What challenges related to payment for services do you anticipate your selected patient may experience?

Use the Internet or other resources to find an article that describes a negotiation situation that resulted in one or both parties seeking a formal intervention resolution.
In an ideal healthcare delivery system, all patients would have access to affordable, high-quality health services that are well coordinated to ensure the continuity and comprehensiveness of care. In reality, patients may have vastly different experiences based on their health problem or injury, the organizations that provide services close to where they live, and how the health services they need are financed.

Consider, for example, a 56-year-old man who has a hemorrhagic stroke in a rural area of Alaska. What services will he need through the duration of his recovery experience? Where will he receive care? How will he pay for the services he needs? Now think about how his situation might compare with that of a 42-year-old woman in Houston, Texas, who arrives at her annual gynecological exam with symptoms associated with ovarian cancer. How might the two patients’ experiences compare in terms of care coordination and the continuity and comprehensiveness of services they receive?

For this Assignment, you will examine the continuum of care a patient may need and research the services available in your area to support the patient. You will convey your findings in a compelling presentation and will use these findings in the Week 4 Discussion as well.

To develop the content for your presentation, record detailed notes as you complete the following steps:

Review the information about the continuum of care and coordination among various health services organizations in the Resources, including the HIMSS resource, Continuum of Care, and the tables in Chapter 1 of the course text.
Read the Week 3 Assignment Patient Information, and select one hypothetical patient on which to focus for this Assignment. Assume your selected patient lives in your local area. If you are an international student, you may choose a geographic area in the United States or use your own location.
Use the pertinent information in Chapters 7, 8, 9, and/or 10 of the Shi and Singh course text and conduct additional research of your own to analyze specific services your hypothetical patient might need, beginning with the onset or diagnosis of an illness or injury and concluding with an end-point of your choosing (i.e., recovery, symptom management, end of life). Also research the types of organizations that provide those services.
Investigate the healthcare organizations in your local area. Based on the services your hypothetical patient needs, select three or four actual settings in which he/she would receive care.
Next, gather information related to the types of insurance each organization accepts. Typically, this would include Medicare, Medicaid, and various types of insurance programs. What challenges related to payment for services do you anticipate your selected patient may experience?
Review the Institute for Healthcare Improvement (2014) resource and consider what it means for healthcare to be safe, effective, patient-centered, timely, efficient, and equitable. Based on your hypothetical patient’s needs, analyze why professionals in healthcare settings need to be aware of the six Institute of Medicine Aims.
Next, prepare to create your presentation using PowerPoint. Examine the Presentation Guidelines and Tips and the Week 3 Assignment Template (both are located in this week’s Resources).

The Assignment


 

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