resp 2

Original assignment: Select a problem of importance to your practice (this might be related to your DNP scholarly project). How can epidemiology be used to improve this situation? Is there a type of observational study that has addressed this problem in the nursing literature? If so, please cite example. If not, what would you design to address your problem?

 

Peer to respond to:

Low adherence to colonoscopy among the Asian population can be attributed to several factors, including cultural beliefs, language barriers, and limited access to healthcare. Many Asian cultures emphasize modesty and may view medical procedures, especially those involving intimate areas, as invasive and embarrassing. This cultural stigma can deter individuals from seeking preventive care such as colonoscopies. Additionally, language barriers can prevent effective communication between healthcare providers and patients, leading to misunderstandings about the importance of colonoscopies and how they are performed. Limited access to healthcare, whether due to socioeconomic factors or lack of insurance, also plays a significant role in reducing adherence rates.

Epidemiology can improve this situation by identifying the specific barriers and facilitators to colonoscopy adherence within the Asian population. By conducting targeted research, epidemiologists can gather data on prevalence rates, risk factors, and health outcomes related to colorectal cancer in this group. This information can then inform public health interventions tailored to the unique needs and preferences of the Asian community. For example, culturally sensitive educational campaigns and translation services can be developed to improve understanding and acceptance of colonoscopies. Additionally, community health programs can be implemented to provide easier access to screening and follow-up care.

One type of observational study that has addressed this problem in the nursing literature is the cross-sectional study by Lee et al. (2014, 2018).  They conducted a cross-sectional study examining the factors associated with colorectal cancer screening among Asian Americans. They found that lower screening rates were associated with lack of physician recommendation, lower health literacy, and cultural barriers. This study highlights the importance of understanding the multifaceted reasons behind low adherence to colonoscopy and provides a foundation for developing targeted interventions.  Another systemic review study by Tong et al. (2015) analyzed multiple studies and found that Asian Americans consistently had lower colorectal cancer screening rates compared to the general U.S. population. The review emphasized the need for culturally tailored interventions to improve screening rates among Asian Americans.

References

Lee, H. Y., Lundquist, M., Ju, E., Luo, X., & Townsend, A. (2014). Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: Which groups are most vulnerable? Ethnicity & Health, 16(6), 527-542. https://doi.org/10.1080/13557858.2011.602392

Lee, H.Y., Lundquist, M., Ju, E., Luo, X., Townsend, A. (2018). “Disparities in Colorectal Cancer Screening Among Asian Americans and Pacific Islanders.” American Journal of Preventive Medicine, 54(5), 701-709. DOI: 10.1016/j.amepre.2018.01.038

Tong, E.K., Nguyen, T.T., Lo, P., Stewart, S.L., McPhee, S.J. (2015). “Colorectal Cancer Screening Among Asian Americans: A Systematic Review.” Journal of Cancer Education, 30(4), 819-827. DOI: 10.1007/s13187-014-0734-y

Are you struggling to create a sound and comprehensive nursing paper? Do you feel overwhelmed with the amount of time and effort it takes to write a good piece? Are you looking for the best nursing paper writing service that can assist you in your nursing paper needs? Look no further than our skilled team of professional writers who specialize in providing high-quality papers with the best nursing paper writing services reviews. Make your order at nursingpaperhelp.com

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

resp. 2

Peer response:

Distinguish between volume- and value-based insurance design.

Volume-based insurance design (VBID) and value-based insurance design (VBID) are two approaches that insurers and purchasers use to structure healthcare benefits with differing focuses:

Volume-Based Insurance Design (VBID):

VBID typically emphasizes the quantity or volume of healthcare services provided to beneficiaries. It often involves traditional insurance models where coverage and copayments are based on service utilization without specific regard to the clinical or economic value of those services (Nash, 2019).

Characteristics: In VBID, insurers may set copayments and deductibles uniformly across services, regardless of their clinical effectiveness or cost efficiency. This approach does not systematically differentiate between high-value and low-value services.

Example: Traditional fee-for-service plans where copayments are consistent for all medical procedures, medications, or services (Chernew et al., 2020).

Value-Based Insurance Design (VBID):

VBID shifts focus to the clinical and economic value of healthcare services. It aims to align cost-sharing and coverage decisions with the value that specific services provide in terms of improving health outcomes and reducing overall healthcare costs.

Characteristics: In VBID, insurers may reduce or eliminate cost-sharing for services deemed high-value (e.g., preventive care, chronic disease management) to encourage their utilization. Conversely, cost-sharing may be increased for low-value services to discourage unnecessary utilization.

Example: Plans that offer lower copayments or deductibles for medications and services proven to be effective in managing chronic conditions like diabetes or asthma (Chernew et al., 2020).

Reasons for Moving Towards VBID and VBID:

Insurers and purchasers are increasingly adopting VBID and VBID for several reasons:

Cost Containment: These approaches aim to control healthcare costs by encouraging the use of high-value services that lead to better health outcomes while discouraging unnecessary or low-value care (Nash, 2019).

Improved Health Outcomes: By aligning incentives with evidence-based practices and preventive care, VBID and VBID can potentially enhance population health and reduce the burden of chronic diseases.

Consumer Engagement: These designs can enhance consumer engagement and satisfaction by making healthcare benefits more transparent and aligning them with individuals’ health needs and preferences (Chernew et al., 2020).

 

Key Takeaways for Training New Employees on HEP Plan:

Required Services: Emphasize that certain preventive care services and screenings are mandatory for enrollment in the HEP plan. This includes annual physicals, dental cleanings, and age-appropriate screenings, which are provided at no cost to encourage early detection and better management of health conditions (Nash, 2019).

Chronic Disease Management: Highlight the benefits for employees with chronic conditions (like asthma, diabetes) such as disease management programs and zero copays for chronic care appointments. This aims to improve health outcomes and reduce long-term healthcare costs (Nash, 2019).

Cost Implications: Clarify the cost structure, including a premium surcharge for non-participation in required services and copayments for emergency room visits when less costly alternatives are available (Nash, 2019).

Mr. Joseph’s Concern about Increased Costs:

While Mr. Joseph may initially perceive potential cost increases due to program requirements and copayments, the HEP plan is designed to promote cost-effective healthcare utilization. By encouraging preventive care and managing chronic conditions more effectively, the plan aims to reduce overall healthcare expenditures over time (Nash, 2019).

Guidance for Harry, the Diabetic Employee:

Diabetes Management: Mr. Arnold should inform Harry about the specific benefits available to him under the HEP plan, such as disease management programs tailored to diabetes, free chronic care appointments with no copay, and access to preventive services without additional cost. Encourage Harry to actively engage in these programs to better manage his condition and improve his health outcomes.

  1. Population and Health Factors Affecting HEP Plan Profitability:

Population Health Impact: The health status of state employees, particularly the prevalence of chronic conditions like asthma, diabetes, and heart disease, significantly affects the HEP plan’s profitability. By targeting these high-risk populations with specialized programs and preventive care, the plan can potentially reduce healthcare costs associated with complications and hospitalizations.

Program Effectiveness: The effectiveness of the HEP plan in improving health outcomes and reducing unnecessary healthcare utilization (e.g., emergency room visits) will contribute to its long-term profitability. Effective communication and education about the plan’s benefits and requirements are crucial for maximizing participation and achieving cost savings.

In conclusion, while initial perceptions about increased costs exist, the HEP plan’s emphasis on preventive care, chronic disease management, and cost-effective healthcare utilization aims to benefit both employees like Harry and the organization through improved health outcomes and reduced healthcare expenditures over time.

From the perspective of a healthcare provider, engaging in value-based purchasing can have both positive and negative implications:

Advantages:

Quality of Care: Value-based purchasing encourages providers to focus on delivering high-quality care and achieving better patient outcomes, which can lead to improved overall health for patients (McWilliams et al., 2019).

Financial Incentives: Providers may benefit from financial incentives tied to performance metrics, such as bonuses or shared savings, which can help offset costs and improve practice revenue (McWilliams et al., 2019).

 

Disadvantages:

Administrative Burden: Participating in value-based purchasing often requires significant investment in data collection, reporting, and compliance with quality measures, which can increase the administrative burden and operational costs (McWilliams et al., 2019).

Risk of Financial Penalties: Providers face financial penalties or reduced reimbursements if they fail to meet performance targets or control costs effectively, which can create financial uncertainty and strain on resources (McWilliams et al., 2019).

Reference:

 

Chernew, M. E., Rosen, A. B., & Fendrick, A. M. (2020). Value-based insurance design. American Journal of Managed Care, 26(9), e273-e276.

David Nash. (2019). The Healthcare Quality Book: Vision, Strategy, and Tools, Fourth Edition: Vol. Fourth edition. AUPHA/HAP Book.

McWilliams, J. M., Landon, B. E., Chernew, M. E., & Zaslavsky, A. M. (2019). Delivery system integration and health care spending and quality for Medicare beneficiaries. JAMA Internal Medicine, 179(4), 524-531.

Are you struggling to create a sound and comprehensive nursing paper? Do you feel overwhelmed with the amount of time and effort it takes to write a good piece? Are you looking for the best nursing paper writing service that can assist you in your nursing paper needs? Look no further than our skilled team of professional writers who specialize in providing high-quality papers with the best nursing paper writing services reviews. Make your order at nursingpaperhelp.com

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now