Q1. Tell us about a healthcare program within your practice
We have several programs within our practice. Medicare is among the programs that help people meet their healthcare needs. It provides health insurance for people who are eligible for social security. This program targets elderly individuals in the community who are above 65 years of age. They are the people who are eligible for social security because disability and it also helps people who suffer from end-stage renal disease. Currently, we have a total number of roughly 40 million beneficiaries and the number is still growing. We also cover home health services for eligible beneficiaries. This includes part-time nursing and assistance that is based at home. We offer services such as speech-language pathology, physical and occupational therapy, medical social services and durable medical equipment among other services. However, for home health services, the individual must be confined to their home.
Q2. What are the costs and projected outcomes of this program?
Medicare has different premiums which have different costs (Polyakova, 2016) . We have different categories which are group in part A, B and C. For part A, most people do not pay monthly premium. People with this premium pay $437 per month. For individuals who have paid Medicare taxes for less than 3 quarters, the standard premium for this part is $437 and for those who have paid Medicare taxes for 30-39 quarters has a standard part A premium of $240. For part A hospital in patient and deductible and coinsurance, an individual pays $1,364 deductible for each benefit period.
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For part B premium, the amount is $135.50 or higher because it depends on an individual’s income. The deductible and co insurance payments for part B is $ 185 per year. After an individual’s deductible is met, the person pays 20% of the Medicare approved amount for most of the healthcare services. Part C and part D monthly premium varies depending on a person’s plan. It is however important to note that this program is fully financed by the government.
Medicare program has had positive outcomes in that, about 90% of individuals who benefit from healthcare services are covered by the program. It has enlighten the heavy burden of chronic illnesses that the elderly people have.
Q3. Who is your target population?
Medicare program targets the elderly people who must be 65 years and older (Damiani et al., 2015) . It consists of individuals who live with disabilities. We also cater for individuals who suffer from end-stage renal disease or kidney failure that requires a transplant. People who are covered by Medicare program must be citizens of U.S (Smith & Medalia, 2014) and are eligible for social security benefits. They must have contributed their payments into the system for at least 10 years.
Q4. What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
Nurses have the role of planning patient care as well as coming up with methods that can help improve the coordination between the staff and other professionals (Al Sayah et al., 2014) . They also offer home healthcare services to the beneficiaries of the program. For example, we have set aside several nurses who deal with elderly patients from the comfort of their homes without necessarily coming to hospital. The reason behind home care programs by Medicare is because most of the individuals who benefit from the program get difficulties in adopting to a different environment.
Q5. What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
Nurses have a crucial role to play as advocates for their patients in this health care program. A nurse has the role of highlighting the benefits of the program to the target population based on experience (Hewitt, 2002). These include benefits such as quality health care out comes, satisfaction of the target population and better patient care. This also include how the quality of services offered through the program can be improved or enhanced in order to improve patient outcomes and ensure safety of the target population. Assessing and explaining the likely impact of the program on patient care is part of a nurse’s advocacy role (Hewitt, 2002). By doing so, the target population will be assisted in getting the resources and care they require in order to be healthy.
Q6. What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
A nurse has the role of assessing the implementation process of the program. Nurses ought to assess the health promotion activities carried out in the program implementation (Little et. al, 2017). The nurse should apply the various types of expertise in health promotion to ensure that the welfare of the patients is catered for during the implementation process. The nurse will ensure that the implementation process is patient centered. This is different from the role of the nurse in the program design process which involves planning of the program. During the design phase, input on the program components, activities etc. is given. However, during the implementation phase, whatever is planned and agreed upon during the designing process is put into action.
Q7. Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
Members of the health care team who are crucial in the implementation of a program include nurses, physicians, technicians, technology experts, dentists, pharmacists and the administration. Health care is team work and each member has a responsibility and role to play in the program implementation. The above stated members are most needed in the implementation process because they are directly involved with the project and the patients (Little et.al, 2017). They have direct contact with patients and therefore are important players in the implementation of a program that directly affects the patients. In addition, they have contact with patient information and therefore their involvement in the implementation logistics is important to ensure that every aspect that is implemented is for the welfare of the patients. They ensure improved patient outcomes and represent their clients in the implementation phase.
References
Polyakova, M. (2016). Regulation of insurance with adverse selection and switching costs: Evidence from Medicare Part D. American Economic Journal: Applied Economics , 8 (3), 165-95.
Damiani, G., Salvatori, E., Silvestrini, G., Ivanova, I., Bojovic, L., Iodice, L., & Ricciardi, W. (2015). Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review. Clinical interventions in aging , 10 , 237.
Smith, J. C., & Medalia, C. (2014). Health insurance coverage in the United States: 2013 . Washington, DC: US Department of Commerce, Economics and Statistics Administration, Bureau of the Census.
Al Sayah, F., Szafran, O., Robertson, S., Bell, N. R., & Williams, B. (2014). Nursing perspectives on factors influencing interdisciplinary teamwork in the C anadian primary care setting. Journal of clinical nursing , 23 (19-20), 2968-2979.
Hewitt, Jeanette. “A Critical Review of the Arguments Debating the Role of the Nurse Advocate.” Journal of Advanced Nursing , vol. 37, no. 5, 2002, pp. 439–445., doi:10.1046/j.1365-2648.2002.02110.x.
Little, J. M., Odiaga, J. A., & Minutti, C. Z. (2017). Implementation of a Diabetes Transition of Care Program. Journal of Pediatric Health Care,31 (2), 215-221. doi:10.1016/j.pedhc.2016.08.009
