Category: Healthcare

Proofread, make sure there are no errors in spelling or grammar, use correct words, and establish a good word flow (for guidance, visit the Writing CenterLinks to an external site.). 
Minimum length of paper 2-3 pages (excluding title page, references, and graphs), double-spaced, in 12-point Times New Roman font. 
Title page (this is not included in the page count)
Background (describe the situation and your target population, why is this significant)
Intervention and program rollout (describe the intervention, what are the components of the program, how will it be implemented)
Expected impact (what are the expected outcomes)
References (use at least 5 references, citation APA style — not included in page count)

Complete attach assignment. The cases are attached also to review. 7 of them you have to review the chart and choose the correct code from the options and 3 of them u have find on your own by reviewing the case

all information is in guidelines and rubric’s. CHART needed for incidence and prevalence
please reach out with any questions

This is what the assignment is based on:
Additional Readings
Required Readings
http://search.proquest.com/docview/1545347367/AAA0F6420A5A44DFPQ/1?accountid=45844
http://search.proquest.com/docview/1370827175/A5E07CE11A14835PQ/1?accountid=45844
Lecture Notes
Welcome to Lesson 8, Laws and Regulations in Managed Care. Wow, it is hard to believe that we are at our final lesson. Throughout the course, we have touched on several regulatory acts and guidelines. This lesson will bring all of these concepts together in order to provide the overall framework for the regulation of managed care organizations. Let’s begin this final lesson of managed care.
Managed care organizations are divided into several broad types of structures: HMOs, Point-of-service (POS) plans, Preferred provider organizations (PPOs), and High-deductible health plans (HDHPs). HMOs provide coverage through a network of contracted physicians. Members usually select a primary care physician. Point-of-service plans have similar structure as HMOs. They cover some level of out of network care. The enrollee pays the cost that is not covered by the plan. Preferred provider organizations provide coverage through a contracted network. They also cover out-of-network services. Services outside the network are paid at a lower rate. High deductible health plans use a health savings account (HSA), a healthcare reimbursement account (HRA), or a medical savings account (MSA).
Managed Care Organizations are subject to federal law and oversight by the state. Most of the state regulation is carried out through the Department of Insurance (DOI). The focus is on how managed care is to be provided to individuals, and what can and cannot be done in conducting business. State laws and regulations are to make sure individuals get the coverage they pay for. The State has established requirements for information given to individuals once individuals are enrolled in plans. Enrollees must be provided with evidence of coverage (EOC). An EOC is a document that tells what services are and are not covered. There are other requirements concerning grievances: expected pay from individuals, network doctors, and requirement for preapproval for medical services. The state also requires that an explanation of benefits (EOB) is sent after a claim has been submitted.
The state requires that all health information be protected. An individual’s health information cannot be used without their consent. Any sensitive information regarding health is protected. Individuals must be informed if their health information is compromised. There are also rules regarding utilization, quality, and contraction with providers. There are protections assuring there are adequate providers in the network.
Federal regulations are carried out by a number of agencies. The U.S. Department of Health and Humans Services (DHHS) is responsible for establishing rules and providing oversight of MCOs. They also set the standards for health information privacy and electronic transactions. The U. S. Department of Labor (DOL) sets the rules governing benefits provided by employers and unions. The U.S. Department of Treasury has the authority to enforce tax laws governing health coverage. The U.S. Department of Justice (DOJ) enforces criminal laws and penalties against MCOs.
There are 5 laws that have the most impact on MCOs. The HMO Act provided the first federal recognition of HMOs and set standards for managed care. ERISA establishes rules for employers and union sponsored health coverage. HIPPA is responsible for health information privacy and security. The ACA enacted additional requirement applying to health insurance markets. The federal tax code provides tax preferences to encourage people to purchase health coverage.
There are times when state and federal governments address the same issues. A determination of whether the state or federal law prevails is one of the challenges regarding conflicts. State law may be preempted if they directly conflict with a specific federal requirement. If the MCOs are unable to follow both the state and federal law, the federal requirements prevail. A number of nongovernmental organizations impact MCOs. The first are organizations that establish electronic healthcare transactions. The second are health plan accreditation organizations.
When there are claim disputes involving medical necessity, the state and the ACA require the claim to be reviewed by an independent review organization. The independent review organization is a panel of medical experts. They review the claim and make a determination with the opportunity to present additional information. There is also the National Association of Insurance Commissioners. This is an association of chief state insurance and managed care regulators. This association operates in the 50 states, District of Columbia, and U.S. territories.
Reference
Kongstvedt, P. R. (2016). Health Insurance and Managed Care: What They Are and How They Work (4th ed.). Jones & Bartlett Learning.

Culture is a complex system, which reflects human experience and behavior. Therefore, understanding aspects that differentiate individuals and groups requires professional nurses to reflect on personal belief systems. Caring for individuals who are “different” than us can unveil personal, ethical, and moral dilemmas. A patient’s culture, behavior, and lifestyle can have a powerful impact on his/her perceptions of health and health care. Take a few minutes to watch Fayth Parks discuss her experiences and research regarding the therapeutic role of culture, in the TEDx Talk, “How Culture Connects to Healing and Recovery” (TEDxAugusta, 2015).
Read the Purnell Model of Cultural Competence that provides healthcare professionals with an organizing framework to help guide them in the delivery of culturally competent care (visit the National Association of School nurses for a visual explanation of the Purnell Model figure). The assigned textbook readings and the Purnell article will provide you an opportunity to learn:
the major assumptions, description, and 12 domains of the model
how the model can be applied in healthcare theory, research, practice, and administration.
Directions
Compose a short narrative (250-300 words) in the discussion space. [This is about one page of text that is typed in Times New Roman, 12-point font, and is double-spaced.]
Select one trait or tradition from your own culture, describe its characteristics, and explain how it is meaningful to you.
Relate this to a domain within the Purnell Model for Cultural Competence (Purnell, 2002) and compare this information to one other culture of your choosing.
What are the similarities and differences of this trait between the two cultures?
Support your content with information from at least one peer reviewed healthcare professional journal article.

This is a writing intensive course. Inasmuch, students will react to the ethical/legal issues presented in the Ted Talk. Students are to write at least 1,000 word reaction paper to the topic. To complete the project:
Identify the Ted Talk reviewed.
Identify at least 3 ethical legal /considerations presented in the Talk.
Argue at least 2 sides in each issue.
How might you experience/face these issues in EMS practice.

Homework Content
In next week’s summative assessment, as a public health manager, you’ll be tasked with creating an action plan based on a chosen community and a disease or health concern that community faces. This week, you’ll begin your research by choosing a health concern or disease and a community affected by it (e.g., Centers for Disease Control and Prevention, 2018, studies of diabetes and Indigenous people of the U.S.).
Create a document or visual that shares your chosen topics and your findings with the faculty member.
Describe the selected disease or health condition and the efforts to control it.
Describe the background of the community.
Describe 2–4 social determinants of health (SDOH) for your community related to this disease or health condition.

Health Science Internship Reflective Paper
It is through reflecting on concepts, actions and concrete experiences that you will recognize that an experience has forged a new way of thinking, encouraged mastery of new skills, and/or facilitated personal and professional growth in accountability, integrity and character. Therefore, a reflective essay will serve as the final assignment for your internship. In this essay you will compare your own perceptions, knowledge, skills and abilities previous to completing your internship with your current perceptions, knowledge, skills and abilities. Thus, the purpose of this assignment is for you to analyze what you have learned as a result of completing your internship and identify components of your program of study that are integrated in your internship experience. Think about how your experiences have influenced your personal, academic and professional growth. Discuss and share your thoughts about these experiences and what they signify for you.
Use the following outline when writing your essay. Each section contains a set of questions and considerations to help guide you through your personal reflection and composition. The length of the paper will vary. However, it should be comprehensive in nature and present a smooth, flowing narrative in anecdotal and autobiographical form of your experience. Use words / phrases in bold as the subheadings for your paper (IVII).
Subheadings are required. Please see the grading rubric following the outline.
I. Overview: A synthesizing paper should be turned in at the completion of the internship. It should begin with a general overview of the internship setting and major objectives of the agency. Identify the objectives of your internship and summarize the strategies to achieve those objectives.
II. Projects / Functions: Describe your primary job function and / or specific projects that you worked on during your internship. If you worked on more than one project or in more than one role, title each activity separately and clearly spell out the who, what, how, and why of it. For each project or work activity, reflect on what you gained from the experience.
III. Products: Did you create any tangible products as part of your internship experience (i.e. needs assessment questionnaire, marketing materials, evaluation instruments, intervention plan and instructional media, manual, etc.)? If so, describe and include in appendix if possible. If creating products was not a function of your internship, what types of tools, instruments, computer programs, educational materials, etc. did you use in your internship? Describe your experience using these tools/products.
IV. Successes and strengths: What were your successes? Reflect on your skills in the work place and determine your strengths and how this lead to success. Have you noticed that some parts of your job come more easily to you than others? What have you discovered about yourself and your skill set? Do you like public speaking? Working behind the scenes? Working with people? Researching? Writing? How have your skills prepared you for this role? What skills do you still have to develop to be more effective in in the work force?
V. Challenges: What were some of your challenges? If there were problems, how did you correct them? What kind of strategy did you develop? What were your failures? What did you learn from these? Did you seen some challenges your supervisor has dealt with during the internship? How were those addressed?
VI. Coursework and Field Work: What have you learned in your coursework at UofM that helped prepare you for your internship experience? Were any courses more helpful than others in preparing you for your specific experience? Have you seen links between lessons in the classroom and tasks in the field? Likewise, what new knowledge or skills have you learned “on the job” that were not part of your coursework or classroom experience at UofM? How will you use this new knowledge or skill set going forward?
VII. Site Reflection: What do you see as advantages and/or disadvantages of doing an internship in this particular setting? What did you learn about yourself? What effect, if any, did the internship experience have on your career plans and goals? Do you recommend your internship site to future interns? What advice would you have for a health sciences student that is about to begin their internship experience. This advice can be specific to your selected internship site, or more broad and include your advice on selecting a meaningful site.

Part 2: The Quality Improvement Initiative Video Presentation 
For your video presentation, you must first create a 10- to 12-slide PowerPoint presentatio
For your Quality Improvement Initiative PowerPoint presentation,
Create a 10 slide PowerPoint that presents the required criteria listed below:
Describe the nature of the business, services or products, and customers served by your chosen hospital.
Evaluate one measure of your choice.
Discuss the importance of your selected measure (e.g., accreditation status, patient safety, and/or financial status of the hospital).
Define two to three SMART (specific, measurable, attainable, relevant, and time-bound) goals for your selected measure to improve. 
Analyze specific local, state, or national policies (e.g., The Joint Commission Standards) that have been developed to improve your selected measure based on evidence-based practice research.
Identify at least three quality improvement and/or risk management tools or methodologies needed for your QI initiative.
Judge the stakeholders involved to accomplish your QI initiative.
Examine other resources (e.g., time, financial, materials, etc.) required for your QI initiative.
Assess an appropriate advanced HIT that can be used to support your QI initiative.
Describe how your QI initiative can be incorporated into the organization’s overall strategic plan.
Determine how to evaluate the effectiveness of your QI initiative.
Must include introduction and conclusion slides.
Design your PowerPoint based upon the Quality Improvement Initiative Final Project Template Download Quality Improvement Initiative Final Project Template.
Compose a transcript for your presentation in the Speaker Notes area.
**I have attached the papers with my quality improvement inititives.**

you must write a paper based on the video I will below. I’ll provide an example paper and the rubric. you don’t need to write about what is being said in the video unless it directly relates to the actions being performed