HC233 Herzing Week 1 Original Medicare Plans And Managed Medicare Plans PPT

Unit 1 Assignment – Patient Handout

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  • Due Sunday by 11:59pm
  • Points 100
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You are a health care manager at Herzing Hospital. The patient population at your organization is insured by the following: 45% Medicare – original plans, 35% Medicare – managed plans (Advantage plans), and 20% Other.

Instructions

  • Create a handout for your staff to provide to patients and refer to in their interactions with patients. In this handout, include the following:
  • Assess the similarities and differences between original Medicare plans and managed Medicare plans (Advantage plans) by comparing strengths and weaknesses to the consumers. Include information such as:
    • Strengths/weaknesses of original Medicare plans and managed Medicare plans (Advantage plans).
    • The effect on your hospital in terms of operational impact, tactical impact, and impact on the strategic plan (remember, you are the manager).
  • Provide two recommendations for improvement (i.e. financial and quality), including your justification of each managed care plan.

Rubric

Unit 1 Assignment – Patient Handout

Unit 1 Assignment – Patient Handout

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeContent

50.0 pts

Level 5

Demonstrates the ability to construct a clear and insightful problem statement/thesis statement/topic statement with evidence of all relevant contextual factors.

45.0 pts

Level 4

Demonstrates the ability to construct a problem statement, thesis statement/topic statement with evidence of most relevant contextual factors, and problem statement is adequately detailed.

40.0 pts

Level 3

Begins to demonstrate the ability to construct a problem statement/thesis statement/topic statement with evidence of most relevant contextual factors, but problem statement is superficial.

35.0 pts

Level 2

Demonstrates a limited ability in identifying a problem statement/thesis statement/topic statement or related contextual factors.

30.0 pts

Level 1

Demonstrates the ability to explain contextual factors but does not provide a defined statement.

0.0 pts

Level 0

There is no evidence of a defined statement.

50.0 pts

This criterion is linked to a Learning OutcomeAnalysisPRICE-P

35.0 pts

Level 5

Organizes and compares evidence to reveal insightful patterns, differences, or similarities related to focus.

31.5 pts

Level 4

Organizes and interprets evidence to reveal patterns, differences, or similarities related to focus.

28.0 pts

Level 3

Organizes and describes evidence according to patterns, differences, or similarities related to focus.

24.5 pts

Level 2

Organizes evidence, but the organization is not effective in revealing patterns, differences, or similarities.

21.0 pts

Level 1

Describes evidence, but it is not organized and/or is unrelated to focus.

0.0 pts

Level 0

Lists evidence, but it is not organized and/or is unrelated to focus.

35.0 pts

This criterion is linked to a Learning OutcomeWriting

10.0 pts

Level 5

The paper exhibits an excellent command of written English languageconventions. The paper has no errors in mechanics, grammar, or spelling.

9.0 pts

Level 4

The paper exhibits a good command of written English language conventions. The paper has no errors in mechanics or spelling with minor grammatical errors that impair the flow of communication.

8.0 pts

Level 3

The paper exhibits a basic command of written English language conventions. The paper has minor errors in mechanics, grammar, or spelling that impact the flow of communication.

7.0 pts

Level 2

The paper exhibits a limited command of written English language conventions. The paper has frequent errors in mechanics, grammar, or spelling that impede the flow of communication.

6.0 pts

Level 1

The paper exhibits little command of written English language conventions. The paper has errors in mechanics, grammar, or spelling that cause the reader to stop and reread parts of the writing to discern meaning.

0.0 pts

Level 0

The paper does not demonstrate command of written English language conventions. The paper has multiple errors in mechanics, grammar, or spelling that cause the reader difficulty in discerning the meaning.

10.0 pts

This criterion is linked to a Learning OutcomeAPAPRICE-I

5.0 pts

Level 5

The required APA elements are all included with correct formatting, including in-text citations and references.

4.5 pts

Level 4

The required APA elements are all included with minor formatting errors, including in-text citations and references.

4.0 pts

Level 3

The required APA elements are all included with multiple formatting errors, including in-text citations and references.

3.5 pts

Level 2

The required APA elements are not all included and/or there are major formatting errors, including in-text citations and references.

3.0 pts

Level 1

Several APA elements are missing. The errors in formatting demonstrate a limited understanding of APA guidelines, in-text-citations, and references.

0.0 pts

Level 0

There is little to no evidence of APA formatting and/or there are no in-text citations and/or references.

5.0 pts

Total Points: 100.0

Expert Solution Preview

Introduction:
As a healthcare manager at Herzing Hospital, this patient handout aims to provide information for patients and help them understand the similarities and differences between original Medicare plans and managed Medicare plans (Advantage plans). Additionally, this handout includes the impact of these plans on the hospital’s operational, tactical, and strategic plan and two recommendations for improvement.

Content:
Both the original Medicare plan and the managed Medicare plan (Advantage plan) offer coverage for healthcare services such as hospital visits, doctor’s visits, and preventive care. The original Medicare plan is funded and managed by the federal government, while the Advantage plan is managed by private insurance companies contracted by Medicare.

The strengths of original Medicare plans include:

– More freedom in choosing healthcare providers.
– Covers most kinds of care without restrictions.
– The overall cost is divided into coinsurance, premiums, and deductibles.

The weaknesses of original Medicare plans include:

– There is a gap incoverage which requires enrollees to pay additional costs, especially in prescription drugs. 
– Limited coverage for dental, vision, and hearing.
– Payments may not cover the full cost of healthcare services.

On the other hand, the strengths of managed Medicare plans (Advantage plan) include:

– Extra coverage on top of the traditional Medicare plan.
– Low out-of-pocket costs by capping annual out-of-pocket spending.
– More comprehensive prescription drug coverage.

The weaknesses of the managed Medicare plan (Advantage plan) include:

– Limited freedom in healthcare providers; only providers within the network are covered.
– May require prior authorization before conducting some procedures.
– More restrictive when it comes to seeking healthcare services outside of the coverage area.

In terms of impact on the hospital’s operations, managed Medicare plans (Advantage plan) may result in an increase in the number of patients. This coverage guarantees low out-of-pocket spending, making healthcare services more accessible and affordable to patients. However, it might have a tactical impact since it restricts the freedom of patients and healthcare providers outside the network.

As a healthcare manager, it is essential to improve the financial and quality aspects of these care plans. One recommendation for financial improvement is to reduce the overall cost and gaps in coverage in the original Medicare plan. This improvement will make healthcare services more accessible and affordable to patients.

A quality improvement recommendation is to regulate coverage to ensure that the managed Medicare plan (Advantage plan) matches the needs of patients’ healthcare services. This improvement will guarantee healthcare services are comprehensive, accessible, and of good quality.

Conclusion:
The handout aims to educate patients about the similarities and differences between original Medicare plans and managed Medicare plans (Advantage plan). Additionally, the handout highlights the impact of these plans on the hospital’s operational, tactical, and strategic plan. Furthermore, two recommendations aimed at improving the financial and quality aspects of care plans are provided.

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