What challenges related to payment for services do you anticipate your selected patient may experience?

Use the Internet or other resources to find an article that describes a negotiation situation that resulted in one or both parties seeking a formal intervention resolution.
In an ideal healthcare delivery system, all patients would have access to affordable, high-quality health services that are well coordinated to ensure the continuity and comprehensiveness of care. In reality, patients may have vastly different experiences based on their health problem or injury, the organizations that provide services close to where they live, and how the health services they need are financed.

Consider, for example, a 56-year-old man who has a hemorrhagic stroke in a rural area of Alaska. What services will he need through the duration of his recovery experience? Where will he receive care? How will he pay for the services he needs? Now think about how his situation might compare with that of a 42-year-old woman in Houston, Texas, who arrives at her annual gynecological exam with symptoms associated with ovarian cancer. How might the two patients’ experiences compare in terms of care coordination and the continuity and comprehensiveness of services they receive?

For this Assignment, you will examine the continuum of care a patient may need and research the services available in your area to support the patient. You will convey your findings in a compelling presentation and will use these findings in the Week 4 Discussion as well.

To develop the content for your presentation, record detailed notes as you complete the following steps:

Review the information about the continuum of care and coordination among various health services organizations in the Resources, including the HIMSS resource, Continuum of Care, and the tables in Chapter 1 of the course text.
Read the Week 3 Assignment Patient Information, and select one hypothetical patient on which to focus for this Assignment. Assume your selected patient lives in your local area. If you are an international student, you may choose a geographic area in the United States or use your own location.
Use the pertinent information in Chapters 7, 8, 9, and/or 10 of the Shi and Singh course text and conduct additional research of your own to analyze specific services your hypothetical patient might need, beginning with the onset or diagnosis of an illness or injury and concluding with an end-point of your choosing (i.e., recovery, symptom management, end of life). Also research the types of organizations that provide those services.
Investigate the healthcare organizations in your local area. Based on the services your hypothetical patient needs, select three or four actual settings in which he/she would receive care.
Next, gather information related to the types of insurance each organization accepts. Typically, this would include Medicare, Medicaid, and various types of insurance programs. What challenges related to payment for services do you anticipate your selected patient may experience?
Review the Institute for Healthcare Improvement (2014) resource and consider what it means for healthcare to be safe, effective, patient-centered, timely, efficient, and equitable. Based on your hypothetical patient’s needs, analyze why professionals in healthcare settings need to be aware of the six Institute of Medicine Aims.
Next, prepare to create your presentation using PowerPoint. Examine the Presentation Guidelines and Tips and the Week 3 Assignment Template (both are located in this week’s Resources).

The Assignment

Download and save the Week 3 Assignment Template. Use the template to create a succinct and engaging PowerPoint presentation. Include the following:

Title slide
Introduction slide
5–7 content slides*
Describe the patient you have selected (including his or her health problem/injury) and identify the geographic area where this patient is located.
Analyze the continuum of care, including specific services the patient may require from three or four actual settings.
Describe a potential challenge related to payment for services this patient may encounter.
Explain why professionals in your selected settings need to be aware of the six Institute of Medicine Aims.
References slide
Include all resources (a minimum of 4) used to develop your presentation and follow APA guidelines.
* Apply the design principles included in Presentation Guidelines and Tips to develop a professional presentation. On your content slides, use a combination of text, photos, graphs, maps, links to websites, and/or other visual elements to convey the information. Create presenter notes of a few sentences to accompany each slide in a way that supports (rather than duplicates) the information presented visually.

This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.

Required Resources
Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett.
Chapter 1, “An Overview of US Health Care Delivery” (p. 3, Table 1–1, “The Complexity of Health Care Delivery”; p. 16, “Continuum of Services” section; p. 17, Table 1–2, “The Continuum of Health Care Services”)
Chapter 7, “Outpatient and Primary Care Services” (pp. 250–284)
Chapter 8, “Inpatient Facilities and Services” (pp. 291–327)
Chapter 9, “Managed Care and Integrated Organizations” (pp. 335–361)
Chapter 10, “Long-Term Care” (pp. 377–408)
Examine Tables 1–1 and 1–3 to identify the types of organizations involved in the continuum of care, as this will inform your work in the Discussion and the Assignment. Read sections of the other text chapters as needed to learn about the specific settings you are addressing in your Discussion postings and the Assignment. This week’s Quiz addresses materials presented in Chapters 7 and 8.

Dunn, L. (2013, June 20). The acute-care continuum: The future of hospital-based care. Becker’s Hospital Review. Retrieved from http://www.beckershospitalreview.com/white-papers/the-acute-care-continuum-the-future-of-hospital-based-care.html
Healthcare Information and Management Systems Society (HIMSS). (2014). Definition: Continuum of care. Retrieved from http://s3.amazonaws.com/rdcms-himss/files/production/public/2014-05-14-DefinitionContinuumofCare.pdf
Institute for Healthcare Improvement. (2014). Across the chasm: Six aims for changing the health care system. Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmSixAimsforChangingtheHealthCareSystem.aspx
Document: Week 3 Patient Information (PDF)
Document: Week 3 Assignment Template (PowerPoint presentation)
Document: Presentation Guidelines and Tips (PDF)