Integration of Health Systems

Note: Before completing this Assignment, please familiarize yourself with the Week 4 Assignment Rubric, located in the Course Information area of the course navigation menu.

Intermountain Healthcare is a high-performing integrated health system with facilities in Utah and Idaho. The health system has a long-standing clinical integration structure that encourages professional collaboration. Despite this, in 1999, many physicians at Intermountain Healthcare found it difficult to fulfill the needs of patients with co-occurring physical and mental health conditions. To efficiently and effectively address this issue, Intermountain Healthcare adopted a mental health integration model in many of its primary care facilities, as well as some of its specialty clinics and partner clinics. The team-based approach has improved the coordination of services, resulting in higher quality care at a savings of cost.

Consider the example above. What advantages does integration afford Intermountain Healthcare? Do other integrated health systems experience similar benefits? Are there disadvantages to integration? If so, what are they?

To prepare for this Assignment, review the information related to vertical and horizontal integration presented in the Learning Resources.

Select one of the following horizontally integrated health systems:

• National Surgical Hospitals
• Select Medical Healthcare
• Sunrise Senior Living
• Labcorp
• Quest Diagnostics
• Pfizer Pharmaceuticals

Also select one of the following vertically integrated health systems:

• Kaiser Permanente
• Mayo Clinic
• Cleveland Clinic
• MedStar Health
• Memorial Hermann Healthcare System Houston

As an alternative, you may use Becker’s Hospital Review resource to identify a vertically integrated health system.

Using the Walden Library and credible sources on the Internet, research your selected health systems. Investigate the rationale for pursuing integration and the strategies each health system has used to achieve integration. Note information related to the size of each health system, settings/locations, and types of services it provides.

Based on your research, consider the ways in which the two health systems are similar to and/or different from one another.

Assess the business and health care-related implications of horizontal and vertical integration of your selected health systems. How does integration impact the management of your selected organizations and the patients/consumers they serve, especially in terms of cost, quality, and access?

Consider any applicable insights you have gained through the Discussion for this week.

The Assignment

Write a paper in which you:

• Compare the horizontally integrated health system and the vertically integrated health system you have selected (e.g., size, settings/locations, and types of services).
• Explain each health system’s rationale for pursuing integration and the strategies it has used to achieve integration.
• Assess the business and health care-related implications of integration for your selected health systems, including how integration impacts the patients/consumers the organization serves.

General Guidance on Assignment Length: Your Assignment should be 3–4 pages, excluding a title page and references. Refer to the Week 4 Assignment Rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work.

Required Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Readings

• Shi, L., & Singh, D. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett.
  • Chapter 9, “Managed Care and Integrated Organizations” (pp. 361–368)
• Cohen, A., Klein, S., & McCarthy, D. (2014). Hill Physicians Medical Group: A market-driven approach to accountable care for commercially insured patients. Retrieved from http://www.commonwealthfund.org/~/media/files/publications/case-study/2014/oct/1770_cohen_hill_physicians_aco_case_study.pdf
• Cutler, D. M., & Morton, F. S. (2013). Special communication: Hospitals, market share, and consolidation. JAMA, 310(18), 1964–1970.
  Retrieved from the Walden Library databases.
• Sanford, K. D. (2013). Integration requires new roles and responsibilities. Healthcare Financial Management, 67(3), 56–60.
  Retrieved from the Walden Library databases.
• Summer, L. (2014). Research insights: Integration, concentration, and competition in the provider marketplace. Retrieved from http://www.academyhealth.org/files/publications/AH_R_Integration%20FINAL2.pdf

Use the following resources to select integrated health systems on which to focus for your Assignment. You may also use this list to develop background information as you research health systems in your area for the Discussion.

• Rodak, S. (2013). 100 integrated health systems to know. Retrieved from http://www.beckershospitalreview.com/lists/100-integrated-health-systems-to-know.html

Vertically Integrated Health Systems

• Cleveland Clinic. (n.d.). Retrieved March 27, 2015, from http://my.clevelandclinic.org
• Kaiser Permanente. (n.d.). Retrieved March 27, 2015, from http://kp.kaiserpermanente.org/
• Mayo Clinic. (n.d.). Retrieved March 27, 2015, from http://www.mayoclinic.org
• MedStar Health. (n.d.). Retrieved March 27, 2015, from https://www.medstarhealth.org/
• Memorial Hermann Healthcare System Houston. (n.d.). Retrieved March 27, 2015, from http://www.memorialhermann.org

Horizontally Integrated Health Systems

• Labcorp. (2014). Retrieved March 27, 2015, from https://www.labcorp.com/
• National Surgical Healthcare. (n.d.). Retrieved March 27, 2015, from http://www.nshinc.com
• Pfizer Pharmaceuticals. (n.d.). Retrieved March 27, 2015, from http://www.pfizerrxpathways.com/
• Select Medical. (n.d.). Retrieved March 27, 2015, from http://www.selectmedical.com
• Sunrise Senior Living. (n.d.). Retrieved March 27, 2015, from http://www.sunriseseniorliving.com/
• Quest Diagnostics. (n.d.). Retrieved March 27, 2015, from http://www.questdiagnostics.com/

  Please include the resources provided to complete this assignment

· Module 2.2 Learning Resources 

Readings:

· Barkholtz, D. (2017). Vanderbilt is a case study for the dreaded EHR conversion. Retrieved from: http://www.modernhealthcare.com/article/20170501/NEWS/170509989 

· Epic. Patient engagement. Accessed from: http://www.epic.com/software#PatientEngagement  

· Media:

deBronkart, D. [e-Patient Dave]. (2011, April 7). TEDx Maastricht-Dave deBronkart-aka e-Patient Dave: Let patients help! [Video file]. Retrieved from https://www.youtube.com/watch?v=2vejkD0Rl3o

Module 2.2 Activity 

This Learning Activity will help you to develop skills and knowledge that you will need for the Competency Assessments. It is highly recommended that you complete this optional activity.

Participatory Healthcare Informatics

After viewing the video “Let Patients Help”, address the following in your paper:

· Explain the driving forces behind the emergence and continuing evolution of the ePatient movement.

· Analyze the issues and challenges associated with the use of social media in healthcare and healthcare education.

· Describe driving forces behind the mHealth movement.

Include a minimum of two scholarly resources to support your statements.

Provide current creditable sources supporting your statements. 

Prepare this paper according to current APA guidelines. 

Purpose 

The purpose of this assignment is to provide the student with an opportunity to explore the nurse practitioner (NP) practice requirements in his/her state of practice, NP competencies and leadership skills to develop a plan to support professional development. 

Activity Learning Outcomes 

Through this assignment, the student will demonstrate the ability to: 

1. Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (CO1)  
2. Analyze essential skills needed to lead within the context of complex systems. (CO3) 
3. Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings. (CO4) 

 Requirements: 

1. The APN Professional Development Plan paper is worth 200 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric. 
2. Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer and Grammarly tools when creating your assignment. 
3. Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty. 
4. The length of the paper should be 5-8 pages, excluding title page and reference page(s). 
5. Support ideas with a minimum of 3 scholarly resources. Scholarly resources do not include your textbook. You may need to use more than 3 scholarly resources to fully support your ideas. 
6. You may use first person voice when discussing information specific to your personal practice or skills.  
7. Current edition APA format is required with both a title page and reference page(s). Use the following as Level 1 headings to denote the sections of your paper (Level 1 headings use upper- and lower-case letters and are bold and centered): 
   • APN Professional Development Plan (This is the paper introduction. In APA format, a restatement of the paper title, centered and not bold serves as the heading of the introduction section) 
   • APN Scope of Practice 
   • Nurse Practitioner (NONPF) Core Competencies  
   • Leadership Skills 
   • Conclusion 

Directions: 

1. Introduction: Provide an overview of what will be covered in the paper. Introduction should include general statements on scope of practice, competencies, and leadership, and identification of the purpose of the paper. 
2. APN Scope of Practice: Research the Nurse Practice Act and APN scope of practice guidelines for the state in which you intend to practice after graduation. Describe the educational, licensure, and regulatory requirements for that state in your own words. Identify whether your state allows full, limited, or restricted NP practice. Discuss NP prescriptive authority in your state. Provide support from at least one scholarly source. Source may be the regulatory body that governs nursing practice in your state. 
3. Nurse Practitioner (NONPF) Core Competencies: Review the NONPF Core Competencies. Describe two competency areas you believe to be personal strengths and two competency areas in which you have opportunities for growth. Discuss two scholarly activities you could do during the master’s program to help yourself achieve NP competencies. Provide support from at least one scholarly source. Source may be NONPF Core Competencies document provided via the link in the week 2 readings. 
4. Leadership Skills: Analyze three leadership skills required to lead as an NP within complex systems. Describe two strategies you could use to help you develop NP leadership skills. Provide support from at least one scholarly source. Textbooks are not considered scholarly sources. 
5. Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper. 

 APA Formatting   

Formatting follows current edition APA Manual guidelines for  

1. title page 
2. running head 
3. body of paper (including citations and headings) 
4. reference page 

 Writing Mechanics  

Writing mechanics follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. The length of the paper is at least 5 pages but no more than 8 pages.  

Assignment Overview

There are various types of plans consumers can select. MCOs, HMOs, PPOs, POSs, or ACOs are the most common ones; however they all supply various benefits and drawbacks. Consumers (patients) have the right to choose the type of plan that best fits their needs. In fact, health care is a consumer-driven industry and as health care costs have continued to increase, consumer-driven health plans (CDHP) have become the next new thing (after managed care) (Fronstin & MacDonald, 2008). As a health care leader, it is vital that you understand the differences in these plans.

Fronstin, P. & MacDonald, J. (2008). Consumer- Driven Health Plans: Are they Working. Retrieved from http://online.wsj.com/ad/employeebenefits-consumer_driven_plans.html

Case Assignment

For the Module 2 Case Assignment, conduct additional research as needed and prepare a 3- to 4-page comparative essay. Your comparative analysis should include a detailed comparative chart (see example at the following source: https://philsblogspace.files.wordpress.com/2012/10/eco-chart.jpg?w=1400). In your comparative analysis and chart, you are to evaluate and discuss:

1. The key features, differences, and disadvantages between MCOs, HMOs, PPOs, POSs, and ACOs.
2. The key features of a Consumer-Driven Health Care Plan (CDHP).
3. The future of CDHPs, MCOs, HMOs, PPOs, POSs, and ACOs.

You are to support your analysis and views with at least four scholarly references (i.e., peer-reviewed journal).

For additional information on how to write a comparative analysis, review the following source: https://writingcenter.fas.harvard.edu/pages/how-write-comparative-analysis

Assignment Expectations

1. Conduct additional research to gather sufficient information to justify/support your proposal.
2. Limit your response to a maximum of 4 pages.
3. Support your proposal with at least 4 peer-reviewed articles. Use the following link for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php.
4. You may use the following source to assist in your formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/.