Colorado Technical University Challenges Facing Electronic Health Records Paper

MHA 540 TUI Utilization Management Utilization Review and Case Management Essentials Paper
Assignment Overview With the consistently rising costs of health care services, utilization management and utilization rev …

MHA 540 TUI Utilization Management Utilization Review and Case Management Essentials Paper
Assignment Overview With the consistently rising costs of health care services, utilization management and utilization review are routinely used in the vast majority of current health care settings. How are they evolving over time, and what is involved in these processes? What do health care managers need to be aware of as the processes play out? In the absence of sweeping policy change (or the complete restructuring of the United States health care system), utilization management and utilization review are much more moderate processes to attempt to preserve the quality of care provided while controlling overall health care expenditures. Let’s learn a bit about each of these processes, and how they are implemented in our current health care environment. Case Assignment Using the information in the required readings as well as some additional research in peerreviewed sources, complete your Case Assignment by answering the following: Compare and contrast utilization review and utilization management in health care. What are the similarities and the differences between each type of assessment? (Hint: One is generally a prospective process, and the other is generally a retrospective process). Explain the specific role of each method in providing value-based health care. Who benefits from the method—the health care system, the insurance company, and/or the patient? Articulate how individual case management is critical to a hospital’s long-term survival. In what way does this practice protect your patients while keeping your doors open for business? What are the ethical pitfalls to be aware of in performing these types of quality reviews? What must health care managers be aware of in terms of ethical pitfalls and also potential unintended negative consequences? Assignment Expectations Conduct additional research to gather sufficient information to support your analysis. Provide a response of 3-5 pages, not including title page and references. As we have multiple required items to be addressed herein, please use subheadings to show where you’re responding to each required item and to ensure that none are omitted. Support your paper with peer-reviewed articles and reliable sources. Use at least three references, and a minimum of two of these from peer-reviewed sources. For additional information on how to recognize peer-reviewed journals, see:Angelo State University Library. (n.d.). Library Guides: How to recognize peer-reviewed (refereed) journals. Retrieved from https://www.angelo.edu/services/library/handouts/peerrev.php and for evaluating internet sources:Georgetown University Library. (n.d.). Evaluating internet resources. Retrieved from https://www.library.georgetown.edu/tutorials/research-guides/evaluating-internet-content You may use the following source to assist in your formatting your assignment:Purdue Online Writing Lab. (n.d.). General APA guidelines. Retrieved from https://owl.english.purdue.edu/owl/resource/560/01/. Paraphrase all source information into your own words carefully, and use in-text citations.Module 2 – BackgroundUtilization Management, Utilization Review, and Case Management EssentialsRequired Reading/ViewingView: Baker, J. (2018). Improving quality of care through utilization management [Video file]. Retrieved from https://youtu.be/g-T-YeP53nY Carasso, S. (2017). Is that test necessary? The key to laboratory utilization management.The Journal of Medical Practice Management: MPM, 33(3), 160-164. Retrieved from theTrident Online Library.Desai, S., Gruber, P. F., Eiting, E., Seabury, S. A., Mack, W. J., Voyageur, C., . . . Terp, S. (2017). The effect of utilization review on emergency department operations. Annals of Emergency Medicine, 70(5), 623-631.e1. Retrieved from the Trident Online Library.El-Othmani, M. M., Sayeed, Z., Ramsey, J. A., Abaab, L., Little, B. E., & Saleh, K. J. (2019).The joint utilization management program: Implementation of a bundle payment model and comparison between year 1 and 2 results. The Journal of Arthroplasty, 34(11), 2532-2537.Retrieved from the Trident Online Library.Parast, M. M., & Golmohammadi, D. (2019). Quality management in healthcareorganizations: Empirical evidence from the Baldrige data. International Journal of ProductionEconomics, 216, 133-144. Retrieved from the Trident Online Library.Suklar, S. (2018). Quality assurance system at primary level of healthcare. Izzivi Prihodnosti, 3(1), 21-53. Retrieved from the Trident Online Library.Wakefield, E., Keller, H., Mianzo, H., Nagaraj, C. B., Tawde, S., & Ulm, E. (2018). Reductionof health care costs and improved appropriateness of incoming test orders: The impact ofgenetic counselor review in an academic genetic testing laboratory. Journal of GeneticCounseling, 27(5), 1067-1073. Retrieved from the Trident Online Library.Optional ReadingInstitute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Available at https://www.ncbi.nlm.nih.gov/books/NBK222274/ (Use this link for free full text .pdf download).

Grand Canyon University Employment Law Scenario Analysis Paper
Write a 750-1,000 word paper in which you review public policy and how it affects employment. Address the following scenar …

Grand Canyon University Employment Law Scenario Analysis Paper
Write a 750-1,000 word paper in which you review public policy and how it affects employment. Address the following scenarios: Scenario 1: Nurse Deb was due for her annual flu vaccination as mandated by her hospital’s policy. Nurse Deb is a big supporter of the antivaccination movement and refused to obtain her annual flu vaccination. Upon notice that nurse Deb did not obtain the vaccination, the nurse manager fired Nurse Deb. Nurse Deb has decide to file a wrongful termination suit. As the director of nursing, how would you handle this situation? What evidence does Nurse Deb have that could help her win the case? What law protects the hospital’s mandated vaccination procedures? How concerned should the hospital be if the lawsuit is a success? If the lawsuit is a success, how does this impact workplace safety and the obligation of the health care facility to provide protection? Scenario 2: Joe Gomez worked as a plant operations specialist at Premier Hospital. While Joe’s manager was working on the HVAC system that protects patients from harmful viruses and bacteria, he noticed that he was not using OSHA-approved filters. Joe felt that it was important to report this to the compliance officer. The day following his report, Joe was fired by his manager. As the CEO of Premier Hospital, how would you handle the situation? How concerned should you be about the termination of Joe? What legal principles are involved and how do they reinforce workplace safety? If Joe was a member of the local employee services union, does this make the termination different? Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Legal and Ethical Issues for Health Professionals Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Burlington, MA: Jones and Bartlett Learning. ISBN-13: 9781284144185

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