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The Essay topic question is why do people tell stories or why is storytelling important, what is the value of storytelling etc.
Use Interpreter of Maladies in essay as an example. You can find an example or a quote that supports the argument you’re making about why people tell stories, and then give a couple of sentences explaining exactly how/why the example or quote supports the argument.
Health Care Financing Administration Case Study
Coding Accuracy
BACKGROUND
In our recent report, Using Software to Detect Upcoding of Hospital Bills (OEI-01-97-00010), we examined the ability of commercially available software to identify DRG upcoding through analysis of electronic claims data. We used two software products to identify 299 hospitals with a high suspected rate of upcoding. We then used accredited medical records professionals to perform a blinded DRG validation on a sample of over 2,600 claims from 50 of these hospitals and a control group of 20 hospitals.
In the course of conducting this study, we developed serious concerns about the potential for abuse of the DRG system through upcoding and about HCFA’s oversight of the accuracy of DRG coding. Specifically, we found that, although the hospitals payment system is functioning well as a whole, the system has significant vulnerabilities to upcoding that can easily be avoided. We also found that, despite these vulnerabilities, Health Care Financing Administration (HCFA) is not performing routine, ongoing monitoring, and analysis of DRG coding to detect problematic DRGs, hospitals, and coding situations that require administrative, educational, or law enforcement intervention.
FINDINGS
THE DRG system is vulnerable to abuse by providers who wish to increase reimbursement inappropriately through upcoding, particularly so within certain DRGs. Our analysis found noticeable, detectable, and curable upcoding abuses among providers and within specific DRGs.
In a focused sample from a group of 299 hospitals that computer software identified as high up coders, we found that an average of 11 percent of DRG bills submitted during 1996 were up coded, versus 5 percent of bills among a control sample of hospitals.
The average rate of upcoding in the control sample of hospitals (those without a high predicted rate of upcoding) was not statistically different from the average down coding rate. However, among hospitals that the software predicted would have a high rate of upcoding, the average upcoding rate was more than twice that of down coding. The difference between upcoding and down coding in these hospitals suggests international abuse oof the DRG system by some providers.
Using data from both our focused review and the more broadly representative 1996 DRG validation performed by HCFA’s clinical data abstraction centers (CDAC), we found that certain DRGs are particularly susceptible to upcoding.
Claims billed for these three DRGs show a clear pattern that exemplifies the upcoding seen in a group of over half a dozen DRGs we examined. These DRGs were up coded disproportionately, especially by our experimentally identified upcoding hospitals, but also among hospitals from the general population represented by the CDAC review and our control sample.
The HCFA does not routinely analyze readily available billing and clinical data that could be used to proactively identify problems in DRG coding.
The HCFA does not routinely analyze data from the annual validation of DRG coding performed by its clinical data abstraction centers.
Since 1995, HCFA has used two specialized contractors called clinical data abstraction centers to validate the DRGs on an annual national sample of over 20,000 claims billed to Medicare. On a monthly basis, the CDACs report detailed data on each claim reviewed to HCFAs Office of Clinical Standards and Quality. These data include original and validated diagnostic coding, original and validated DRGs, and reasons for any variance between the DRGs_ The purpose of this validation effort is to provide HCFA with insight as to the accuracy of DRGs billed to Medicare.
However, we found that HCFA performs no routine, ongoing analysis of CDAC data. In our interviews with staff at the two HCFA components that have responsibility for DRGs—the Office of Clinical Standards and Quality, and the Center for Health Plans and Providers—staff were unable to identify any routine monitoring and analysis of CDAC data. In our review of HCFAs instructions to the peer review organizations (PROs), contractors who have statutory responsibility for DRG oversight, we found no Instructions advising them to perform regular analysis of CDAC data.
Yet we believe that analysis of CDAC data can be of great value to HCFA in overseeing the accuracy of DRG coding. For example, in HCFAs 1996 DRG validation, the CDACs found a 4 percent upcoding rate with estimated net overpayment of $183 million. Some may suggest that overpayments of $183 million in an $80 billion program (less than one-quarter percent) indicate that the DRG payment system does not have major problems with upcoding and warrants no further analysis. However, our analysis presented above shows that by digging below the immediate surface, upcoding problems are readily apparent.
The HCFA does not routinely analyze data from hospitals, despite the fact that these data are ideally suited for monitoring and analysis of DRGs.
The HCFA maintains valuable clinical, demographic, and administrative data that form the underlying basis of each of the over 10 million DRG-based claims billed to Medicare each year. Data for each hospitalization include diagnosis codes, procedure codes, beneficiary demographics, admission and discharge detail, cost reporting data, and hospital identifier for linkage with provider demographics. Whether used on its own to monitor billing patterns and trends or used to further explore potential problem areas identified within CDAC data, data from hospital claims can provide valuable information to assist in HCFAs oversight of DRG coding.
However, we found that HCFA does not make routine use of data from hospital claims for monitoring and analysis of DRG coding. In our interviews with staff at both HCFAs Office of Clinical Standards and Quality and its Center for Health Plans and Providers, staff were unable to identify any routine monitoring and analysis of DRG billing data. Interviews at HCFAs Program Integrity unit, within the Office of Financial Management, revealed that HCFA conducts some limited analysis of billing data. However, this analysis is done on a very broad level, primarily to identify’ coverage issues.
We also reviewed HCFAs current instructions to the Medicare Pros We found no instructions to the PROs advising them to perform any routine monitoring and analysis of DRG coding, despite the fact that PROs already have a complete set of inpatient billing data provided to them by HCFA. In fact, HCFA staff told us that the PROs were instructed not to do “coding projects” within their current contract. We did find that PROs are involved in sporadic activity around DRG oversight; however, this activity often is in support of an OIG investigation.
Source: United States Department of Health and Human Services_ (1999). Monitoring the accuracy of hospital coding. Retrieved from https://oig.hhs.gov/oei/reports/oei-01-98-00420.pdf
Submit a 5 – 6 page essay to answer the following question, and be sure to refer to specifics in the case study to support your answers and point of view. The final essay assignment is worth 100 points.
What
Essay Question #1: Chapter six in the Essentials of International Relations textbook discusses “types of war” on pages 191-206. Define and discuss the different ways wars are fought including Conventional War, Unconventional Warfare, Terrorism, and Cyberwarfare. Be sure to bring in plenty of examples from the textbook as you explore each of these different types of warfare.
Essay Question #2: Chapter eight in the Essentials of International Relations textbook focuses on International Political Economy. For this essay you will explain how the globalized economy works today with a particular focus on international finance, international trade and negotiations, and economic regionalization (see especially pages 279-294). Be sure to bring in plenty of examples from the textbook as you write your essay.
Digital e Book:
https://digital.wwnorton.com/46490
Accounting Cost Systems and Cost Behavior
Assignment Overview
Preparation of an Income Statement for The Serious Reader Company
The first case of this course provides an opportunity to prepare a segmented variable costing (contribution margin, behavioral) income statement and analyze the information. This is a very small company and the information may seem simplistic at first glance. Don’t forget that numbers and hands-on practice best illustrate many basic accounting concepts.
The Serious Reader Company is a small online retailer operating out of a garage apartment. The owner buys books at garage sales, thrift shops, library sales, and whenever an opportunity arises. The company classifies all books into five categories based on cost of acquisition and estimated sales price. See below for details about books purchased and sold during the last year (20XX).
Price Categories
A B C D E
Units Sold 4,000 1,000 500 400 400
Unites Purchased 6,000 1,200 1,000 1,000 1,000
Resale Price $4.00 $12.00 $20.00 $45.00 $60.00
Cost $0.50 $4.00 $10.00 $20.00 $20.00
In addition to purchasing inventory (used books), the company incurs some operating expenses.
Variable Operating Expenses
Shipping per book $1.50
Common fixed expenses
Internet-related costs $10,000
Travel, etc. $4,000
Advertising $1,000
Other overhead $5,000
Case Assignment
Required:
Computations (use Excel)
• Prepare a segmented variable costing (behavioral) income statement for the company in good format.
• Prepare a second variable costing statement assuming 90% of all the books in each category purchased were actually sold.
• Prepare a third variable costing statement assuming that the price is increased by 50% for all five categories (use original sales information).
• The owner enjoys the used-book business. Any suggestions as how to turn this into a full-time business venture so the owner can quit his other job? Prepare another income statement to support your idea.
Memo (use Word)
Interpret the results from the computations and explain how the information is useful. Write a 4- or 5-paragraph memo to the owner of the business. Start with an introduction and end with a recommendation. Each of the four or five paragraphs should have a heading.
Short essay to comment on the questions below (use Word). Start with an introduction and end with a summary or conclusion. Use headings. Maximum length of two pages.
• Why do many organizations make the effort to prepare a different type of income statement for internal purposes?
• Variable costing is not just about preparing income statements. Provide at least three scenarios in which understanding how costs behave is useful.
Assignment Expectations
Each submission should include two files: (1) An Excel file; and (2) A Word document. The Word document shows the memo first and short essay last. Assume a knowledgeable business audience and use required format and length. Individuals in business are busy and want information presented in an organized and concise manner.
• Column 1: HCA Program Learning Objective (provided for you).
• Column 2: A summary of how your content addresses the objective in your research project. Paragraph style writing, in the third person, should be used.
Column 3: Identify the references used to support each learning objective
PO1. Articulate theories and principles of health care management
PO2. Articulate management principles to functional areas of health care.
PO3. Identify determinants and measurements of health and disease in epidemiology, public health, promotion of health, and disease prevention.
PO4. Identify unique characteristics of law and ethics in health services.
PO5. Apply management skills to leadership concepts.
PO6. Compare health service organizations and delivery structures, functions, and professionals.
Assessment Commentary Directions: Respond to the prompts below (no more than 8 single-spaced pages, including prompts) by typing your responses within the brackets following each prompt. Do not delete or alter the prompts; both the prompts and your responses are included in the total page count allowed. Refer to the evidence chart in the handbook to ensure that this document complies with all format specifications. Pages exceeding the maximum will not be scored.
1. Analyzing the Focus Learner Performance
a. Identify the lesson objectives from the learning segment measured by each daily assessment record for both learning targets.
b. Describe any changes in the assessments (baseline and/or final), daily assessment records, and/or lesson objectives related to either learning target from what was described in the lesson plans, and explain why changes were made.
c. If the work sample or the final assessment for the supporting/secondary learning target is an excerpt from a video from Task 2: Instructing and Engaging the Focus Learner, provide a time-stamp reference here.
d. Summarize the focus learner’s progress toward each learning target as reflected in the lesson objectives. Each summary can be presented in a chart or described in several paragraphs.
e. For each learning target as reflected in the lesson objectives, analyze the focus learner’s strengths (what s/he appears to understand or do well) and where s/he continues to struggle or need greater challenge, including any patterns in errors, confusions, or needs. Be sure to cite evidence from your summary (above) as part of this discussion.
f. Identify any patterns in the related to focus learner performance and level or types of supports provided to the focus learner. How did this support affect the learner’s progress toward each learning target?
Cite evidence from the work sample, the baseline data, daily assessment records, and final assessment (if different from the daily assessment record) as needed, to clarify or illustrate your summary and analyses.
2. Feedback to Guide Further Learning
Refer to specific evidence of submitted feedback to support your explanations.
a. In what form did you submit your evidence of feedback to the focus learner for the final assessment for the primary learning target? (Delete choices that do not apply.)
Written directly on work samples or in a separate document
In an audio file
In a video clip from the instruction task (provide a time-stamp reference) or in a separate video clip
b. Explain how feedback provided to the focus learner addresses his/her individual strengths and continuing needs relative to the lesson objectives for the primary learning target measured in the work sample.
c. How will/did you support the focus learner to apply the feedback to guide improvement within the learning segment or in subsequent learning tasks?
d. How will/did you support the focus learner to move toward using error prevention strategies, self-assessment, self-instruction, and/or self-correction?
3. Evidence of Use of the Expressive and/or Receptive Communication Skill (function) and Other Communication Demands
You may provide evidence of the focus learner’s use of the targeted expressive and/or receptive communication skill (function) and other communication demands from ONE, TWO, OR ALL THREE of the following sources:
1. Use video clips from Task 2 and provide time-stamp references.
2. Submit an additional video file named “Communication Use” of no more than 5 minutes in length and provide time-stamp references. See Task 3 Evidence Chart for acceptable file types. Submit the clip in Task 3 Part C.
3. Use the work sample analyzed in Task 3 and cite use of the targeted communication skills.
When responding to the prompts below, use concrete examples from the clips (using time-stamp references) and/or the focus learner’s work sample as evidence.
Explain the extent to which the focus learner had opportunities to use the targeted expressive and/or receptive communication skill (function) and other communication demands (vocabulary demands, syntax, social use of communication, situational expectations) to access the learning task and/or to demonstrate learning.
4. Using Assessment to Inform Instruction
Consider what you know about the focus learner and the effectiveness of your instruction/intervention and the learning environment when designing next steps related to both learning targets. Consider all aspects of instruction, including support and environmental modification, as appropriate. Connect your next steps to your analysis of the focus learner’s performance. Support your decisions with principles from research and/or theory, particularly as it relates to evidence-based practices.
a. For both learning targets, describe next steps for instruction to
reinforce current progress toward or attainment of the associated lesson objectives
support further progress in the curriculum after achievement of the lesson objectives.
b. Based on what the focus learner knows and can do and your next steps, describe implications for the focus learner’s iep goals and/or curriculum.
Introduction:
Electronic Health Records (EHRs) have revolutionized the clinical record keeping systems in physician’s offices. Before the Centers for Medicare and Medicaid (CMS) started the incentive programs for EHR implementation, only 10% of the physicians used EHRs in their offices. Now, roughly 80% of the physician’s offices in the country are utilizing electronic media for clinical applications.
Directions:
In a 5-page essay, discuss how EHRs function within the physician’s office and
focus on what it means to use the EHR “meaningfully” through the Meaningful
Use Incentive program.
Readings:
https://www.pbs.org/newshour/health/health-insurance-exchange-101-1
Additional Resources:
International Classification of Disease-historical perspective and discussion
• http://www.who.int/classifications/icd/en/
ICD-10 Conversion
• http://www.aapc.com/icd-10/faq.aspx
Pros and Cons of the EHR
• http://minnesota.publicradio.org/display/web/2011/06/06/health-careindustry-online/
• http://healthcare.adsc.com/blog/bid/309915/Pros-and-Cons-ofElectronic-Health-Records
Taking the Next Step with EHRs – Meaningful Use (It is expected that everyone
reads the majority of the left hand links on this government website)
• https://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrin
centiveprograms
Provider Reimbursement – Pay for Performance
• https://www.healthaffairs.org/do/10.1377/hpb20121011.90233/full/
Changes in Primary Care – The Medical Home
• http://www.ncsl.org/research/health/the-medical-home-model-ofcare.aspx
Clinical Analytics
• http://www.himss.org/library/clinical-business-intelligence/clinicalbusiness-intelligence-primer/types-of-clinical-analytics
Patient Centered Medical Homes
• http://ushealthpolicygateway.com/vii-key-policy-issues-regulation-andreform/patient-protection-and-affordable-care-act-ppaca/ppacaresearch-and-analysis/aca-impact-on-quality-and-outcomes/patientcentered-medical-homes-pcmhs/
According to the below mentioned articles, we have to reflect on the following questions:
– Do you think arguments in the two articles are grounded in good research?
– Say in detail why you think so. Use as many as possible of the categories of judgement
– feel free to be critical.
1- Blanding, M. (2017b) Why Global Investments Are Still a Good Bet [online]. Available at:
http://hbswk.hbs.edu/item/why‑global‑investments‑are‑still‑a‑good‑bet (accessed 6 October 2017).
2- Mag, G. (26 September 2017) Financial Crime Compliance Costs Soar, New Research Shows
[online]. Available at:
www.globalbankingandfinance.com/financial‑crime‑compliance‑costs‑soar‑new‑research‑shows/ (accessed 6
October 2017).
Define the purpose of social movements and identify the 4 types of social movements as outlined by Aberle (1966) and then explain the 4 stages of social movements of the women’s movement in an australian context
Assignment 4: People Management Scorecard
Introduction
A successful workforce strategy is rooted in the mission, vision, and major goals of the organization, and it impacts all parts of the employee lifecycle. In this final assignment, you will assess your organization on its workforce strategy and people management processes.
You will use the People Management Scorecard tool, provided in your course, to pull together your evaluation of the various components of people management across the organization. This tool enables you to make a well-structured and succinct evaluation of the state of people management and workforce strategy in your organization, and to develop relevant ideas for improvement in the weaker areas.
The areas you will assess are:
1. Alignment with Mission, Vision, and Goals
2. Hiring Process
3. Team Management and Diversity
4. Differentiation
5. Performance Reviews
6. Letting People Go
7. Coaching, Development, and Culture
Instructions
Prepare for this assignment by downloading the Scorecard tool, found in the Assignment Information folder for Week 9 of your course in Blackboard. Save the Scorecard file as a Word document, using your name and following the format shown below:
• LastName_FirstName_JWI520_Scorecard.docx
o e.g. Doe John_ JWI520_Scorecard.docx
Using the organization where you currently work, or an organization with which you are familiar:
• Write your Introduction in the first section of the Scorecard:
o In this section, provide a brief description of your organization, including its products or services, industry sector, location, number of employees, etc. Provide a brief, high-level summary of the organization’s current approach to people management and overall workforce strategy. This section must be no more than 300 words.
JWI 520: People Management
Academic Submissions and Evaluations
© Strayer University. All Rights Reserved. This document contains Strayer University confidential and proprietary information and may not be
copied, further distributed, or otherwise disclosed, in whole or in part, without the expressed written permission of Strayer University. This course guide is subject to change based on the needs of the class.
JWMI 520 – Assignment 4 (1218) Page 2 of 4
• Fill out all 7 sections in the Scorecard. Each section covers one component of people management or workforce strategy at your organization.
• For each item, complete all 3 columns:
o Column 1: provide a score of A, B, or C for that area of people management
(A = Excellent / B= Satisfactory / C = Poor)
o Column 2: provide a brief rationale that clearly illustrates the reasons for your score
o Column 3: provide an actionable recommendation to improve or maintain performance • Write your Recommendations Summary in the final section of the Scorecard:
o In this section, write a short synopsis or summary of all your change recommendations for the people management process. Explain how the various recommendations will work together to create significant improvements to the existing people management processes at your organization.