Loading...

Messages

Proposals

Stuck in your homework and missing deadline? Get urgent help in $10/Page with 24 hours deadline

Get Urgent Writing Help In Your Essays, Assignments, Homeworks, Dissertation, Thesis Or Coursework & Achieve A+ Grades.

Privacy Guaranteed - 100% Plagiarism Free Writing - Free Turnitin Report - Professional And Experienced Writers - 24/7 Online Support

Introduction to healthcare quality management second edition pdf

16/10/2021 Client: muhammad11 Deadline: 2 Day

Healthcare Management Search Questions

Use the sample managed care contract of the Illinois Department of Healthcare and Family Services (the Illinois Medicaid agency) in the following link to answer the following questions: https://www.illinois.gov/hfs/SiteCollectionDocuments/201824001MCOModelContractRev3RedLine.pdf .

A. (2 points) Identify the section of the contract that names the parties to the contract.

i. Who are the parties to the contract?

ii. Which party is the Medicaid agency and which party is the managed care plan?

B. (2 points) Which party is paying for the services in the contract?

C. (6 points) Identify the sections of the contract which describe the following payment methodologies and describe the payment methodologies:

i. the base payment methodology

ii. sanction methodology

iii. bonus methodology

D. (30 points) Chapters 8, 10 and 11, respectively, discuss improving patient safety, utilization management, and organizing for quality.

i. (9 points) Organizing for Quality

a. Identify the section(s) of the contract that mandate that the managed care plan has a quality management system in place

b. Describe the quality management system that the contractor is required to implement

c. Identify the stakeholders involved and give an opinion as to why you think there is a mandate in the contract to include these stakeholders

d. Identify the topics selected for performance measure and improvement activities

ii. (9 points) Patient Safety Management

a. Identify the sections and describe two topic areas where patient safety is required

b. Describe the patient safety quality requirements

c. Identify the stakeholders involved and give an opinion as to why you think there is a mandate in the contract to include these stakeholders

d. Identify the sections where performance improvement tools are recommended for the patient safety guidelines and describe the tools

e. Identify the sections where data sources are recommended for the patient safety guidelines and describe the sources

f. Identify the sections and describe two performance measures used

iii. (9 points) Utilization Management

a. Identify the section(s) and describe the utilization review guidelines

b. Identify the sections and describe 2 of the following:

- the performance measures and standards used

- benchmarks used

- tools used

c. Identify the section and definition of the utilization management program

d. Identify one section where continuous improvement is required and describe the improvement

e. How and where is medical necessity defined?

f. Identify and describe one section of the contract that mandates

- prospective medical necessity review

- concurrent medical necessity review

- retrospective medical necessity review

g. Identify the section and describe the medical conditions for which clinical practice guidelines and best practices are required

h. Identify the section and describe the organizations and committees used to establish the basis for the clinical practice guidelines

iv. (1 point) Identify the sections of the contract where the Medicaid agency is demanding that the contractor address issues in Medicaid recipients access transportation and use of telemedicine. Describe the contractual requirements.

v. (1 point) Identify two sections of the contract where there are environmental requirements of the contractor related to state and federal environmental protection agencies. Give an opinion as to why these requirements exist.

vi. (1 point) Identify the section of the contract and the organization(s) responsible for accrediting the managed care plans.

4. Conduct an internet search for the following quality models for improving patient safety: Failure Mode and Effects Analysis (FMEA) and Root Cause Analysis (RCA).

a. Find an example of each model. For each model, identify the internet site and the date.

b. (9 points) For the FMEA model, identify:

i. The process that is being reviewed

ii. Process steps

iii. Potential failure mode for each step

iv. Potential effect of each step

v. The criticality score of each step

vi. The critical failure of each step

vii. The root cause of the critical failure for each step

viii. The actions intended to eliminate or reduce failure or mitigate effects of critical failure of each step

ix. The measures of success used for each step

x. Identify the quantitative and qualitative performance improvement tools that were discussed, respectively, in chapters 3 and 6 that were utilized in the FMEA models and give an opinion whether they were appropriate

xi. Identify the members of the performance improvement team and give an opinion if they are appropriate for the project (use Chapter 7 and 8 criteria)

xii. Why was the FMEA model chosen, e.g. the process that is being reviewed to prevent an adverse event, and given an opinion if FMEA is the appropriate model to utilize

c. For the RCA model

i. Identify the team members and give an opinion if they are appropriate for the project (use Chapter 7 and 8 criteria),

ii. Identify the adverse event

iii. Identify the causal factor(s)

iv. Identify the root cause(s)

v. Identify the action category (ies)

vi. Identify the risk reduction strategy (ies) implemented

vii. Identify the quantitative and qualitative performance improvement tools that were discussed, respectively, in chapters 3 and 6 that were utilized in the root cause models and give an opinion whether they were appropriate

viii. Why was the RCA model chosen and given an opinion if the RCA is the appropriate model to utilize

Homework is Completed By:

Writer Writer Name Amount Client Comments & Rating
Instant Homework Helper

ONLINE

Instant Homework Helper

$36

She helped me in last minute in a very reasonable price. She is a lifesaver, I got A+ grade in my homework, I will surely hire her again for my next assignments, Thumbs Up!

Order & Get This Solution Within 3 Hours in $25/Page

Custom Original Solution And Get A+ Grades

  • 100% Plagiarism Free
  • Proper APA/MLA/Harvard Referencing
  • Delivery in 3 Hours After Placing Order
  • Free Turnitin Report
  • Unlimited Revisions
  • Privacy Guaranteed

Order & Get This Solution Within 6 Hours in $20/Page

Custom Original Solution And Get A+ Grades

  • 100% Plagiarism Free
  • Proper APA/MLA/Harvard Referencing
  • Delivery in 6 Hours After Placing Order
  • Free Turnitin Report
  • Unlimited Revisions
  • Privacy Guaranteed

Order & Get This Solution Within 12 Hours in $15/Page

Custom Original Solution And Get A+ Grades

  • 100% Plagiarism Free
  • Proper APA/MLA/Harvard Referencing
  • Delivery in 12 Hours After Placing Order
  • Free Turnitin Report
  • Unlimited Revisions
  • Privacy Guaranteed

6 writers have sent their proposals to do this homework:

Exam Attempter
Academic Master
Homework Guru
Assignment Solver
Smart Accountants
Top Class Results
Writer Writer Name Offer Chat
Exam Attempter

ONLINE

Exam Attempter

I will be delighted to work on your project. As an experienced writer, I can provide you top quality, well researched, concise and error-free work within your provided deadline at very reasonable prices.

$19 Chat With Writer
Academic Master

ONLINE

Academic Master

I find your project quite stimulating and related to my profession. I can surely contribute you with your project.

$28 Chat With Writer
Homework Guru

ONLINE

Homework Guru

I reckon that I can perfectly carry this project for you! I am a research writer and have been writing academic papers, business reports, plans, literature review, reports and others for the past 1 decade.

$19 Chat With Writer
Assignment Solver

ONLINE

Assignment Solver

I can assist you in plagiarism free writing as I have already done several related projects of writing. I have a master qualification with 5 years’ experience in; Essay Writing, Case Study Writing, Report Writing.

$44 Chat With Writer
Smart Accountants

ONLINE

Smart Accountants

I can assist you in plagiarism free writing as I have already done several related projects of writing. I have a master qualification with 5 years’ experience in; Essay Writing, Case Study Writing, Report Writing.

$26 Chat With Writer
Top Class Results

ONLINE

Top Class Results

I reckon that I can perfectly carry this project for you! I am a research writer and have been writing academic papers, business reports, plans, literature review, reports and others for the past 1 decade.

$34 Chat With Writer

Let our expert academic writers to help you in achieving a+ grades in your homework, assignment, quiz or exam.

Similar Homework Questions

A fund set up so that a bond can be retired at maturity is called a _______ fund. - Bargaining power of buyers netflix - Stress inoculation training worksheets - Reaction of aspirin with ferric chloride - Integration Paper Assignment and complete worksheet2 - Allan murray farm services - Three things i'm grateful forthree things i'm grateful for - Cisco switch stack current state removed - Kim Woods only - BMGT 365 - Individual Deliverable #2 - Crisis Leadership Report - A beautiful mind book chapter summary - Preparing Statement of Cash Flows - Everyday use - Ch - Silver carbonate on heating gives - First time seven lions piano sheet music - Brian phillipson sacramento ca verdict - Volcano looking sores on skin - East egg great gatsby - Comment - Discussion - Acis water cooler spares - What do organisms use energy for - Fsi fire suppression service manual - Information management at homestyle hotels - Alicia molik nathan buckley relationship - Ogilvy and mather creative brief template - Management - Macbeth act 2 question answers - Accounting - Qbcc home warranty insurance table - Wsp montreal quebec canada - Hi amp buss 80 amp - Japanese studies oxford brookes - Majoring in psychology helms pdf - How to recruit a zombie in hollywood u - Imagery in 1984 examples - How costco became the anti wal mart - Mccauley propeller overhaul times - I am not your perfect mexican daughter sparknotes - Elements of film powerpoint - +91_9414601882 lOvE thE prOblEm nOt yOur sOlutiOn in Asansol, Kolhapur - How do you simplify imaginary numbers - Introduction and Bibliography - El enfermero le la temperatura al paciente. (tomar, ir) - Quadratic inequalities exam questions - The second coming multiple choice questions - Ender's game giant's drink - Mini case enterprise architecture at nationstate insurance - Excel: Short-Term Finance - RHETORICAL ANALYSIS - Internal Assessment Survey 04 - Hemingway big two hearted river summary - Analysis of a potassium chlorate potassium chloride mixture - Picot question examples dialysis - Roasted plantain with groundnut - Preparation of esters experiment grade 12 answers - Gartner penetration testing magic quadrant - Nicola de la haye - 5/36 blacket street downer - Discussion Questions - ESSAY PAPER (Doctoral Level) - Truth in montana 1948 - Ethical behavior within firms in relation to financial management - 107nrwk3obj - Mitosis and meiosis lab 5 answers - Tesla brand audit - Characters in my sisters keeper - Essay type - MBA - Main - Dis 5 - Publicly funded early childhood programs - Nurs521reply prompt2 - Ib economics ia cover sheet - The ____ shortcut keys remove character formatting - Mbrc planning scheme front setback requirements - Discussion essay - Cyclohexene saturated or unsaturated - Assignment 8 - Market share simulation - Pinkerton cpp case study - Environmental choice ccd 110 - Changingminds org leadership vs management - Electromagnetic induction lab report conclusion - How much is 400 acres - What project management tasks should kelvin perform before his next meeting? - E rewards market research - Cooks mill camping area - Is fort street high school good - St ignatius uniform shop - Unit 4 discussion bd Intd670 - Saflok card reader wiring diagram - Wk2 project - International development job search - How to use navy dive tables - Holofernes army crossing the euphrates river - Loss of innocence archetype - Does Buddhism (or Hinduism) have more or less conflict (or compatibility) with science than Christianity? - Mic6 5 16 plate 14 x14 - Unit 5 IP PC - Daughter of oedipus and jocasta crossword