economic and regulatory drivers on healthcare delivery systems Identify major gaps in access to healthcare for determining areas of opportunity for improved access to quality healthcare Explain initiatives targeted at maintaining or improving the health status of specific populations Prompt After choosing the topic for your course project from the options provided in the overview, you will work to develop your healthcare delivery systems research paper. Within the final research project you will address your chosen gap in access, including existing initiatives in place to address the gap, and economic and regulatory factors that are currently in place to address the gap. 1 Specifically, the following critical elements must be addressed: I. Introduction A. Describe a specific gap in the delivery of healthcare. Include the specific population affected by the gap. B. Briefly describe the history of this gap in access to healthcare. Has this been an issue historically, or is it a modern issue? C. Explain the impact that the socioeconomic background of the population has on their access to healthcare. D. Describe how the healthcare delivered to the population is affected by the gap in access. E. Predict any potential implications if this gap in access is not addressed. II. Existing Initiatives A. Explain an existing healthcare initiative that was put in place to address this gap in access. B. Explain the specific goals of the existing initiative in place to address this gap in access. C. Describe the circumstances around the development of the existing initiative. Consider when it was developed and what factors were considered. D. Describe the resources required to fund the existing initiative. E. Explain why the existing initiative is not meeting its intended purpose and now requires improvement. III. Regulation A. Explain a current regulation regarding the existing initiative that has been identified and the context in which it was developed. Why is this regulation important? B. Describe the regulatory level that the existing initiative is being addressed at. Consider the potential for multiple levels of regulation. IV. Conclusion: Explain the effectiveness of the existing initiative and associated regulations in addressing this gap in the delivery of healthcare to the target population. Does the initiative align with initiative in place to support other gaps? Are there conflicting interests to be aware of? Milestones Milestone One: Topic Selection In Module Three, you will submit a 2- to 3-page paper explaining why the topic you chose is a gap in healthcare and analyze the specific population impacted by the issue. This assignment will be graded with the Milestone One Rubric. Milestone Two: Existing Initiatives In Module Five, you will submit a 2- to 3-page paper in which you will identify and analyze an initiative that addresses the gap you chose as the topic for your final project. This assignment will be graded with the Milestone Two Rubric. 2 Final Submission: Healthcare Delivery Systems Research Paper In Module Seven, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final project. It should reflect the incorporation of feedback gained throughout the course. This submission will be graded with the Final Project Rubric. Final Project Rubric Guidelines for Submission: Your healthcare delivery systems research paper should be 5 to 8 pages. It should be double-spaced, include one-inch margins, use 12-point Times New Roman font, and at least three sources cited in APA formatting. Critical Elements Introduction: Gap Exemplary (100%) Meets “Proficient” criteria and description demonstrates keen insight into the healthcare delivery processes Proficient (85%) Describes a specific gap in the delivery of healthcare, including the specific population affected by the gap Introduction: History Meets “Proficient” criteria and description demonstrates a nuanced understanding of the premise of the gap Meets “Proficient” criteria and the explanation demonstrates a sophisticated awareness of the relationship between socioeconomic status and access to healthcare Meets “Proficient” criteria and description demonstrates a nuanced understanding of the healthcare delivery processes as they relate to consumer access Briefly describes the history of this gap in access to healthcare Introduction: Socioeconomic Background Introduction: Affect Explains the impact socioeconomic background has on a population’s access to healthcare Describes how the healthcare delivered to the population is affected by the gap in access 3 Needs Improvement (55%) Describes a specific gap in the delivery of healthcare, including the specific population affected by the gap, but the description is cursory or contains inaccuracies Describes the history of this gap in access to healthcare, but description is verbose or contains inaccuracies Explains the impact socioeconomic background has on a population’s access to healthcare, but explanation is cursory or illogical Describes how the healthcare delivered to the population is affected by the gap in access, but description cursory or contains inaccuracies Not Evident (0%) Does not describe a specific gap in the delivery of healthcare to a specific population Value 7.9 Does not describe the history of this gap in access to healthcare 7.9 Does not explain the impact socioeconomic background has on a population’s access to healthcare 7.9 Does not describe how the healthcare delivered to the population is affected by the gap in access 7.9 Introduction: Implications Meets “Proficient” criteria and predictions demonstrate a sophisticated awareness of the interrelationship between healthcare access and other variables Meets “Proficient” criteria and explanation demonstrates keen insight into the needs for addressing the gap Predicts any potential implications if this gap in access is not addressed Predicts any potential implications if this gap in access is not addressed, but predictions are unrealistic or unrelated Does not predict any potential implications if this gap in access is not addressed 7.9 Explains an existing healthcare initiative that was put in place to address this gap in access Does not explain an existing healthcare initiative that was put in place to address this gap in access 7.9 Existing Initiatives: Goals Meets “Proficient” criteria and explanation demonstrates a nuanced understanding of the purpose of the existing initiative Explains the specific goals of the existing initiative in place to address this gap in access Does not explain the specific goals of the existing initiative in place to address this gap in access 7.9 Existing Initiatives: Development Meets “Proficient” criteria and description demonstrates a sophisticated awareness of the elements involved in the development of initiatives Meets “Proficient” criteria and description demonstrates a complex grasp of the funding requirements of healthcare delivery initiatives Meets “Proficient” criteria and explanation demonstrates keen insight into the needs of the initiative and its shortcomings Describes the circumstances around the development of the existing initiative Explains an existing healthcare initiative that was put in place to address this gap in access, but explanation is cursory or contains inaccuracies Explains the specific goals of the existing initiative in place to address this gap in access, but explanation is cursory or contains inaccuracies Describes the circumstances around the development of the existing initiative, but description is unclear or incomplete Describes the resources required to fund the existing initiative, but description is illogical or contains inaccuracies Does not describe the circumstances around the development of the existing initiative 7.9 Does not describe the resources required to fund the existing initiative 7.9 Explains why the existing initiative is not meeting its intended purpose and now requires improvement, but explanation is cursory or contains inaccuracies Does not explain why the existing initiative is not meeting its intended purpose and now requires improvement 7.9 Existing Initiatives: Address Gap Existing Initiatives: Resources Existing Initiatives: Improvement Describes the resources required to fund the existing initiative Explains why the existing initiative is not meeting its intended purpose and now requires improvement 4 Regulation: Current Regulation Meets “Proficient” criteria and explanation demonstrates a sophisticated awareness of how context influences the development of regulations Explains a current regulation regarding the existing initiatives that have been identified and the context in which it was developed Regulation: Regulatory Level Meets “Proficient” criteria and description demonstrates a nuanced understanding of regulatory control levels Describes the regulatory level at which the existing initiatives are being addressed Conclusion Meets “Proficient” criteria and explanation demonstrates a complex grasp of the relationship between individual initiatives and the healthcare system Explains the effectiveness of the existing initiative and associated regulations in addressing this gap in the delivery of healthcare to the target population Articulation of Response Submission is free of errors related to citations, grammar, spelling, syntax, and organization and is presented in a professional and easy to read format Submission has no major errors related to citations, grammar, spelling, syntax, or organization Explains a current regulation regarding the existing initiatives that have been identified and the context in which it was developed, but explanation is cursory or contains inaccuracies Describes the regulatory level at which the existing initiatives are being addressed, but description is cursory or unrelated Explains the effectiveness of the existing initiative and associated regulations in addressing this gap in the delivery of healthcare to the target population, but explanation is cursory or unrelated to the overall healthcare system Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Does not explain a current regulation regarding the existing initiatives that have been identified and the context in which it was developed 7.9 Does not describe the regulatory level at which that the existing initiatives are being addressed 7.9 Does not explain the role of this gap in the delivery of healthcare to the population or the initiative in place to address this gap 2.6 Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas 2.6 Total 5 100% Hospital Readmissions Reduction Program Kristen Earle Southern New Hampshire University March 30, 2022 Hospital Readmissions Reduction Program Many countries put priority on health and work to try to improve efficiency and achieve certain health goals. Quality of care in the United States for people’s health have resulted in several initiatives aiming to improve efficiency in health care particularly related to rising costs of pharmaceuticals for the aging population. Efficiency in such cases focuses on the best way of allocating available funds to achieve health goals. The initiative that addresses the gap of rising costs of pharmaceuticals in the aging population is the Hospital Readmissions Reduction Program (HRRP). The initiative is seen as a quality measure and reduces the health cost curve (McIlvennan, Eapen & Allen, 2015). The Hospital Readmission Reduction Program was established in 2012 and the money allocated to improve efficiency was provided. The Affordable Care Act (ACA) ensured that hospitals were financially penalized for high readmissions rates within 30 days for certain illnesses including heart failure, myocardial infarction, and pneumonia (McIlvennan, Eapen & Allen, 2015). At first, the initiative gained a lot of attention from the medical community both positives and negatives but the goal that needed to be achieved was to reduce the costs incurred for avoidable readmissions. Goals The specific goal as stated above is to reduce the avoidable readmissions of the aging population (McIlvennan, Eapen & Allen, 2015). The high rate of readmissions results in unfavorable patient outcomes and high financial costs. When patients are not given quality care but several care processes are involved, the patient gets readmitted within 30 days. That increases the medical expenses for the companies paying for the bills. Before the implementation of the initiative, most of the Medicare discharges had readmission within 30 days. Among all the readmissions, 12% of them can be avoided which means a lot of money is being used to care for the treatment and diagnosis procedures. Another goal for the initiative is to improve patient outcomes instead of focusing on a few core processes (McIlvennan, Eapen & Allen, 2015). The initiative has brought transitions of care where most of the institutions focused on looking at the causes and predictors of readmission. Therefore, that focuses on improving the quality of care from the process performance to the patient outcomes. Many organizations have improved care to avoid the penalties of high risk of readmissions. Previously, the main aim was to take care of a few care processes and failed to look into the cases and prevention strategies for the conditions affecting the aging population. So, simply the main goal is to improve care while reducing the rising costs of care. Circumstances around the establishment of the initiative The initiative was implemented in 2012 and before that time hospitals did not have any incentives provided to reduce the readmission rates (Boccuti & Casillas, 2015). For the failure of the incentives, the health organizations did not try their best to reduce admissions are improve health care that solved the problem. So, the result of the readmissions increased health care costs for the insurance organization. It was through such circumstances that the high rising costs of care increased inequality because not many people would afford to pay for such high costs. With the Federal government willing and aiming to create equity and improve health performance, the initiative was introduced to reduce high health costs. Also, after the discharge other treatments were not catered by Medicare which resulted in high rates of readmission (McIlvennan, Eapen & Allen, 2015). The inpatient prospective payment system has used the method to receive payment. So, the payment ensured all the inpatient stay and outpatient services were charged starting from the day of admission or within 3 days. So, post-discharge care was not provided in the payment system. The inability of the patient to cater for -discharge care resulted in poor patient outcomes and thereby leading to readmissions. Resources required to fund the initiative The resources required to fund the initiative are the incentives provided by Medicare. The program provides a direct financial incentive to hospitals participating in inpatient prospective payment systems to reduce the readmissions rates (McIlvennan, Eapen & Allen, 2015). The hospitals with excess readmissions are penalized so that they work hard to improve patient care and efficiency in the delivery of health services. The percentage penalized is saved in the Medicare Hospital Insurance Trust Fund to help the beneficiaries in lowering the costs of part B premium. Also, the hospitals provide resources to investigate and determine the causes and predictors that lead to readmissions. That involves improved employees’ skills and research to improve quality care within the facility. The combination of organizational resources and that of Medicare provided the funds necessary for improving efficiency and reducing health costs. Need for improvement for HRRP The initiative has significantly reduced the readmission rates in many hospitals but the problem of rising costs is still persistent in the country and health inequality is a gap that the initiative has failed to reduce. According to Brown (2018), suggests that health inequalities in the United States are stark because of social inequalities. The risk-adjustment model did not consider socioeconomic status. Hospitals that serve in regions with disadvantaged people are at high risk of penalties. Socioeconomic factors also contribute to the health outcome of every patient. In such a case that the hospital work in such a region, they need more funding to help people get adequate post-discharge care until full recovery because failure may lead to readmissions. Sometimes hospitals see taking care of such communities put the facility at high risk. Therefore, through the initiative, the needy communities are denied resources and funding to take care of the disadvantaged through penalties. So, improvement must be done to accommodate the socioeconomic factors as a way to improve equality which is still a challenge in the national healthcare system. References Brown, T. H. (2018). Racial stratification, immigration, and health inequality: A life courseintersectional approach. Social Forces, 96(4), 1507-1540. McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation, 131(20), 1796-1803. Boccuti, C., & Casillas, G. (2015). Aiming for fewer hospital U-turns: the Medicare hospital readmission reduction program. Policy Brief. 1 Healthcare Delivery Process Gap Kristen Earle Southern New Hampshire University March 18, 2022 2 A Gap in Efficiency Related to the Rising Cost of Pharmaceuticals for the Aging Population All people should have reliable access to efficient and reliable healthcare services. However, the aging population is more susceptible to healthcare challenges because of the growing cost of pharmaceuticals. The population’s vulnerability prevails because most of its members cannot work or grow their income levels. Consequently, it depends on the working people to serve their life demands. This situation leaves them unable to observe the healthcare measures associated with their various mental and physical health challenges (Rockwood & Wang, 2018). In some cases, the drugs related to this population are also more costly than others. Such conditions lower the aging population’s affordability and discourage relative drug adherence. The efficiency challenges related to the rising cost of pharmaceuticals for the aging population have characterized the healthcare sector for ages. Its prevalence is significantly associated with various legislative policies and government projects. For example, Medicare has specific characteristics that limit its reliability to the aging population. One of such limitations is Medicare’s inability to cover outpatient prescription drugs. This characteristic leads to significant discrimination against the senior population members because most healthcare issues call for outpatient treatment procedures (Watanabe et al., 2018). The challenge prevailed before and after healthcare coverage options like Medicare and Medicaid because various members cannot afford the available coverage costs. The healthcare challenges facing the aging population are significantly associated with its socioeconomic background in various ways. For example, the discussion in the above parts shows most members of this group are economically unstable because they depend on the 3 support of the working population. However, such help is also missing because most older adults live away from their children and other society members. They are retired from their career activities and have the unreliable physical strength to help them meet their friends at such ages. Following such reasons, older people face extreme extents of isolation from the rest of society. Consequently, they become more vulnerable to mental health issues like dementia, stress, loneliness, and depression. Secondly, this isolation denies the elderly sufficient chances to express their needs and challenges to necessary society members (Watanabe et al., 2018)). Thus, they suffer health issues for long periods without meeting reliable remedies. Following the prevailing gap in efficiency related to the rising cost of pharmaceuticals for the aging population, several healthcare services are unaffordable to older adults. This effect discourages victims from adhering to the specific treatment requirements associated with their health conditions. Secondly, this gap compromises the quality of healthcare services reaching the aging population. The inability of the population members to afford the necessary treatment options influences the healthcare providers to serve them with affordable treatments (Goldsteen et al., 2020). However, such alternative options are less effective in solving the underlying healthcare conditions. Failure to address this gap can lead to multiple implications for the aging population and other sectors of society. The primary implication resulting from this gap is a lower quality of life in the elderly. This implication can subdivide into several others depending on the specific factors characterizing different individuals, families, and communities. For example, it can lead to an increased mortality rate among the members within this bracket because of the resultant limited drug supply. Additionally, it can increase chronic illnesses among elderly elders because of their inability to address diseases immediately after infection (Goldsteen et al., 2020). Thus, 4 policymakers, non-governmental agencies, medics, and other reliable parties should work together to promote the affordability of pharmaceuticals for the aging population. 5 References Goldsteen, R. L., Goldsteen, K., & Goldsteen, B. (2020). Jonas’ introduction to the U.S. health care system (9th ed.). Springer Publishing Company. Rockwood, K., & Wang, J. (2018). Aging medicine: A platform to understand health needs in rapidly aging populations. Aging Medicine, 1(1), 4-4. https://doi.org/10.1002/agm2.12018 Watanabe, J. H., McInnis, T., & Hirsch, J. D. (2018). Cost of prescription drug-related morbidity and mortality. Annals of Pharmacotherapy, 52(9), 829-837. https://doi.org/10.1177/1060028018765159

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