In this module, you learned about the healthcare insurance coverage options the government offers. While programs such as Medicare and Medicaid are detailed and comprehensive, they can also be overwhelming to understand. In this assignment, you will write a brief summary that explains the factors one needs to consider for Medicare coverage. You will also create a Medicare plan grid that will simplify the requirements of Medicare for a consumer.

From strategic planning and healthcare reimbursement perspectives, this activity will help you understand the types of services Medicare and Medicaid pay for in each program. This activity will help you complete Section 2 (Strategic Planning) and Section 3 (Healthcare Reimbursement) of the course project.

Scenario

You work in a consumer-facing role in a healthcare organization where you help with finances and reimbursement. In your role, you must manage a lot of healthcare consumers who have been scammed or who have signed up for Medicare and Medicaid plans without understanding all the factors; these consumers are subsequently disappointed when their needs are not met. You have heard from many consumers who visited www.medicare.gov to understand their choices but found so much information and unfamiliar terminology that they became frustrated and quit. They often just end up signing for the “simple plan” rather than choosing something else that “might not be quite right.”

As part of an ongoing consumer-outreach program your organization has launched, you want to create some aids that will better educate your consumers about the factors that impact healthcare-reimbursement plans so they can choose a plan that is right for them. Your aids will be put up on your organization’s website for maximum impact. In your aid, explain in brief the factors that affect the consumers’ choice of Medicare and prepare a Medicare Plan Choices grid. Then determine if they will be eligible for Medicaid assistance. Here is a sample grid that will help you organize your thoughts.

Medicare Part AMedicare Part BMedicare AdvantageMedicare Part D

Coverage includes hospital inpatient, long-term care, skilled nursing facilities, home health, hospice

Coverage includes physician services, medical services, medical supplies (i.e., outpatient coverage)

Coverage in managed care options include services excluded in Part A and Part B: long-term nursing, custodial care, dental services, vision services, hearing aids

Coverage includes Medicare drug benefit; outpatient coverage

No premium needed

Premium needed

Premium needed, amount depends on scope of service

Premium needed; premium amount varies

Deductible amount: $1,250

Deductible amount: $142

Deductible amount: costs vary

Deductible amount: $275

Co-payment amount varies by service

Co-payment amount varies by service

Co-payment amount varies

Co-payment amount at 25%

This activity will help you distinguish between the Medicare and Medicaid programs. It will also enable you to evaluate how Medicare and Medicaid impact consumer choice.

Directions

Create a Medicare Plan Choices guide to help consumers understand how to choose a Medicare plan. This activity includes three parts:

• At-a-Glance: Write an “at-a-glance” section to briefly explain the factors that impact the choice of a Medicare plan. Also explain if any enrollment deadlines need to be considered.
• Medicare Plan Choices Grid and Medicaid Eligibility: Create a Medicare Plan Choices grid to help consumers select the plan that is best for them. The sample grid given in the Scenario section will give you some guidance on how to create your own grid for this assignment.
• Further Support: Provide additional resources to help consumers make their choice about which type of Medicare plan is best for them, whether to consider a Medicare Advantages plan, and whether they are eligible for Medicaid.

If you need writing support, access the Online Writing Center through the Academic Support module of your course.

Specifically, you must address the following rubric criteria:

Part 1: At-a-Glance

1. Summary of Relevant Factors and Deadlines: Summarize all the factors and enrollment deadlines that consumers should consider before they opt for a Medicare plan. Write your summary in one to two short paragraphs.

Consider the following questions to guide your response:

• What are the costs and coverage considerations involved in the selection of a plan?
• How do prescription drugs and choice of doctors and hospitals affect the choice of a Medicare plan?
• If a consumer misses the deadline for enrollment, can they still buy a plan?

Part 2: Medicare Plan Choices Grid and Medicaid Eligibility

1. Medicare Grid: Create a grid that displays all the appropriate factors and information influencing the choice of a Medicare plan. Refer to the sample grid given in the Scenario section to help you organize your thoughts. Include the following information in your response:
   1. Create a brief consumer profile in one to two sentences. This profile will act as an example to help you build the grid. Consider that the consumer is in the 65+ age group. Assume some additional relevant information about their income (which will impact premiums) and eligibility (which will impact Medicaid eligibility). This information will be displayed as part of the aid on your organization’s website.
   2. Create the grid using the profile you built. Your grid should include the following details about each of the four parts of Medicare:
      1. Coverage
      2. Premium
      3. Deductible(s)
      4. Co-payment(s)
      5. Examples of covered services
      6. Any other details you think are importantMake sure the grid is easy for consumers to understand. Remember that they have probably already visited some websites and have found them difficult to comprehend.Consider the following questions to guide your response:
2. Medicare Advantage and Medicaid: Determine whether a consumer should consider a Medicare Advantage plan. Also, state whether they will be eligible for Medicaid assistance and why or why not.Consider the following questions to guide your response:

Part 3: Further Support

1. Additional Resources: Identify at least two websites or other resources to help the consumers select a Medicare plan. Add these resources as a separate section after the grid.

All the claims in your deliverable should be evidence based. Your citations should be from your independent search for evidence (not from the scenario, textbook, or module resources) of credible sources and be current within the last five years. You are required to cite a minimum of two sources, at least one of which should be separate from your own research. Refer to the IHP 630 Library Guide located in the Start Here section of the course for additional support.

What to Submit

Submit your Medicare Plan Choices guide as a 2- to 3-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Make sure to include all three parts of the activity in the guide. Sources should be cited according to APA style.

Overview

Even before the Affordable Care Act was enacted, the government-run Medicare and the state-run Medicaid programs extended healthcare services to all U.S. citizens above age 65, to citizens with disabilities, and to citizens belonging to low-income groups. Considering the rising cost of healthcare services, create a PowerPoint presentation comparing the two programs.

This activity will help you distinguish between Medicare and Medicaid. It will also enable you to assess the impact of Medicare and Medicaid on organizational financial performance and strategic planning.

Directions

Create a PowerPoint presentation with speaker notes. In your speaker notes, be sure to indicate which notes belong with each slide.

If you need writing support, access the Online Writing Center through the Academic Support module of your course.

Specifically, you must address the following rubric criteria:

1. Medicare vs. Medicaid: Describe the differences between the federal Medicare program and the Medicaid program in your state and how they impact financial reimbursement from the perspective of the healthcare system. Consider the following questions to guide your response:
   • What are the features of the two healthcare programs?
   • Considering the age and disabilities of the groups covered by the two programs, what aspects of healthcare services will be in most demand?
   • How will you obtain updates about the changes in the Medicare Physician Fee Schedule and the state Medicaid Physician Fee Index?
2. Costing and Strategy: Explain why healthcare administrators need to consider cost when strategically planning for Medicare and Medicaid population growth. Consider the following questions to guide your response:
   • What is the percentage growth in consumer base?
   • Which healthcare services (for example, virtual healthcare, wellness programs, fitness center memberships, and so on) are the most in demand because of this consumer growth?
   • What changes can you propose in healthcare strategies to meet this change?
3. Cost-Reduction Initiatives: Identify cost-reduction initiatives and state how you would operationalize them within the healthcare environment. Consider the following questions to guide your response:
   • Which are the services with the greatest potential to reduce costs?
   • Would external relationships with other healthcare systems or service providers help reduce costs?
   • Would helping the consumers choose the correct healthcare plans help curb costs?
4. Cost Control: Describe at least two effective, alternative ways to control rising healthcare costs Consider the following questions to guide your response:
   • Which are the healthcare services where the costs have gone up the most?
   • Which preventative healthcare services could be used to control these costs?
   • Which less expensive services could be offered as alternative options?

Note that your presentation should be evidence based. Your citations should be from your independent search for evidence (not from the scenario, textbook, or module resources) of credible sources and be current within the last five years. You are required to cite a minimum of two sources overall. Refer to the IHP 630 Library Guide located in the Start Here section of the course for additional support.

What to Submit

Your submission should include a 4- to 6-slide PowerPoint presentation and a 2- to 4-page Word document containing your speaker notes. Use a clear, professional font and appropriate PowerPoint presentation slide design. Speaker notes should be typed in 12-point Times New Roman font, double spacing, and one-inch margins. Sources should be cited according to APA style.

Please follow instructions carefully 

10 – 12 pages (2500 -3000 words) DUE: NOV 27

You will need to consult with at least three to five academic research papers (includes a bibliography),in addition to the class articles and any other sources). 

Integrated Research Essay: Choose an issue that poses a challenge for families. (The scope is almostendless but here are a few examples; communication, marriage, divorce, blending families, sexuality,addictions, illness, immigration and grief). Research the issue and maintain this theme throughout thepaper to understand more about how this issue affects and impacts (potential and otherwise) individualsand the family system. Utilizing the systemic perspective framework we’ve discussed, focus your paper toinclude the following:a) Clearly describe the topic and the presence of these challenges and opportunities.b) Discuss what it is about this issue that draws your attention. How may this relate to any ofyour own family of origin stories?c) Include the following concepts to a lesser or greater degree in your discussion: boundaries,identity, alliances, roles, rules, communication styles and resiliency.d) What enables the family to use the differences and challenges constructively? What forcesmay inhibit constructive conflict responses?e) Illustrate with a metaphor that reflects a family dealing with this issue.f) What have you learned from the research and writing on this subject?g) What questions for further research do you have? Elaborate.

You will need to consult with at least three to five academic research papers (includes a bibliography),in addition to the class articles and any other sources). A title page and complete reference page arerequired. The paper will be evaluated for scholarly research, elaboration of family systems conceptsand integration of this issue with the course material and your own life experience.10 – 12 pages (2500 -3000 words) DUE: NOV 28 50%REQUIRED TEXT:Day, Randal. (2010). Introduction to Family Processes. (5th ed). Milton Park: Routlege. Available throughthe UW bookstore and as an ebook through the UW library.