FOR APLUS WRITER ONLY !

EVERYTHING NEEDS TO BE APA STYLE , 

THIS IS DUE ON WEDNESDAY ! 

TWO SEPERATE DOCUMENTS 

CHAPTERS ARE ATTACHED ! 

DISCUSSION ONE 

After reading Chapter 1 through 4, you should be familiar with quality improvement initiatives including NCQA’s HEDIS® measures (Links to an external site.)Links to an external sithttp://www.ncqa.org/hedis-quality-measurement/hedis-measures

Health plans and physicians must ensure they are meeting standards set by the accreditation agencies, such as NCQA. As a physician practice manager for Dr. Jones, you have just conducted a mock survey of the patient chart data. The data shows that your physician practice is not meeting standards for two HEDIS® measures.

  • Choose two HEDIS® measures (from the list below) that must be implemented in a physician practice to improve patient outcomes.
  • Describe the sources of data needed to conduct the two measures. 
  • Using one of the quality improvement models (Lean, PDSA, or Six Sigma), explain how you would use the model to implement the two chosen HEDIS® Measures.

Mammograms:

  1. Women age 50-74 years, who have had a mammogram during the preceding 24 months. Exclusion of those women who have undergone bilateral mastectomy.

Prostate Screening:

  1. Male 50 years and greater who have received an annual PSA and/or Digital Rectal Exam.

Your initial post should be 250-300 words 

DISCUSSION TWO

The Department of Health and Human Services has oversight of several agencies (i.e., FDA, CDC, AHRQ, NIH, CMS) that regulate health care in the United States. Regulation encompasses insurance plans, cost, research, safety, all in the name of delivering quality care in a cost effective manner. These agencies are responsible for monitoring compliance and enforcing legislative mandates. However, the debate continues on government regulation and its effect on ensuring quality care. After completing this week’s reading, review the following articles listed below, which were published 11 years apart. Analyze the cost-quality paradigm noted in the articles. Considering the many governmental mandates and regulations to reduce costs and ensure the delivery of quality care that have been implemented over the years, discuss your opinion regarding why costs have continued to rise without improving quality. List two examples that illustrate your point.

  • DHHS Article related to Cost and Quality (2002) https://aspe.hhs.gov/basic-report/confronting-new-health-care-crisis-improving-health-care-quality-and-lowering-costs-fixing-our-medical-liability-system
  •  (Links to an external site.)Links to an external site.
  • Institute of Medicine article (2013) http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2013/US-Health-International-Perspective/USHealth_Intl_PerspectiveRB.pdf (Links to an external site.)Links to an external site.

Your initial post should be 250-300 words 

SOURCE 

Moin, T., Scales, C., & Sinay, T. (2014). Principles of healthcare quality management: Tools and applications [Electronic version]. Retrieved from https://content.ashford.edu

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