NRS 451 Research a Health Care Organization or Network that Spans Several States with in the United States (United Healthcare, Vanguard, Banner Health, etc.)
NRS 451 Research a Health Care Organization or Network that Spans Several States with in the United States (United Healthcare, Vanguard, Banner Health, etc.)
United HealthCare is the largest medical insurance company in the US. The company gives insurance covers to people who have the risk of getting cancer. The company has done many experiments on their premium payments physically, and it had to discourage the physical cost of premiums from drug sales. It encourages the oncologists to purchase drugs (George, 2016). Although the objective is not just to reduce the cost of drugs, they had to help curb the overuse of cancer drugs. Their bundle payment depends on specific stages of cancer. The techniques of the program hoped that bundled payment would help improve the outcome and give quality care. The United HealthCare has an excellent capacity of the base finance, which allows it to finance all the requirements by the clients. The company is trying to provide the very best service to its clients.
Organization’s Readiness
The United HealthCare is willing to make sure everything concerning cancer to be dealt with quickly. They have come up with some measures which will make things easy for the citizens. The United Health care is ready to do everything that is required to make their clients access the medical cover with ease. They have reduced the premium payment to ensure the cost is affordable to everyone. They have lowered it to some percentage depending on the income of individuals and the risks exposure by an individual. Before the UHC determines the bundled payments, it checks on the 19 conditions of which the pilots are given a yearly analysis and debate before coming up with the set standard of a bundle (Kumar, 2016). This is because different oncologists deliver the service based on the National Comprehensive Cancer Network (NCCN). The NCCN instructs people to go for chemotherapy after breast cancer surgery. The UHC payment is based on the scheduled fee, which doesn’t exclude the expense of the drug reimbursement and the actual drug costs.
Struggling to Meet Your Deadline?
Get your assignment on NRS 451 Research a Health Care Organization or Network that Spans Several States with in the United States (United Healthcare, Vanguard, Banner Health, etc.) done on time by medical experts. Don’t wait – ORDER NOW!
Meet my deadline
The ASCO, which is a wing on the UHC, was more concerned and supportive of the experiment, this pilot program is helpful and innovative in a manner that can solve complex problems. The ASCO came up with strategies that aimed at separating the payment for medical care attention provided to patients. This would help in the provision of medicine to a patient who will treat their diseases. By separating the payment, the company helped individual groups have easy access to the medical facilities. This was done because some cancer medicine is too expensive and unaffordable to some citizens. The patients would pay their bundles with ease as required by the United Healthcare.
The other thing the UHC did was to do frequent therapies because patients go through different stages while battling cancer that is 15%-20% of patients with a unique experience. There is some toxic or more rapid progression where a person needs to make some changes (Toebes & Hallo de Wolf, 2015). The United HealthCare needs to establish consistency between 80%-85% of the patient to create efficiency and reducing the costs and increasing the patient’s safety. For over ten years, Kansas City, which is a cancer center, treated people, and many people visited the clinical path. The clinic received 19 stages and different cancer categories. This was due to the measures which the UHC had come up with to help people access the cancer health care services and the therapies which reduced the cancer rates to some percentage in the US.
Strategic Plan To Improve The Network Operation
The United HealthCare has some plans which are aimed at achieving the objectives of the company at large. The UHC has assessed all the strength, weakness, opportunities, and threats about the organization and finally coming up with a strategy which will help it run smoothly to achieve the goals. The UHC has some practices in the pilot that will aid in building efficiencies giving out the appropriate care. The UHC chairman Roy Page P.H.D said that “Doctors and chefs in the kitchen are the same.” All the piloting techniques would make it easy for the flow of medicine on the pathways. It will also facilitate the easy movement of staff and cancer patients in the US.
The biggest problem the UHC is facing is financial problems. It’s tough for them to provide all the requirements at a go to many patients as the cancer treatments are costly. Hence, they formulated the pooling of the resources, which implies the collection of premiums together and later on disburse on treatment (George, 2016). This was due to the increased financial burden on the patients. Cancer drugs are costly and can cost over tens of thousands of dollars in the process of treatment and always needs 20% co-payments, which many cants afford. The IMS health gave out a highlight on the sale of chemotherapy drugs in the pharmacy. This may cost over 20 billion since the cost of cancer care is rapidly rising at a speed that many American citizens can’t sustain. The UHC formulated a pool where the patients will be paying bundles that they can afford and later be used to treat them (Kumar, 2016). Still, they are focused on cutting costs when possible. This is solely to make cancer care be accessed easily by all American citizens.
The organization is facing many issues from a different dimension; they include; The patients cannot afford the money required by the company, which is a big challenge to citizens and the company despite trying hard to lower all costs. The other problem is the increased number of coverage, which leads to exhaustion of the available resources. This is making it hard and goes beyond the budget of healthcare to serve people. The ratio of the available resources to the people with common cancer is at a deficit. The other problem that the company face is the chronic state of patients, which requires a lot of money (Toebes & Hallo de Wolf, 2015). Many patients are at a chronic condition, which becomes too expensive for the company; this poses a significant challenge to the organization. Despite all the problems the healthcare has some plans to counter these problems.
Inventory Management decisions model
In the past, healthcare didn’t have much focus on the inventories. However, the US government implemented diagnostic groups that led to pre-fix levels of compensation. These systems help to contain the rising cost of managing diseases in the US. This paper address the issues of inventory hence the involvement of this model (George, 2016). Since managing cancer is expensive to the company, there is the necessity of inventory tools. The biggest problem being cost in the managing of cancer there is the need for comparing the inventory cost and service levels of the business. In comparing the inventory policies, we focus on the latest sequence of outsourcing to distribute the non-critical medical supplies directly. This model will help in solving all the financial problems experienced by United HealthCare.
Conclusion
In summary, the United HealthCare is playing a significant role in ensuring all patients with cancer can access the medical facilities. The UHC came up with measures that will help to reduce the premium payments by the citizens. The company provided some pilot services to make the operation of cancer easy, and the movement of medicine be faster. Even though the company is facing many problems like affordability, chronic state, and financial issues, they do all they can to provide the services to their clients. They have made sure many cancer patients go for chemotherapy and get medical attention.
Referrence(s)
George, M. (2016). Healthcare Norms under Universal Healthcare (UHC) for
Maharashtra. Journal Of Health Management, 18(4), 569-583. https://doi.org/10.1177/0972063416666163
Kumar, P. (2016). How to strengthen primary health care. Journal of family medicine and
primary care, 5(3), 543.
Toebes, B., & Hallo de Wolf, A. (2015). Private Sector Involvement in Healthcare and UHC:
Assessment in Light of the Right to the Highest Attainable Standard of Health. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.2649845
Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.
Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:
Describe the health care organization or network.
Describe the organization’s overall readiness based on your findings.
Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:NRS 451 Research a Health Care Organization or Network that Spans Several States with in the United States (United Healthcare, Vanguard, Banner Health, etc.)
NRS 451 Research a Health Care Organization or Network that Spans Several States with in the United States (United Healthcare, Vanguard, Banner Health, etc.)
ou are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Health Organization Evaluation – Rubric
Criteria Description
Health Care Organization or Network
5. Excellent
27 points
Health care organization or network is clearly and accurately described.
4. Good
22.95 points
Health care organization or network is described. Some detail is needed for clarity.
3. Satisfactory
20.25 points
Health care organization or network is summarized. Some information is needed. There are minor inaccuracies related to the representation of the organization or network.
2. Less Than Satisfactory
17.55 points
Health care organization or network is partially presented. There are significant omissions and inaccuracies.
1. Unsatisfactory
0 points
Health care organization or network is not described.
Criteria Description
Assessment of Overall Organizational Readiness
5. Excellent
27 points
Assessment of overall organizational readiness is described in detail. Degree of organizational readiness is established. Strong evidence and rationale support the assessment.
4. Good
22.95 points
Assessment of overall organizational readiness is described. Degree of organizational readiness is generally established. Some evidence or rationale is needed for support.
3. Satisfactory
20.25 points
Assessment of overall organizational readiness is summarized. Degree of organizational readiness is partially established. More information, rationale, and support are needed.
2. Less Than Satisfactory
17.55 points
Assessment of overall organizational readiness is partially presented. There are significant omissions. Degree of organizational readiness is not established.
1. Unsatisfactory
0 points
Assessment of overall organizational readiness is omitted.
Criteria Description
Strategic Plan
5. Excellent
36 points
The strategic plan is well developed. Network growth, nurse staffing, resource management, and patient satisfaction are addressed in detail. The plan is supported with strong evidence and rationale.
4. Good
30.6 points
The strategic plan addresses network growth, nurse staffing, resource management, and patient satisfaction. Some evidence or rationale is needed for support.
3. Satisfactory
27 points
The strategic plan generally addresses network growth, nurse staffing, resource management, and patient satisfaction. More information, rationale, and support are needed.
2. Less Than Satisfactory
23.4 points
Strategic plan is partially presented. Plan contains major omissions. The plan fails to address issues outlined in the assignment criteria.
1. Unsatisfactory
0 points
Strategic plan is omitted.
Criteria Description
Identification of Current or Potential Issues in Organizational Culture and Impact of These to Strategic Plan
5. Excellent
27 points
Current or potential issues in the organizational culture are clearly identified. The potential impact of these on the strategic plan is thoroughly described and supported with evidence and rationale.
4. Good
22.95 points
Current or potential issues in the organizational culture and the potential impact of these on the strategic plan are discussed. Some evidence or rationale is needed.
3. Satisfactory
20.25 points
Current or potential issues in the organizational culture are generally discussed. The impact of these on the strategic plan is summarized. Evidence and rationale are needed to support claims.
2. Less Than Satisfactory
17.55 points
Current or potential issues in the organizational culture are partially summarized. The potential impact of these on the strategic plan is unclear. There are omissions and inaccuracies throughout.
1. Unsatisfactory
0 points
Current or potential issues in the organizational culture and the impact of these to strategic plan are omitted.
Criteria Description
Theory or Model to Support Implementation of Strategic Plan
5. Excellent
27 points
Theory or model to support strategic plan implementation is proposed. The theory or model demonstrates strong support for implementation of the strategic plan for the organization. Compelling rationale supports why the theory or model is the best choice.
4. Good
22.95 points
Theory or model to support strategic plan implementation is proposed. The theory or model demonstrates support for implementation of the strategic plan for the organization. General rationale is provided for why the theory or model is the best choice.
3. Satisfactory
20.25 points
Theory or model to support strategic plan implementation is proposed. The theory or model demonstrates some support for implementation of the strategic plan for the organization. It is unclear why this theory or model is the best choice. More information is needed.
2. Less Than Satisfactory
17.55 points
Theory or model to support strategic plan implementation is partially described. It is unclear how the theory or model would support implementation of strategic plan for the organization.
1. Unsatisfactory
0 points
Theory or model to support strategic plan implementation is omitted.
Criteria Description
Thesis Development and Purpose
5. Excellent
9 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
4. Good
7.65 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
3. Satisfactory
6.75 points
Thesis is apparent and appropriate to purpose.
2. Less Than Satisfactory
5.85 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Criteria Description
Argument Logic and Construction
5. Excellent
9 points
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
4. Good
7.65 points
Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
3. Satisfactory
6.75 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
2. Less Than Satisfactory
5.85 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
1. Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
9 points
Writer is clearly in command of standard, written, academic English.
4. Good
7.65 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
3. Satisfactory
6.75 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
2. Less Than Satisfactory
5.85 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
5. Excellent
3.6 points
All format elements are correct.
4. Good
3.06 points
Appropriate template is fully used. There are virtually no errors in formatting style.
3. Satisfactory
2.7 points
Appropriate template is used. Formatting is correct, although some minor errors may be present.
2. Less Than Satisfactory
2.34 points
Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.
1. Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. Excellent
5.4 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. Good
4.59 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
4.05 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. Less Than Satisfactory
3.51 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Total 180 points
