27 Mar What does Heide pay out-of-pocket and what does Medicare pay for the acute hospitalization phase, skilled nursing facility, rehabilitation services, nursing home care, home health services, personal care, and prescriptions?

Choose one of the health care agencies discussed in Unit Two and discuss a current policy issue that involves that entity (examples: mental health, home health, women’s health, long-term care, community health centers, VA, etc.).

Consider how the Affordable Care Act effects the agency.

Consider any ethical or legal concerns within the health care agency.

Propose a policy that may influence health outcomes within the agency.

How would the needed policy be best implemented?

 

Heide, aged 72, has both Medicare A and B coverage without Medicaid or a Medigap policy. Heide is hospitalized for a cerebral vascular event (stroke) due to a deep vein thrombus of the leg with pulmonary embolus. She is in the hospital for 70 days during the acute phase for care. She is being seen by a nurse practitioner, neurologist, and pulmonary medicine. Her condition has improved somewhat and she is being transferred to the skilled nursing facility for rehabilitation. She stays in the facility for 30 days, but remains unable to care for herself at home. Heide is sent to a nursing home for custodial care where she lives for three months. Surprisingly, she experiences great improvement in functionality. Heide is released to return to her own home where she received physical therapy from a home health agency. She also has home care services provided for 4 hours a day, three times a week. This service aids in buying food, cooking, and light cleaning of the home. Heide has seven medications for maintenance care.

What does Heide pay out-of-pocket and what does Medicare pay for the acute hospitalization phase, skilled nursing facility, rehabilitation services, nursing home care, home health services, personal care, and prescriptions? (Payment)

What ethical dilemmas are present in Heide’s case? (Ethical)

How do the following concepts impact the situation? (Community):

Community-based care

HEDIS

Health policy needs

Patient advocacy

If Heide lived in a rural community, how would the concept of “critical access hospitals” impact this situation? (Rural)

 

 

Address the above content in a PowerPoint slide set. (This assignment requires only the PowerPoint slides. It does not require an accompanying recorded presentation.) Be sure to reference at least 2 current peer-reviewed sources in your slides (less than 5 years old). Your slide set should include the following elements for a total of 10 slides:

 

Title slide

One slide per bullet point from question one (4 slides) and two (4 slides)

References slide with sources listed in APA format, also be sure to include in-text citations on individual slides

 

 

***Pertinent information should be included on the slide itself, not in the “notes” view. Only the slides will be viewed for grading.

 

Healthcare Delivery and Financing PPT Rubric

Healthcare Delivery and Financing PPT Rubric

Criteria Ratings Pts

Question 1: ACA effect on chosen agenc

Excellent

Summary of the ACA affects chosen agency is well articulated.

Question 1: Ethcial or legal concerns

Excellent

Thoroughly discusses ethical or legal concerns within chosen agency.

Question 1: Proposes Policy

Excellent

Proposed policy for chosen agency and discussion of how it affects health outcomes is well articulated.

Question 1: Implementation

Excellent

Thoroughly discusses implementation of proposed policy.

 

Question 2: Payment

 

Excellent

Addresses the question; includes both Heide’s and Medicare’s payment for all 7 of the components.

 

 

Question 2: Ethical

Discussions of ethical dilemmas is well articulated.

Question 2: Community

Excellent

Discusses all 4 of the concepts thoroughly with clear understanding.

Question 2: Rural

Excellent

Discussion of the effect of critical access hospitals on rural healthcare is well articulated.

Organization and Formatting

Excellent

APA guidelines consistently followed on presentation/ reference slides (0 APA errors). Includes 2 current peer-reviewed references. Presentation contains 10 slides, including a title and reference slide.

Grammar, spelling, and punctuation

Excellent

Presentation contains 0-1errors in grammar, punctuation, and spelling.