Calculate the standard deviation of the wealth of Mary if she has no insurance

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Suppose Mary can have good health with probability 0.95 and bad health with probability 0.05. If Mary has a good health her wealth will be $90,000, if she has bad health her wealth will be $10,000 (after paying the health bill). Suppose that the utility of wealth come from the following utility function: U(W)=W^0.5

Note: When the question is about utilities, report the answer with one decimal. When the question is about money, report integers (without comas for thousands). In both cases, round appropriately. 

1.    Find the reduction in wealth if Mary has bad health.

2.    Find the expected wealth of Mary if she has no insurance.

3.    Find her utility if she has bad health and she has no insurance.

4.    Find her utility if she has good health and she has no insurance.

5.    Find the expected utility of Mary if she has no insurance.

6.    Find the certain equivalent wealth of this lottery.

7.    If she has full insurance, find the payment the insurance company made to her if she has bad health.

8.    Find the maximum premium she is willing to pay for full insurance.

9.    Find the fair premium if she is fully insured.

10. Find her expected utility if she paid the fair premium and has full insurance.

11. Calculate the standard deviation of the wealth of Mary if she has no insurance.

12. Calculate the standard deviation of the wealth of Mary if she has full insurance.

13. Calculate the profits made with Mary's policy for the insurance company if the premium is fixed at $5,000 with full insurance.

14. Calculate Mary's expected utility if she pays a premium of $5,000 and she is full insured.

15. Suppose the case of fair premium and full insurance, and the insurance company has only one client (Mary). Calculate the standard deviation of the profits.

16. Suppose the case of fair premium and full insurance, and the insurance company has two identical clients like Mary. Under the assumption that the covariance between both clients' risk is zero, what would be the standard deviation of the profits of the insurance company. 

key actions you could take to monitor privacy and security violations that may occur after the implementation of HIMS in your health care organization

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Assignment 1: Technology Assessment and Government Regulations 
Due Week 3 and worth 150 points

You are the senior manager of a large healthcare organization. The senior management team must decide on a Health Information Management Systems (HIMS) for the organization that will encompass several clinical and administrative departments. You will need to create a PowerPoint presentation that will persuade your CEO to purchase your chosen HIMS. Your presentation should also contain some important aspects of HIMS (EMR) such as, implementation, interoperability, productivity, and support challenges.

Create a twenty to twenty five (20-25) slide PowerPoint presentation in which you:

Create an argument to be presented to the CIO the need to integrate all clinical and administrative departments using a Health Information Management System in your health care organization. Note: Your title slide is considered as one (1) slide.

Identify and analyze the most significant EHI, EHR, HIPPA, and HITECH current regulations in your state. Next, determine two (2) ways they could impact the integration of HIMS in your health care organization. Be sure to include three (3) potential solutions to address these regulation challenges.

Propose three (3) privacy and security measure that will help health care providers avoid security breaches, data loss, and better allow them to concentrate on caring for their patients. Next, develop an action plan to protect patient information that complies with EHI, HER, PHI, HIPAA legal requirements.

Suggest three (3) key actions you could take to monitor privacy and security violations that may occur after the implementation of HIMS in your health care organization.

Use at least three (3) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources. N ote: Your references slides is considered as one (1) slide.

The specific course learning outcomes associated with this assignment are:

Demonstrate an understanding of the basic technology underlying health care information systems.

Apply senior management’s role in information technology management.

Use technology and information resources to research issues in health information systems.

Write clearly and concisely about health information systems using proper writing mechanics.

Click here to view the grading rubric.

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Determine the Key elements of the proposed needs assessment

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Analyze and apply two (2) Needs Assessment Methods (1) Planner & (2) Participant: The
purpose of this exercise is for the student to systematically plan two assessment processes for specific target population(s). A more thorough checklist will be provided. 
(1) Choose your preferred definition of Need from either the Bradshaw or Isaac & Michaels sources.
(2) Using a health topic of interest or health issue choose a specific target population
(3) Decide which needs assessment protocols you choose to research and write about:
a. One Resource Tool to collect data about your target population must come from the
following – Epidemiological Data/ Records of Health and Health Care / Health Risk
Appraisal Instruments / Information from significant others / Examination of current
literature
b. One Resource Tool to collect data about your target population must come from one of
the following – Community Forum / Focus Group / Opinion Leader’s Survey / Survey of
the target population / Fieldwork and Observation / Delphi Procedure
(4) After researching your two preferred needs assessment data techniques from a & b above, you
are to describe these two methodologies and indicate in prose how you would implement these
methodologies to determine the health needs of your target population you have selected
(5) The assignment will be evaluation on the basis of the following:
a. Articulation of the needs assessment protocol for each methodology
b. Organization and clarity of the process
c. Relevance of the needs assessment data technique
d. Grammar and spelling
Important NOTE:
I have attached the following: 
– The checklist for designing need assessment.
– The Powerpoint that can be used to guide and help the expert.
The tobic must be a health tobic or health issue and I want 4 pages.
Document Preview:

.. -.€”o Checklist for Designing Needs Assessment I. Preparation: A. Determine the Key elements of the proposed needs assessment 1. Identify the purpose to be served by the needs assessment 2. Before proceeding, insure that this is defensible, ethical and potentially viable 3. Define the client and other audiences B. Clarify the Reasons for the study l. What are the stated reasons (selection of persons groups or to participate in a program, allocation of funds, modification of the curriculum, interpretation program of outComes, public or relations?) 2. What possible unstated reasons justify exist (to previous a decision to cancel a program or to discharge certain personnel)? 3. Before proceeding, insure that reasons the for the study are honorable C. Make an Initial Approximation of the Client,s and Audiences information needs 1. What are their questions 2. What areas of the program or issue are most deficient? What knowledge and skills are needed 3. What information do they think they needpolitical viability Secure and maintain groups of key 1. Involve members these groups thrcughout the Maintain communication with 2. study protocol and honor appropriate 3. Determine (s) interest the subject of E. Characterize population interest of the of 1. Decide on a definition Describe this population 2. F. Identify other variables needs to be learned about the setting? 1. What of particular interest? What program variables are 2. monitored? variables should be 3. What outcome side effects of the program that 4. Are there any expected negative should be monitored? possible positive side effects? 5. How about judgments and importance of needs 6. about the existence Whose should be obtained? 1 of the information should be obtained about costs What program? qualifications of the program? 8. about the intrinsic What for study G. Formulate a general design the Define key terms 1. objectives of the study 2. State the…

Analyze the environmental force/trend you selected

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Environmental forces and trends (i.e., competitors, new technologies, socioeconomic, population and business factors, and changing regulations) can have a tremendous impact on the success of an organization’s marketing plan. Therefore, it is important for health care leaders to continuously assess the strengths, weaknesses, opportunities, and threats (SWOT) of these forces and trends to ensure that their organizations are applying the appropriate marketing strategies. For this Assignment, you need to conduct a SWOT analysis of an environmental force or trend and consider how it might impact your own health care organization.

To prepare:

  • Select a contemporary environmental force/trend, such as politics in health care, new technological advances in health care, the impact of recession/economic issues on utilization of health care, etc. Using the Library, locate and review a scholarly article that discusses this force/trend.
  • Reflect on your own health care organization. Imagine you have been hired as a marketing consultant to help guide your organization in understanding evolving environmental forces/trends that may impact marketing.Note: If you do not currently work for a health care organization, you may select one that is of interest to you.

The Assignment

In a 4- to 5-page report, address the following:

  • Analyze the environmental force/trend you selected. Include how the organization in the article is using the force/trend to better understand itself.
  • With your selected health care organization in mind, conduct a SWOT analysis of the environmental force/trend you selected.Note: Be sure to use the SWOT Analysis Template in this week’s Learning Resources.
  • Analyze how the force/trend might impact the marketing of your organization. Recommend strategies to maximize opportunities and overcome threats.

mechanisms are developed to inform workers of hazards (and their assessment) that have been identified in their work area

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You work in a large department store and are the newly appointed health and safety representative for your work group. The organization is wanting in compliance with its health and safety compliance.

It is up to you, therefore, to ensure that the following requirements are met:

*health and safety legislation and codes of practice are available and communicated to all workers

*the key provisions of the relevant acts, regulations and codes of practice that apply to the business are communicated to workers

*workers receive information regarding:

*the organization’s health and safety policies, procedures and programs

*the responsibilities, duties and obligations of managers, supervisors, persons conducting businesses or undertakings (PCBUs) or their officers, and of workers in the workplace

*mechanisms are developed to inform workers of hazards (and their assessment) that have been identified in their work area

*support for work teams is provided, to help them manage work area hazards and associated risks

*implementation of procedures that workers can follow if issues raise are ignored

*procedures are implemented so that consultation about health and safety issues and participation in key mechanisms for improving health and safety within the work culture will occur

*a health and safety training needs analysis is conducted

*methods of addressing the training requirements of workers are determined

*suitable policies and procedures related to the use of data to identify hazards, asses risks and control risks, including fire, emergency, evacuation are implemented

*management of health and safety records, incident investigations and reporting

*audits

Explain how you will address ALL of these things.

Explanations should be relatively detailed and must cover all of the listed requirements.

Upload your answer for assessment.

U.S. Department of Health and Human Services

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DUE 2/10  10 P.M EST
BE ON TIME
ORIGINAL WORK
5 Pages not including Title and ref page

 
Alternative Funding Sources
For this part of your Scholar-Practitioner Project you will evaluate funding sources for the public health initiative you selected which is PrEP (HIV prevention program. Then, you will submit a mock grant proposal for an appropriate grant to supplement or allow expansion of your selected public health initiative.

Follow guide from previous week and paper is included so review
INSTRUCTIONS WERE: 
 
Part 2: Financial Accounting Analysis
For this part of your Scholar-Practitioner Project you will develop a financial accounting analysis of the public health initiative you selected in week 2. In your analysis, be sure to incorporate return on investment, time-value of money, and inflation factors.
The financial accounting analysis should include:

A 5-year proposed budget including major line items (see blank form for proposed budget on NIH grants page located in the course syllabus or here: 
Online Article: U.S. Department of Health and Human Services (2009, June). Public health service: PHS 398. Detailed Budget for Initial Budget Period Form Page 4  and Form Page 5
http://grants.nih.gov/grants/funding/phs398/phs398.html (Concentrate on the budget and completing the two form sections)
Grant Application PHS 398. U.S. Department of Health and Human Services Public Health Service.

There is a $500,000 Direct Cost per year limit ( as noted in the PHS 398 Instructions page 22)

An analysis of budget line items, costs, sources of revenue, and deficits (This is the budget justification)
An analysis of the fiscal soundness and long-term viability of the public health initiative
PAPER ATTACHED..SO PLEASE FOLLOW

Government Regulatory Agencies and Impact on Consumer Choices

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HCS 490 Week 2 Learning Team Assignment Government Regulatory Agencies and Impact on Consumer Choices Outline Resource: Government Regulatory Agencies and Impact on Consumer Choices Outline grading criteria located on the student website. Resource: Material: Agency Overview located on the student website. Health care consumers and providers have access to a variety of health care products and services, which may be a benefit and a challenge. Governmental oversight of health care products and services exist and affect both the type and quality of products and services to which health care consumers have access. Health care products and services are regulated by a variety of governmental agencies, such as the following: The Food & Drug Administration (FDA) The FDA Division of Drug Marketing, Advertising, and Communications (DDMAC) The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services To prepare for the Government Regulatory Agencies and Influence on Consumer Choices Presentation due in Week Five, you must develop a content outline that is submitted to the facilitator for approval in Week Two. This outline serves as the foundation for your presentation. Explore the agencies in the government links pertaining to the government agencies in the Health Care Web Links section on the student website and the Material: Agency Overview document. Select a government agency and product or service category. Write a 350- to 700-word outline to turn in to your facilitator for review. Include the following: The identity of the agency and the role of the governmental agency selected The health care product or service category selected Your initial rationale for selecting this area of focus

Pharmacotherapy for Cardiovascular Disorders paper

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Cardiovascular diseases cause significant morbidity and mortality globally and in the US. Besides, their prevalence in the US is increasing gradually thus, they pose potential threats and challenges to the American healthcare system. Despite the advancement in treatment, patients with cardiovascular diseases do not receive optimal care. This is attributed to their complex nature, which requires a good understanding of their risk factors and pathophysiology and how these factors influence pharmacodynamics and pharmacokinetic processes. Pharmacotherapy for Cardiovascular Disorders Essay.

Case Overview

The selected case study for this assignment involves a patient named AO who was obese and has subsequently gained 9 pounds. AO has a diagnosis of hyperlipidemia and hypertension with the following prescribed medications: Sertraline 25 mg, doxazosin 8 mg, atenolol 12.5 mg and Simvastatin 80 mg daily, with hydralazine 10 mg qid. Pharmacotherapy for Cardiovascular Disorders paper

Patient Factors

The selected patient factor is behavior concerning AOs obesity. This means that AO’s lifestyle has a high-calorie intake and decreased physical activity. As explained by Shattat (2015), the pathophysiology of obesity-related hypertension is attributed to the accumulation of fat in the intravascular space and intra-abdominal muscles, it activates the renin-angiotensin system and leads to retention of sodium hence increased renal absorption.

Obesity and hyperlipidemia complicate the management of cardiovascular disorders. Therefore, poor circulation and poor nutrition affect the pharmacokinetics and pharmacodynamics of this patient. It is inarguable that AO has poor nutrition and reduced circulation, which is influenced by obesity and limited physical activity respectively. The two factors lead to vasoconstriction that accompanies hypertension and the build-up of plaque as observed in hyperlipidemia. As emphasized by Arcangelo & Peterson (2013), it is necessary to understand how these risk factors affect the management of cardiovascular disorders and their side effects on the patient’s ability to respond to drug therapy to achieve desired therapeutic outcomes. This understanding will also influence clinical decision making on appropriate dietary and therapeutic modifications to attain specific treatment goals. AO should consider making modifications to his diet and have a regular physical exercise to improve his cardiovascular health and efficacy of the recommended treatment plan. Pharmacotherapy for Cardiovascular Disorders Essay

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Pharmacodynamics & Pharmacokinetics

It is not clear if AO adheres to prescribed medications since he has several pills to take daily. Based on the recommendations provided by the AHA (American Heart Association), patients with hypertension should be given combined therapy to reduce the risks of side effects and non-compliance. AO is at a high risk of hydralazine associated SLE. Besides, the combination of doxazosin and atenolol produces synergistic effects such that, the latter blocks alpha 1 receptors resulting in the dilation of blood vessels reducing the peripheral resistance (Pokrovsky, Polishchuk & Polischuk, 2017).  However, atenolol is cardio-selective thus blocks beta 1 receptors even at the lowest doses. Pharmacotherapy for Cardiovascular Disorders paper

Improving the Drug Therapy Plan

AO’s drug plan has numerous areas that need improvement. First, AO’s prescription has atenolol, which is a beta-blocker. Beta-blockers act by blocking the effects of adrenaline to influence vasodilation, improve the flow of blood and lower blood pressure. Beta-blockers are major contributors to hyperlipidemia according to currently existing research (Carey & Wheaton, 2018).  Besides, according to the recommendations provided by the FDA, it is not the 1st line dug of choice in hypertension management. Based on these reasons, atenolol must be discontinued in this patient’s drug therapy. Discontinuation of atenolol should also prompt the discontinuation of hydralazine since the latter is administered alongside a diuretic and a beta-blocker. Pharmacotherapy for Cardiovascular Disorders Essay.

The FDA recommends diuretics for hypertension 1st line managements. For this patient, a daily dose of 12.5mg hydrochlorothiazide (HCTZ) is the most appropriate. As a thiazide diuretic, HCTZ acts on the renal system by decreasing the reabsorption of sodium in the distal convoluted tubule (Roush & Sica, 2016). It is also worth mentioning that thiazides are not only beneficial but also safe in patients with diabetes and reduce the risk of high mortalities from stroke and heart disease. However, it should be administered in the lowest dose possible. AO is not a known diabetic. However, she has several risk factors for diabetes, which should prompt the need to determine whether she has diabetes.

Simvastatin, a statin, is appropriate for managing this patient’s hyperlipidemia. Simvastatin acts by decreasing cholesterol production in the liver by blocking the HMG CoA enzyme (Arcangelo & Peterson, 2013). Besides, it is the FDA‘s recommended drug for the 1st line management of hyperlipidemia based on a patient’s blood cholesterol levels. Therefore, to determine if simvastatin is still effective, I would order for a blood cholesterol test. On the other hand, I would recommend that AO take doxazosin at night since it causes orthostatic hypotension as a major side effect. Pharmacotherapy for Cardiovascular Disorders Essay.

 References

Arcangelo, V. P., and Peterson A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins

Carey, R. M., & Wheaton, P. K. (2018). Prevention, detection, evaluation, and management of high blood pressure in adults: Synopsis of the 2017 American College of Cardiology/American Heart Association hypertensive guideline. Annals of Internal Medicine, 168(5), 351-358.

Pokrovsky, V., Polishchuk, L., & Polischuk, S. (2017). The methodology for assessing the effectiveness of the therapy. Research Results in Pharmacology, 3, 91.

Roush, G. C., & Sica, D. A. (2016). Diuretics for hypertension: a review and update. American journal of hypertension, 29(10), 1130-1137. Pharmacotherapy for Cardiovascular Disorders Essay

Shattat, G. F. (2015). A review article on hyperlipidemia: types, treatments and new drug targets. Biomedical and Pharmacology Journal, 7(1), 399-409.

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Paper details

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.  As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. Pharmacotherapy for Cardiovascular Disorders paper

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

  • Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
  • Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. Pharmacotherapy for Cardiovascular Disorders Essay

Write a 2- to 3-page paper that addresses the following:

  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
  • Scenario: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:
  • Atenolol 12.5 mg daily
  • Doxazosin 8 mg daily
  • Hydralazine 10 mg QID
  • Sertaline 25 mg daily
  • Pharmacotherapy for Cardiovascular Disorders Essay

Practice Immersion Clinical Evaluation Tool

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Practice Immersion Clinical Evaluation Tool

Practice Immersion Clinical Evaluation Tool – Agency/Site

Agency/Site Criteria

Student Evaluation

   Faculty Evaluation Comments
Does Not Meet Meets Excels* Does Not Meet Meets Excels*
1.       Agency/site was able to provide the opportunities for the student to meet practice immersion clinical objectives. ☐ ☐ ☒ ☐ ☐ ☒
2.       Agency/site was able to establish a comfortable, yet stimulating, practice environment. ☐ ☐ ☒ ☐ ☐ ☒ Practice Immersion Clinical Evaluation Tool

Criteria:

Does Not Meet:  Elements are missing.

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Meets:  Agency/site meets this criterion.

Excels:  Agency/site meets this criterion and further a teaching point opportunity or expanded information, guidance, or other element to further enhance student learning. Practice Immersion Clinical Evaluation Tool

Agency/site – strengths:

Student Evaluation Faculty Evaluation
Practice Immersion Clinical Evaluation Tool

 

 

Agency/site – areas of improvement needed:                                                                                                                         

 

Student Evaluation Faculty Evaluation

 

Agency/site – Suggestions to incorporate more responsiveness to student learning needs:

Student Evaluation Faculty Evaluation

 

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Practice Immersion Clinical Evaluation Tool – Mentor

Clinical Criteria

Student Feedback of Mentor Experience

 Comments
Does Not Meet Meets Excels*
3.       Exemplify professionalism in diverse health care settings. ☐ ☐ ☒
4.       Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents. ☐ ☐ ☒
5.       Implement patient care decisions based on evidence-based practice. ☐ ☐ ☒
6.       Utilize patient care technology and information management systems. ☐ ☒ ☐
7.       Communicate therapeutically with patients. ☐ ☐ ☒
8.       Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care. ☐ ☐ ☒
9.       Understand the human experience across the health-illness continuum. Practice Immersion Clinical Evaluation Tool ☐ ☐ ☒
10.    Provide culturally sensitive care. ☐ ☐ ☒
11.    Preserve the integrity and human dignity in the care of all patients. ☐ ☐ ☒

Criteria:

Does Not Meet:  Elements are missing; mentor did not achieve.

Meets:  Mentor meets this criterion.

Excels:  Mentor meets this criterion and further incorporates a teaching point scenario or expanded information, guidance, or other element to further enhance student learning. Practice Immersion Clinical Evaluation Tool

 

Practice Immersion Clinical Evaluation Tool – Student

Clinical Criteria Mentor 

Sign Off

Faculty Sign Off

 Comments
Does Not Meet Meets Excels*
12.    Exemplify professionalism in diverse health care settings. ☐ ☐ ☐ ☒
13.    Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents. ☐ ☐ ☐ ☒
14.    Implement patient care decisions based on evidence-based practice. ☐ ☐ ☐ ☒
15.    Utilize patient care technology and information management systems. ☐ ☐ ☐ ☒
16.    Communicate therapeutically with patients. ☐ ☐ ☐ ☒
17.    Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care. ☐ ☐ ☐ ☒
18.    Understand the human experience across the health-illness continuum. ☐ ☐ ☐ ☒
19.    Provide culturally sensitive care. ☐ ☐ ☐ ☒
20.    Preserve the integrity and human dignity in the care of all patients. ☐ ☐ ☐ ☒

Criteria:

Does Not Meet:  Elements are missing; student is required to remediate this element to pass the course

Meets:  Student meets this criterion. Practice Immersion Clinical Evaluation Tool

Excels:  Student meets this criterion and further incorporates a teaching point scenario.

Practice_Immersion_Clinical_Evaluation_Tool

Practice Immersion Clinical Evaluation Tool

Leadership and management nursing Essay

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Identify one specific contemporary issue or trend that you are interested in learning more about. Choose from the categories below. For example you might want to learn more about why it is more difficult for some groups to receive care than others, which would fall under Client Access to Care. Or, you might want to compare nursing practice in the U.S. with how nurses practice in Japan, which would fall under the category of Global Healthcare and Nursing.

Global Healthcare and NursingHealthcare ReformU.S. Healthcare FinancingNursing\’s Role in the U.S. Healthcare SystemIntegrative HealthcareNursing Leadership and ManagementNursing EducationNursing PracticeNursing ProfessionalismAdvancing Nursing as a ProfessionClient Access to CareDelivering Client CareInterdisciplinary Teamwork and CollaborationEthical Practices in HealthcareQuality and Safety in Healthcare DeliveryHealth/Nursing Informatics

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Once the issue or trend is identified, find five important/significant facts about it, substantiated by an evidence-based article. Include the article in your submission. Leadership and management nursing Essay.

Create an 8-10 slide PowerPoint presentation with speaker notes, in-text citations and a reference page slide.

 

uLEADERSHIP AND MANAGEMENT: HEALTH CARE REFORM – ACA

unAme:

uInstitution:

uINTRODUCTION

uACA remains highly debated in USA.

uOperational for close to a decade.

uRemains contentious with divisive opinions over costs and benefits.

uReducing the number of uninsured individuals. Leadership and management nursing Essay

uIncreasing quality of care.

uReducing costs

uExpand insurance coverage

uImproved health care delivery systems

Affordable Care Act (ACA) is perhaps one of the most debated health care reform topics in the USA. Close to a decade since was enacted, ACA remains at the forefront of public policy debates. Although representing a significant achievement in health care reforms, it remains persistently contentious with divisive opinions over the associated costs and benefits, and whether it should be repealed or replaced. It is undeniable that the legislation has had a profound effect on health care delivery in the country, through substantially reducing the number of uninsured individuals, increasing quality of care, and reducing costs. These benefits have been realized through efforts targeted at expanding insurance coverage and improving health care delivery systems. Despite the significant benefits, ACAs continued presence appears uncertain owing to the public policy debates on the legislation (McIntyre & Song, 2019) Leadership and management nursing Essay.

uFACT #1: EXPANDED INSURANCE COVERAGE

uCreated marketplaces for health insurance.

uEncouraged choice and competition.

uSubsidized insurance plans.

uExpanded Medicaid program eligibility.

uTargeted persons living below poverty line.

ACA has expanded insurance coverage in two ways. Firstly, it has created marketplaces for health insurance through encouraging choice and competition. This allows the market to compare between many insurers and choose a plan that best fits the existing needs. Additionally, it has provided subsidized insurance plans for persons living below the poverty line. Secondly, it has expanded Medicaid program eligibility so that persons living below the poverty line can access insurance. Since it was enacted, insurance coverage has increased by approximately 20 million people (McIntyre & Song, 2019) Leadership and management nursing Essay.

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uFACT #2: RESHAPED PRIVATE INSURANCE

uEstablished new consumer protections.

uProtections against discriminations.

uProtected persons with pre-existing conditions.

uAbolished lifetime and annual limits.

uIntroduced dependent coverage provision.

ACA has improved private health insurance in three ways. It has established new consumer protections that have created a fairer market place. Under the legislation, private insurers are prohibited from discriminating against individuals on the basis of health status. Prior to the legislation, persons with preexisting conditions were required to pay higher premiums, and it was not uncommon for them to be denied insurance. In addition, the legislation abolished lifetime and annual limits on covered benefits Leadership and management nursing Essay. Besides that, the legislation introduced a dependent coverage provision that increased the age of children dependents up to 26 years of age thus allowing more young people to enjoy insurance coverage (McIntyre & Song, 2019). Leadership and management nursing Essay

uFACT #3: LEGISLATIVE CHALLENGES

u50 million attempts to repel the legislation.

uContinued survival a testament to ACA’s durability.

uPolitical debate challenging owing to vote implications.

The Senate and Congress have presented numerous legislative challenges targeted at ACA. For one, they have advanced more than 50 billion attempts to repeal the legislation either in part of whole. Its continued survival, although with slim legislative advantages, is a testament to the legislation’s legislative durability Leadership and management nursing Essay. Besides that, the political challenge of withdrawing health benefits for a significant proportion of the population has made the possibility of removing the bill insurmountable despite being on tenuous grounds divided along partisan lines (McIntyre & Song, 2019).

uFACT #4: CHALLENGES FROM TRUMP ADMINISTRATION

uUsed presidential veto power to terminate funding for cost reductions.

uReduced resource allocations towards public education and outreach activities.

uEliminated some consumer protections.

The Trump administration has repeatedly undertaken regulatory actions to undermine ACA, arguing that these actions promote state innovation and consumer choice. Firstly, the administration has used presidential veto power to unilaterally terminate funding for cost-reductions. This has negatively affected insurance enrollment through reducing supplemental subsidies so that some low income households are no longer able to afford health insurance. This action has also destabilized the insurance market Leadership and management nursing Essay. Secondly, it has reduced resources allocated to public education and outreach activities, resulting in low insurance enrolment. Thirdly, it has eliminated some of the consumer protections, such as allowing states modify Medicaid by requiring that nondisabled beneficiaries join the workforce before qualifying for insurance benefits (McIntyre & Song, 2019).

uFACT #5: JUDICIAL CHALLENGES

uThreat to legislative sustainability.

uTurned Medicaid expansion into a state option.

uJudicial rollback of subsidies on ACA marketplaces.

uTexas ruling of 2018 zeroed-out mandate as unconstitutional.

Judicial actions have been a threat to the legislation, particularly its sustainability. In 2012, the Supreme Court determined that Medicaid expansion was not a nationwide mandate but a state option. This has enabled some states to refuse to expand Medicaid program to include more persons living below the poverty line. Yet another challenge is judicial rollback of subsidies on ACA marketplaces. Another challenge in the Texas ruling of 2018 that made a ruling against the zeroed-out mandate as being unconstitutional. Since the mandate is an integral part of the legislation, then the implication is that the rest of ACA could also be scrapped Leadership and management nursing Essay. The case is currently before an appeals court, and there is a possibility of the judicial processes proceeding to the Supreme Court (McIntyre & Song, 2019). Leadership and management nursing Essay

uLOOKING FORWARD

uPossibility of repeal is dim.

uPossibility of stabilizing ACA also slim.

uVoter influence could have significant effects.

uDebate is an opportunity to rethink the role of government as represented by judiciary, legislature and executive.

Although the possibility of repealing ACA appears dim since the democrats control Congress, the possibility of stabilizing the legislation similarly appear slim. This is especially so in the face of Trump administration opposing the bill. Besides that, health care remains an important issue among voters, and politicians must consider the political repercussions of taking a stance. Leadership and management nursing Essay. Perhaps, the debate on ACA is an opportunity for the roles of the different arms of the government (judiciary, legislature and executive) in health care policy to be evolved.

uRECAP

uReference

uMcIntyre, A. & Song, Z. (2019). The US Affordable Care Act: reflections and directions at the close of a decade. PLoS Med, 16(2), e1002752. DOI: 10.1371/journal.pmed.1002752. Retrieved from https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002752 Leadership and management nursing Essay

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