Compare and contrast each of the three questions related to
Compare and contrast each of the three questions related to Managed Care Organizations, Medicare Compare and contrast each of the three questions related to Managed Care Organizations, Medicare, and Medicaid with one another and explain how they were similar and different to each other. Managed care organizations emphasize physicians’ responsibilities to control patient access to expensive hospitalization and specialty care, a principle dubbed “gatekeeping.” Some argue that “gatekeeping” is unethical because it introduces financial factors into treatment decisions. Others say it improves quality by promoting the use of the most appropriate levels of care. Medicare is an area that often gets overlooked and is seen as a burden financially. Discuss alternatives to ease the drain on Medicare resources. Medicaid is shouldering an ever-increasing burden of cost for long-term care for the elderly, with enormous impacts on state budgets throughout the nation. Discuss alternatives to ease this drain on Medicaid resources. Develop an APA-formatted essay discussing the three entities. Describe what they are and how they differ. Include an introduction to let the reader know what will be found in the essay. Create a table to provide comparison of the three entities. The table can be used as the body of the paper, or it can be added as an addendum after the Reference page. If you opt to add it as an addendum, refer to the table in the narrative in the body of the essay. As in all essays, include a conclusion to provide a summary of the material. This assignment highlights your ability to do research and display information in a table format. Include citations, as appropriate, for information in the table. Refer to chapter 7 in the APA manual, specifically pages 223 -224 for information on tables using words for displaying information. Required Source Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett. Read Chapter 8. The following specifications are required for this assignment: Length: 750 words Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment. References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least two (2) scholarly sources to support your claims. Format: Save your assignment as a Microsoft Word document (.doc or .docx). File Name: Name your saved file according to your first initial, last name, and the module number (for example, “RHall Module 1.docx”) Expert Answer and Explanation Healthcare Finance In the United States (US), healthcare is paid for or financed in a variety of ways. One of the ways is the out-of-pocket method where individuals pay directly for services they have been offered. The second way is private insurance. Other people have health insurance coverage as a tax-free benefit from their employer (Sultz & Young, 2017). Most working individuals are covered by employer-provided healthcare insurance, a managed care plan, such as a Health Maintenance Organization, or traditional indemnity insurance. The third method is public insurance and programs. For instance, the government has Military Health Insurance to cover the health of military personnel and their dependents as well as veterans. Other health insurance programs run by the government include Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP) (Sultz & Young, 2017). People often confuse Medicare, Managed Care Organizations (MCOs), and Medicaid. The purpose of this essay is to compare and contrast Managed Care Organizations, Medicare, and Medicaid by giving their similarities and differences. The Three Entities The first entity is MCO. MCOs are integrated organizations in the healthcare system focused on managed care as a method of reducing care costs while maintaining a high quality of care. The focus of MCOs is to reduce the cost of care while keeping the quality high. There are four types of MCOs (Seiler et al., 2022). The first type is Health Maintenance Organization (HMO). HMO manages care by requiring beneficiaries to see a network of health providers at a much lower cost. It also needs beneficially to see their primary care provider (PCP) before any provider who is not in the network. The second type is Preferred Provider Organization (PPO). This form of MCO allows one to see any doctor they like, in the network or outside (Opoku et al., 2022). The beneficially may pay less for seeing an in-network provider and higher for the outside network provider. The third is Point of Service (POS). This program combines HMO and PPO where one can see providers in and outside the network but at slightly higher costs. The last type is Exclusive Provider Organization (EPO) (Opoku et al., 2022). It also combines HMOs and PPOs’ features. Its costs are less than PPO but higher than HMO. The second entity is the Medicare program. Medical is a federal health insurance program for some young people with disabilities, adults aged 65 years or older, and individuals with End-Stage Renal Disease (Agarwal et al., 2021). Drain in Medicare resources can be eased through the following alternatives. First, reducing unnecessary complications and preventable readmissions. Complications and readmission increase the cost of care and thus puts more burden on Medicare (Committee for a Responsible Federal Budget, n.d). Second, the drain can be reduced by decreasing the use of high-cost drugs. Lastly, the program should use the value-based model to pay physicians where they are paid based on efficiency, quality, and care coordination. The third entity is the Medicaid program. Medicaid is a health insurance program that provides health coverage to millions of US citizens, including children, low-income adults, elderly adults and people with disabilities, and pregnant women (Linder et al., 2018). States administer the program based on federal requirements. The program is funded both by the federal government and state governments. Drain in Medicaid resources can be eased through the following alternatives. First. Physician payment should be modified to decrease unnecessary care. physicians should be paid using the salaried system with a relatively modest bonus for quality (Linder et al., 2018).
[ANSWERED 2023] Describe the difference between a nursing practice problem and a medical practice problem
Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem. Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem. EXPERT ANSWER AND EXPLANATION Nursing vs. Medical Practice Problem Nursing practice problem assesses Whereas a nursing practice problem is identified during the nursing assessments conducted on a patient’s condition, medical practice problem is one which focuses on the pathology of the patient. Specifically, a nursing practice problem assesses the human response to the health conditions (Milner & Cosme, 2017). For example, when a patient presents to the facility with headaches, fever, and other physical symptoms, a triage nurse could identify the condition as a nursing practice problem, where they offer the patient the relevant nursing diagnosis. On the other hand, when a patient is seen to have a condition which requires his pathology to be assessed and the healthcare giver recognizes that it could be stroke, then this is a medical practice problem. Why PICOT should be based on Nursing Practice Problem A PICOT seeks to address various elements of nursing care, and hence it should be primarily based on a nursing practice problem and not on a medical practice problem. In the nursing practice problem, the care needs of the patient from the time they get out of the healthcare environment to the time they are diagnosed by the doctor to the after-care periods are addressed (Meyer, 2017). Also, in the nursing practice problem, there is collection of information about the patient, and this helps to draw relevant conclusions based on the PICOT questions. This way, it is easy to collect diverse data about the patient and their condition. Also, with the nursing practice problem, it is more likely that the PICOT will improve population health. References Meyer, M. N. (2017). Evidence-Based Practice: Success of Practice Change Depends on the Question. Evidence-Based Practice in Nursing: Foundations, Skills, and Roles. Milner, K. A., & Cosme, S. (2017). The PICO Game: An Innovative Strategy for Teaching Step 1 in Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing, 14(6), 514-516. Alternative Expert Answer How Nursing and Medical Practice Problems differ Medical and Nursing Practice ProblemThere is a difference between a nursing and a medical practice problem. The former is a clinical issue that a provider identifies and notes when assessing the patient, and it constitutes one physiological health, and the emotional and psychological responses linked to the patient’s physical health. An example is a patient with hypertension and diabetes developing stress because of their health. In this case, a nurse would want to know all these details about the patient including the manner in which they respond to the disease. One can also look at this particular problem as one which can be addressed through patient education, counseling and health promotion (Cook et al., 2018). Conversely, the latter is about the medical condition or the pathology of a medical disorder in which the provider determines the patient’s disorder. If a provider measures the body’s insulin and manages to determine that body’s insulin level is low, they can conclude that the condition is type 1 diabetes (Yoo et al., 2019). Basing PICOT on the Nursing Practice Problem When preparing a PICOT, it is important to base it on the nursing practice problem (NPP). This is because the NPP addresses majority of the elements of the nursing care. Some of these elements include the diagnosis information, patient care goals, screening of the risks, and the outcomes. The PICOT also addresses all these elements considering that it focuses on the patient, their health, the intervention that can help promote recovery compared to another treatment, and results of the treatment. It equally focuses on the clinical outcomes (Ho et al., 2016). Given that the PICOT addresses all the elements of the nursing problem, it make sense to base PICOT on the NPP. References Cook, D.A., Pencille, L.J., Dupras, D.M., Linderbaum, J.A., Pankratz, V.S., & Wilkinson, J.M. (2018). Practice variation and practice guidelines: Attitudes of generalist and specialist physicians, nurse practitioners, and physician assistants. PLoS ONE 13(1), e0191943. Doi: https://doi.org/10.1371/journal.pone.0191943. Ho, G.J., Liew, S.M., Ng, C.J., Hisham Shunmugam, R., & Glasziou P (2016). Development of a Search Strategy for an Evidence Based Retrieval Service. PLoS ONE 11(12), e0167170. Doi: https://doi.org/10.1371/journal.pone.0167170. Yoo, J.Y., Kim, J.H., Kim, J.S., Kim, H.L., Ki, J.S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PLoS ONE 14(12): e0226742. Doi: https://doi.org/10.1371/journal.pone.0226742. Place your order now on the similar assignment and get fast, cheap and best quality work written by our expert level assignment writers. Other Answered Questions: SOLVED!! Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. ANSWERED!! Assume you are a nurse manager on a unit SOLVED! Discuss how elimination complexities can affect SOLVED! How would your communication and interview ANSWERED!! Post your PICO(T) question, the search terms ANSWERED!! Re-read Take a Closer Look: Exploring Claude What is the difference between a nursing problem and a medical problem? In the world of healthcare, it’s crucial to understand the fundamental differences between nursing problems and medical problems. While both are essential aspects of patient care, they serve distinct purposes and require different approaches. This article will delve into the nuances that set nursing practice problems apart from medical practice problems, providing clarity on this critical subject. Nursing Practice Problem vs. Medical Practice Problem Defining Nursing Practice Problems Nursing practice problems, often referred to