Describe challenges and barriers to access, affordability, and availability for individuals with and without insurance.

Describe challenges and barriers to access, affordability, and availability for individuals with and without insurance.

HE003: Delivery of Services

Short Answer Submission Form

Your Name: First and last

Your E-Mail Address: Your email here

Instructions
Write your responses where it reads “Enter your response here.” Write as much as needed to satisfy the requirements indicated. Each item contains the Rubric which will be used to evaluate your responses.

1. Raymond is a 54-year-old man who lives in a rural part of Mississippi. He is a skilled worker but his job does not provide health insurance. Raymond does not qualify for Medicaid, and he cannot pay for health insurance. He has not received consistent or coordinated healthcare for most of his life. The closest clinic is over 30 miles away, and he does not have the money for both the co-pays and gas. Raymond has been diagnosed with hypertension, and his family history includes pulmonary embolisms and heart disease.

Emmanuel is 55-year-old man who lives in Jackson, Mississippi. He is an office manager and receives insurance from his employer. Emmanuel has had annual medical and dental exams from the same providers for several years. Emmanuel has a family history of Type 2 diabetes and he was recently diagnosed as pre-diabetic and obese. Emmanuel received referrals to an endocrinologist and a registered dietitian, and he was instructed to increase his physical activity.

· Describe the challenges and barriers to access; affordability; and availability for Raymond and Emmanuel. (1–2 pages)

· Describe the potential social, economic, and health outcomes for Raymond and Emmanuel if prevention had a higher priority in the US. (1 page)

Your Response

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Rubric

0

Not Present

1

Needs Improvement

2

Meets Expectations

3

Exceeds Expectations

Sub-Competency 1: Describe how the delivery of care is affected for those with and without insurance in relation to cost, quality, and access.

Learning Objective

LO 1.1: Describe challenges and barriers to access, affordability, and availability for individuals with and without insurance.

Comparisons between patients’ history of care and possible health outcomes are missing.

Response inaccurately describes the different challenges and barriers to access, affordability, and availability for the individuals in the case presented. Or, issues of access, affordability, and/or cost are not discussed.

Challenges and barriers do not illuminate differences between insured and uninsured individuals.

Response accurately describes the different challenges and barriers to access, affordability, and availability for the individuals in the case presented.

Challenges and barriers illuminate differences between insured and uninsured individuals.

Response demonstrates the same level of achievement as “2,” plus the following:

Response includes examples about how health insurance affects patient and population health outcomes and impacts life expectancy.

Response describes challenges and barriers for a third individual (hypothetically) to highlight additional nuances related to access, affordability, and availability of individuals with and without insurance.

Learning Objective

LO 1.2: Describe potential social, economic, and health outcomes if prevention has a higher priority in the U.S.

Description of potential social, economic, and health outcomes if prevention has a higher priority in the U.S. is missing.

Response vaguely or inaccurately describes potential social, economic, and health outcomes for the individuals in the case presented, given an increase in preventative care in the US, or Response does not address the situations of both individuals in the case.

Response accurately describes potential social, economic, and health outcomes for the individuals in the case presented, given an increase in preventative care in the US.

Response demonstrates the same level of achievement as “2,” plus the following:

Response provides examples of two preventative care programs and how they affect social, population, economic, and health outcomes.

2. Define the continuum of care process, including objectives and the relationship to organizations and patients. (2–3 sentences)

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Rubric

Sub-Competency 2: Explain the continuum of care process in a variety of settings.

Learning Objective

LO 2.1: Define the continuum of care process.

Definition of the continuum of care process is missing.

Response vaguely defines the continuum of care process.

Response clearly defines the continuum of care process, including objectives and the relationship to organizations and patients.

Response demonstrates the same level of achievement as “2,” plus the following:

Response provides examples that illustrate the benefits of the services along the continuum of care.

3. Describe the following settings and types of care, including objectives and basic components. (2–3 sentences each)

· Primary care

· Secondary (general hospital)

· Tertiary (teaching)

· Specialty hospitals

· Outpatient programs (surgery, outpatient rehab)

· Nursing homes

· Rehabilitation settings

· Assisted living

· Home health

· Hospice

Your Response

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Rubric

Sub-Competency 2: Explain the continuum of care process in a variety of settings.

Learning Objective

LO 2.2: Describe various healthcare settings and types of care.

Descriptions of various healthcare settings and types of care is missing.

Response inaccurately describes the following settings and types of care and/or does not include objectives and basic components.

· Primary care

· Secondary (general hospital)

· Tertiary (teaching)

· Specialty hospitals

· Outpatient programs (surgery, outpatient rehab)

· Nursing homes

· Rehabilitation settings

· Assisted living

· Home health

· Hospice

Response describes the following settings and types of care, including objectives and basic components.

· Primary care

· Secondary (general hospital)

· Tertiary (teaching)

· Specialty hospitals

· Outpatient programs (surgery, outpatient rehab)

· Nursing homes

· Rehabilitation settings

· Assisted living

· Home health

· Hospice

Response demonstrates the same level of achievement as “2,” plus the following:

Response describes how the services may be coordinated for a particular patient.

4. Describe the personnel who should be part of a multidisciplinary team that focuses on patient-centered care in an inpatient setting. Include at least six disciplines and provide a rationale for each, including each member of the team. (1 page)

Your Response

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Rubric

Sub-Competency 3: Explain processes, roles, and responsibilities in the delivery of healthcare.

Learning Objective

LO 3.1: Describe the disciplines that should be part of a multidisciplinary team for a particular healthcare context.

Description of the disciplines that should be included in a multidisciplinary team is missing.

Response vaguely describes, or describes fewer than six disciplines that should be part of a multidisciplinary team focused on patient-centered care in an inpatient setting.

Response provides limited or illogical justification for inclusion of the disciplines chosen.

Response thoroughly describes at least six disciplines that should be part of a multidisciplinary team focused on patient-centered care in an inpatient setting.

Response provides a logical justification for the choice of disciplines included in the multidisciplinary team.

Response demonstrates the same level of achievement as “2,” plus the following:

Response describes how team composition and expertise benefit patient outcomes.

5. You are assisting the human resource director at a large general hospital. As part of a report to the chief executive officer (CEO), she has asked you to outline specific roles and goals for at least three clinical, three technical, and three administrative departments (minimum of nine departments). List these hospital departments, and describe the roles and goals of each. (1–2 pages)

Your Response

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Rubric

Sub-Competency 3: Explain processes, roles, and responsibilities in the delivery of healthcare.

Learning Objective

LO 3.2: Define the roles of clinical, technical, and administrative professions in the delivery of healthcare.

Description of the roles and goals of hospital departments is missing.

Response vaguely describes the roles and goals of hospital departments.

Response thoroughly describes at least three roles and one goal of clinical, technical, and administrative departments.

Response demonstrates the same level of achievement as “2,” plus the following:

Response describes how the departments work together to achieve organizational and outcome goals.

6. Admission policies can differ between various types of healthcare organizations. Provide compare and contrast how admission policies could differ between for-profit and nonprofit organizations, and how this difference relates to access to care.

Your Response

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Rubric

Sub-Competency 3: Explain processes, roles, and responsibilities in the delivery of healthcare.

Learning Objective

LO 3.3: Explain how admission policies differ in various types of healthcare organizations and how this relates to access to care.

Explanation about how admission policies differ in various types of healthcare organizations and how this relates to access to care is missing.

Response vaguely explains how admission policies differ in various types of healthcare organizations and how this relates to access to care; and/or the differences between for-profit and not-for-profit healthcare organizations are unclear or missing; and/or only one difference is addressed.

Response clearly explains two differences about how admissions policies differ in various types of healthcare organizations and how this relates to access to care.

Response includes differences between for-profit and not-for-profit healthcare organizations.

Response demonstrates the same level of achievement as “2,” plus the following:

Response provides clearly written descriptions of two types of nonprofit and two types of for-profit hospitals and the types of patients they serve.

7. There are many different organizations and institutions that are major players in the healthcare system. Briefly describe how each of the following influences healthcare: (4–6 sentences each). Please consult at least one reference other than the website in formulating your answer, for each organization.

· Pharmaceutical Research and Manufacturers of America (PhRMA)

· Food and Drug Administration (FDA)

· American Medical Association (AMA)

· American Hospital Association (AHA)

· Joint Commission (JC)

· Centers for Medicare and Medicaid Services (CMS)

· State Department of Health (student’s state)

· Centers for Disease Control and Prevention (CDC)

· U.S. Department of Health and Human Services

Your Response

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Rubric

Sub-Competency 4: Describe the organizations and institutions that are major players in the healthcare system.

Learning Objective

LO 4.1: Describe how major healthcare organizations and institutions influence healthcare.

Description of how major healthcare organizations and institutions influence healthcare is missing.

Response vaguely or incompletely describes how each of the following influences healthcare:

· Pharmaceutical Research and Manufacturers of America (PhRMA)

· Food and Drug Administration (FDA)

· American Medical Association (AMA)

· American Hospital Association (AHA)

· Joint Commission (JC)

· Centers for Medicare and Medicaid Services (CMS)

· State Department of Health (student’s state)

· Centers for Disease Control and Prevention (CDC)

· U.S. Department of Health and Human Services

Response clearly and accurately describes how each of the following influences healthcare:

· Pharmaceutical Research and Manufacturers of America (PhRMA)

· Food and Drug Administration (FDA)

· American Medical Association (AMA)

· American Hospital Association (AHA)

· Joint Commission (JC)

· Centers for Medicare and Medicaid Services (CMS)

· State Department of Health (student’s state)

· Centers for Disease Control and Prevention (CDC)

· U.S. Department of Health and Human Services

Response demonstrates the same level of achievement as “2,” plus the following:

Response provides examples about how patients are directly impacted by two or more of these major players.

8. Define vertically integrated health systems and horizontally integrated systems, including the business goals and patient outcomes. Then, explain the impact these systems have on healthcare today. (1 page)

Your Response

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Rubric

Learning Objective

LO 4.2: Define vertically and horizontally integrated health systems.

Definition of vertically and horizontally integrated health systems is missing.

Response vaguely defines vertically and horizontally integrated health systems and/or does not include the business goals and/or patient outcomes.

Response vaguely explains how these systems impact healthcare today.

Response clearly defines vertically and horizontally integrated health systems, including the business goals and patient outcomes.

Response explains how these systems impact healthcare today.

Response demonstrates the same level of achievement as “2,” plus the following:

Response provides an example of vertically and horizontally integrated health systems.