BACKGROUND

The U.S. healthcare delivery system is very unique, complex and large. The system is composed of medical suppliers, payers, public and private providers, research organizations, ACOs, educational institutions, managed care organizations, integrated networks, and a full continuum of service providers from prevention, primary care, sub-acute, ambulatory care, rehabilitative, long-term care and end-of-life care. The scope and size of the system consists of basic delivery functions: financing, delivery (providers), payment and insurance. Delivery refers to the actual provision of services by many different providers, financing involves funding for services, insurance companies function as a claims processor and pay for services rendered by specific providers. There are many different types of insurance products and payment programs such as Medicare and Medicaid. The role of managed care has expanded and there are numerous external forces constantly shaping the delivery of health care in the United States. The continuum of healthcare is extensive with a focus on cost, access and quality of care.

PURPOSE

This is an individual assignment completed over the course of 7 weeks. The assignment takes a systems approach and requires you to examine the functional pieces of a health delivery system in the United States. Being able to analyze services and systems in addition to organization and functions is an important competency. Developing a framework enables you to analyze the structure and organization of services and systems. The project enables you to apply concepts, theories and models using an applied and integrated systems approach. You select a large city or healthcare system and then study the various system features, inputs, outputs and resources. This project enables you to demonstrate skills, knowledge and competencies needed to be a successful healthcare manager.

In order to complete this project, you need a framework that provides a conceptual base to examine the structure and organization of the healthcare system. This assignment draws upon a systems framework as developed by Leiyu Shi and Douglas Singh (2015) in their book Delivering Health Care in America: A Systems Approach (6th Edition). In this assignment you examine the size and scope of the system, the basic components of health services delivery and major system characteristics. The assignment further examines trends, directions, concepts of health, new innovations, health status and health risks. You must develop a comprehensive analysis in a detailed report.

ASSIGNMENT

You are going to conduct a Comprehensive Health Services and Systems Analysis (CHSSA) and develop a detailed report. This report will be prepared over the course of 7 weeks with specific sections of the report being developed each week and submitted for review. In this assignment you will:

  1. Select a State, large city or comprehensive healthcare system to study.
  2. Conduct individual research, gather and interpret data.
  3. Prepare a table of contents, figures, tables, graphs and other illustrations.
  4. Develop appendices to support major sections of the report.
  5. Submit your final paper using “Vericite” for professional integrity and plagiarism(please see syllabus for instructions).
  6. Use appropriate references and sources of information.
  7. Submit specific sections of the report in week #1, week #2, week #4 and week #7.
  8. Consult with other students in the course to get ideas and share sources of information.
  9. Properly cite sources and develop a reference section.
  10. Conduct graduate level research and writing.

Your professional paper must reflect graduate level work, writing skills, research efforts, critical thinking and analysis. The report must be typed and double spaced. You must use headings and subheadings as you develop your systems framework. The paper must be clear and concise with no spelling or grammar errors. You will use the publication style of the American Psychological Association, Publication Manual of APA, 6th edition, 2009. Failure to submit an accurate, well organized, and comprehensive professional report will result in a reduced grade. All sections of the paper must be submitted for examination by the due dates so designated. Your completed paper should not exceed 50 pages and is submitted at the end of week #7.

IMPORTANT:

  1. Only the final submission in week #7 will be graded by the Professor. The work submitted in week #1, week #2 and week #4 will be reviewed to monitor your progress in completing the assignment.
  2. Work that is plagiarized will result in the paper being returned to be properly redone with a reduction in 2 letter grades.
  3. The paper must reflect graduate level research, writing skills, critical thinking and analysis.
  4. For the written assignment in week #7, your assignment will utilize the “Vericite” feature. This will indicate the authenticity of your work and identify any plagiarism. Read the information on using “Vericite” very carefully before you submit your paper.
  5. You are encouraged to consult with other students in the course to get their ideas and feedback on your efforts. Students are encouraged to share reliable and valid sources of information.
  6. In order to make sure that all required areas are addressed, it is recommended that the paper contain headings corresponding to Content Areas 2-12 as detailed in the grading criteria below.

CHSSA CONTENT AREAS

The assignment has specific content areas and requires you to describe in detail each CHSSA section.

GRADING CRITERIA

Content Area Points
1. Has the selected system been approved by the instructor? 1 5
2. Does the paper have an appropriate Title page, Table of Contents and Introduction that states the purpose of the analysis, the geographic area being studied and a description of the population served? 2 5
3. a. What are the appropriate descriptive demographics of the population?

b. What is the health status of the population?

c. What particular health risks does the population face?

d. How does the population access the system?

e. What are the utilization statistics?

3 15 total

3

3

3

3

3

4. a. If the system is of a specific geographic locale, what is the annual expenditure on healthcare

or

If the system is a provider entity, what are its gross revenues, expenses, profit or surplus, net fund balance or endowment?

b. What insurances are available to the population and what are the market shares of each.

4 10 total

5

5

5. a. Describe the organizational structure (or structures if a geographical area) of the providers.

b. Describe the clinical services available within the system.

c. Describe the continuum of care by organizational entity (e.g. acute care hospitals, ancillary outpatient centers, long-term care facilities, home health, hospice, primary care physician offices, et.)

d. For what clinical services must the population travel to another geographic area?

5 20 total

5

5

5

5

6. a. Do any out-of-area providers maintain referral relationships with the system?

b. how many physicians and non-physician professionals work within the system?

c. What is the total employed workforce within the system?

d. What diagnostic and treatment technology is available in the system?

e. What are the workforce needs (current and future)?

6 5 total

1

1

1

1

1

7. a. What is the system’s medical error rate?

b. What are the key quality indicator measures for the system?

c. What Patient Safety measures are in place in the system?

d. Are there any health policy issues confronting the system?

e. Is the system growing, stagnant, or decreasing in size?

7 5 total

1

1

1

1

1

8.

9.

10.

11.

a. How has PPACA impacted the system?

b. Is the system engaged in population health efforts?

a. Does the system participate in any ACOs or PCMHs?

a. Has there been any market consolidation in the last five years?

a. Are there any state health reform initiatives impacting the system?

8

9

10

11

15 total

3

3

3

3

3

12. a. Are there issues of social justice confronting the system?

b. How does the system deal with ethical issues?

c. Are there any cultural issues impacting the system?

d. How would you describe the values of the system?

e. On balance, does the system meet all of the needs of the population?

12 5 total

1

1

1

1

1

13. a. Does the CHSSA reflect sufficient research effort on the part of the student?

b. Are the references appropriate for the CHSSA?

c. Have the secondary research sources been properly cited within the text in conformity with APA style?

13 5 total

2

1

2

14. Are tables, figures, graphs and appendices appropriately formatted? 14 5
15. Is the paper free of all spelling, grammar and writing errors? 15 5
Total Points 100

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