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Analysis of Pertinent Health Issue

Analysis of Pertinent Health Issue

Sample Answer 

Analysis of Pertinent Health Issue

Description of the National Issue/Stressor and Its Impact on the Organization

The rising cost of health care is one of the primary issues facing most Americans today, affecting the achievement of the Quadruple Aim. As a result, the country has recorded a drop in the number of employers (companies) willing to enroll their employees in comprehensive employment-based private insurance (EBPI) plans. Studies have shown that despite federal spending on healthcare increasing, the cost of taking insurance plans has never dropped. For example, in the 2017 financial year, the U.S. spent a total of $3.5 trillion (which represents 18% of the gross domestic product) on healthcare services – a figure that is more than double the average amount spent by most developed European economies (Committee for a Responsible Federal Budget, 2018). In simple terms, this translates to roughly $17,000 per individual. However, reports still indicate that EBPI rates have increased over time. For example, a single coverage has jumped from $432 to approximately $789 between 1996 and 2006. Family coverage has increased from $1.305 to roughly $2,890 (Buchmueller & Monheit, 2009).

These high insurance costs are negatively impacting my work environment significantly. Specifically, for fear of attracting higher EBPI plan costs, our small insurance company has failed to increase staff members. Because the Patient Protection and Affordable Care Act policy, which became effective on 1 Jan 2014, stipulates that employers or companies with more than 50 employers must register their staff members on an EBPI plan, the rising cost of care means that fewer employers can meet this requirement. In fact, because failure to do so can attract a penalty of nearly $2,000, reports suggest that most small-scale businesses fear expanding their workforce past the fifty mark to avoid paying the hefty EBPI costs (Yu & Dick, 2012).

This is a major challenge as an organization because we are understaffed, overworked, underpaid, and demoralized. Presently, we are about 45 employees serving more than 10 locations. This implies that some of us work without rest or a holiday break. Most importantly, the insurance firm has blatantly failed to enroll most of us in the EBPI plan because it is too expensive.

In response to the increasing costs of care, which have also left most employees uninsured, our organization has taken the initiative to lobby for policy changes to reduce the premiums, co-pays, and deductibles associated with EBPI. With a relatively lower EBPI, most health insurance companies and care facilities (especially startups) can afford to hire more staff members and pay for their employment insurance plans. Our organization is also pushing for the federal government to increase the tax subsidy provided to employers with more workers – an initiative that will increase participation (Buchmueller & Monheit, 2009). Finally, we are pushing for the government to implement managed care as the defining insurance plan as well as implement an employee-based system of care.

Summary of the Articles Reviewed on the National Healthcare Stressor/Issue and How It is Being Addressed

The first article by Buchmueller & Monheit (2009) analyzes one of the major problems affecting the achievement of the Quadruple Aim in American healthcare institutions – the dwindling fortunes of the EBPI. According to the two researchers, employers play a fundamental role in lowering the cost of care in America by financing health insurance plans. In particular, the two experts explore some of the initiatives, especially through legislation, that can positively impact healthcare reform, encouraging employers to consider taking workplace insurance plans for their staff members. In response to the crises facing employer-sponsored insurance (ESI), the authors suggest two main remedial measures: mandatory participation and voluntary participation. Specifically, mandatory participation should be categorized into individual (nongroup insurance and ESI) and comprise subsidies, income exemptions, penalties, and enforcement. On the other hand, the employer category should also be categorized into two (including all play and pay or play). Subsidies and exemptions (based on hours, wages, and firm size) are also the main policy changes the government should implement. As for voluntary participation, the authors suggest that coverage should be categorized into ESI and nongroup insurance, which should also consist of outreach programs, eligibility for subsidy measures, and subsidies.

Whereas the first article suggests plans for improving EBPI or ESI healthcare plans, the second article by Yu & Dick (2012) attempts to put into perspective the overall effects of the rising cost of health care on individuals and families enrolled in employment-based private insurance. In their conclusion, the two authors suggest that the rising cost of healthcare can potentially reduce EBPI enrollment and availability, as well as the financial security guaranteed by this plan, particularly for low-income earners.

Summary of the Strategies used to Address Organizational Impact of the National Care Stressor and How they Might Impact My Organization

The two main approaches suggested include mandatory participation and voluntary participation. Mandatory participation comprises subsidies, income exemptions, penalties, and enforcement. The advantage of this to my organization is that subsidies and income exemptions will possibly lower the cost and affordability of the EBPI plans, meaning that the insurance firm will employ more people and will provide employer-based cover for every employee. The downside is that mandatory penalties and enforcement can potentially scare the company from implementing the changes for fear of attracting a severer punishment. Some might view these mandatory rules as being draconian in nature.

The second strategy suggested is voluntary participation, which comprises subsidies and exemptions based on hours, wages, and firm size. The benefit of voluntary participation is that such policy changes are friendly in nature and can encourage more participation. Our company will likely enroll most of us in the EBPI plan because it can voluntarily withdraw its membership and sponsorship if it finds the rules inconvenient or unpleasant. However, the only downside is that the company might not even be interested in the plan because it is voluntary rather than compulsory.

References

Buchmueller, T. C., & Monheit, A. C. (2009). Employer-sponsored health insurance and the promise of health insurance. Inquiry, 46, 187-202. Retrieved from https://journals.sagepub.com/doi/pdf/10.5034/inquiryjrnl_46.02.187

Committee for a Responsible Federal Budget. (2018). American health care: Health spending and the federal budget. Retrieved from http://www.crfb.org/papers/american-health-care-health-spending-and-federal-budget

Park, B., et al. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388

Auerbach, D. I., Staiger, D. O., &Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869

Yu, H., & Dick, A. W. (2012). Impacts of rising health care costs on families with employment-based private insurance: A national analysis with state fixed effects. Health Services Research, 47(5), 2012-2030. doi: 10.1111/j.1475-6773.2012.01397.x

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Question 


Analysis of Pertinent Health Issue

Assignment Details

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

Analysis of Pertinent Health Issue

Analysis of Pertinent Health Issue

To Prepare:

  • Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
  • Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
  • Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

  • Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
  • Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
  • Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

 

Required Readings

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

  • Chapter 2, “Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 37–62)
  • Chapter 3, “Current Challenges in Complex Health Care Organizations: The Triple Aim” (pp. 63–86)

Read any TWO of the following (plus TWO additional readings on your selected issue):

Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869

Note: You will access this article from the Walden Library databases.

Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aa

Note: You will access this article from the Walden Library databases.

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303

Note: You will access this article from the Walden Library databases.

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230

Note: You will access this article from the Walden Library databases.

Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005

Note: You will access this article from the Walden Library databases.

Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388

Note: You will access this article from the Walden Library databases.

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from

https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3 

Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040

Note: You will access this article from the Walden Library databases.

Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531

Note: You will access this article from the Walden Library databases.

Rubric Detail

The response accurately and thoroughly describes in detail the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate, clear, and detailed data to quantify the impact of the national healthcare issue/stressor selected.

A complete, detailed, and specific synthesis of two outside resources reviewed on the national healthcare issue/stressor selected is provided. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided.

The response accurately and thoroughly explains in detail how the healthcare issue/stressor is being addressed in other organizations.

A complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response accurately and thoroughly explains in detail how the strategies may impact an organization both positively and negatively, with specific and accurate examples.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

Uses correct grammar, spelling, and punctuation with no errors.

Uses correct APA format with no errors.

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