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JWI 570: Leading through the Bureaucracy in Healthcare Assignment 2 Assignment 2: Report to the Compliance Committee Due: Monday, 9:00 am (eastern), Week 7 (20% of course grade) Scenario You are a healthcare consultant with a background in regulatory strategy and compliance. You have been hired by a healthcare organization, to help them develop a strategy to address a current regulatory challenge that impacts your organization in terms of cost, quality, and/or access to care. After doing your research, you will write a short summary report, to be presented to the Compliance Committee at its upcoming meeting. Topic Selection You may pick your own topic for this assignment, but it must fit within this overall definition: a regulatory challenge in a healthcare organization that impacts cost, quality, and/or access to care. There are two ways that you may identify your topic: • If applicable, you may pick a regulatory challenge or issue in your own current or past healthcare workplace. Some possible areas where you may find a topic are listed below: o Compliance with a current or future rule or regulation; telemedicine implementation; billing or coding issues; EHR functionality. OR • If you do not have a healthcare workplace example, search for an article about a relevant challenge. Be sure to include a link to the article in your references. Some source journals and websites are listed below: o Journals: The Wall Street Journal, Forbes, Business Week, The Economist, Modern Healthcare, or The Journal of the American Medical Association. o Websites: American Hospital Association at www.aha.org, American College of Healthcare Executives at www.ache.org, or The American Public Health Association at www.apha.org. Note: Please contact your instructor if you need help with selecting a topic for this assignment. © 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. JWI 570 – Assignment 2 (1252) Page 1 of 5 JWI 570: Leading through the Bureaucracy in Healthcare Assignment 2 Instructions Based on your chosen topic, write a concise summary report to the Compliance Committee of 2 to 3 pages. Your report must include the following four sections: • • Executive Summary o Briefly describe the healthcare organization concerned, including its location, size, major products or services, the community it serves, etc. o Provide a clear, concise description of the regulatory challenge or issue facing the organization. Assessment of the Issue Provide an assessment of the issue by answering these questions: • o How did the organization discover this challenge? o What is the impact of this issue on cost, quality, and/or access to care? o How does this issue affect compliance with rules and regulations? Recommendation Describe an actionable strategy to address the regulatory challenge, including: • o Major actionable steps of the strategy/solution o Timeline to implement these steps o Resources, including staff, materials, facilities, financing, etc. Outcomes and Measures Describe the expected results and outcomes of the strategy and indicate how success will be measured. This section should answer these questions: o How will your recommended actions improve compliance? o How will your recommended actions mitigate the impacts of the regulatory issue on cost, quality, and/or access to care? o What data will be needed to measure these results and impacts? o What is the next step if the strategy does not achieve its desired effect? © 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. JWI 570 – Assignment 2 (1252) Page 2 of 5 JWI 570: Leading through the Bureaucracy in Healthcare Assignment 2 Formatting Requirements • Typed, double-spaced, using Times New Roman or Ariel font (size 11 or 12), with one-inch margins on all sides. • The body of your report must not exceed 3 pages in length. • The report must include the four sections indicated in the assignment instructions. • In place of a Cover page, provide the following Headings on Page 1 of your report: • o TO: Insert Professor’s Name o FROM: Insert Your Name o DATE: Insert Assignment’s Due Date o RE: Report to the Compliance Committee Citations and references must follow the formatting instructions found in the JWMI Writing Standards Guide. Check with your professor for any additional instructions. Note: The References page is not included in the required page length. © 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. JWI 570 – Assignment 2 (1252) Page 3 of 5 JWI 570: Leading through the Bureaucracy in Healthcare Assignment 2 RUBRIC - Assignment 2: Report to the Compliance Committee Criteria Honors High Pass Pass Low Pass Unsatisfactory 1. Provide a clear and concise description of the organization and the regulatory challenge that it faces. Provides an exemplary description of the organization and the regulatory challenge. Excellent level of clarity and conciseness. Provides a very good description of the organization and the regulatory challenge. Very clear and concise. Provides a satisfactory description of the organization and the regulatory challenge. Clear and concise. Provides a partial description of the organization and the regulatory challenge. Not fully clear and concise. Does not provide or inadequately provides a description of the organization and the regulatory challenge. Not at all clear or concise. Writes an exemplary assessment that includes how the regulatory challenge was discovered, its impact on cost, quality, and/or access to care, and its effect on compliance with rules and regulations. Writes a very good assessment that includes how the regulatory challenge was discovered, its impact on cost, quality, and/or access to care, and its effect on compliance with rules and regulations. Satisfactorily assesses how the regulatory challenge was discovered, its impact on cost, quality, and/or access to care, and its effect on compliance with rules and regulations. Partially assesses how the regulatory challenge was discovered, its impact on cost, quality, and/or access to care, and its effect on compliance with rules and regulations. Does not assess how the regulatory challenge was discovered, its impact on cost, quality, and/or access to care, or its effect on compliance with rules and regulations. Describes an exemplary and actionable strategy to address the challenge, with excellent details about major steps, timeline, and resources needed. Describes a very good, actionable strategy to address the challenge with clear details about major steps, timeline, and resources needed. Satisfactorily describes an actionable strategy to address the challenge, with adequate details about major steps, timeline, and resources needed. Describes a partial, but incomplete, actionable strategy to address the challenge, with limited details about major steps, timeline, and resources needed. Does not describe or inadequately provides an actionable strategy to address the challenge, with minimal detail about major steps, timeline, and resources needed. Weight: 20% 2. Write an assessment that includes how the regulatory challenge was discovered, its impact on cost, quality, and/or access to care, and its effect on compliance with rules and regulations. Weight: 20% 3. Describe a recommended, actionable strategy to address the challenge, including details about major steps, timeline, and resources needed. Weight: 25% © 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. JWI 570 – Assignment 2 (1252) Page 4 of 5 JWI 570: Leading through the Bureaucracy in Healthcare Assignment 2 Criteria Honors High Pass Pass Low Pass Unsatisfactory 4. Describe the expected results of the strategy, indicate how success will be measured, and describe the next step if the strategy does not achieve the desired effect. Provides an exemplary description of the expected results of the strategy, indicates very well how success will be measured, and describes an excellent next step if the strategy does not achieve the desired effect. Provides a very good description of the expected results of the strategy, indicates clearly how success will be measured, and describes a good next step if the strategy does not achieve the desired effect. Satisfactorily describes the expected results of the strategy, indicates how success will be measured, and describes an adequate next step if the strategy does not achieve the desired effect. Partially describes the expected results of the strategy and/or partially indicates how success will be measured, and/or partially describes the next step if the strategy does not achieve the desired effect. Does not describe or inadequately describes the expected results of the strategy, and/or does not indicate how success will be measured, and/or fails to describe the next step if the strategy does not achieve the desired effect. Minimal minor mechanical errors; text flows very well; report clearly expresses the student’s ideas in an exemplary manner that logically develops the topics. Few mechanical errors; text flows well; report clearly expresses the student’s ideas in a manner that logically develops the topics. Some mechanical errors; text flow is satisfactory; report is mostly clear; assertions and conclusions are generally justified and explained. Mechanical errors make the report difficult for the reader to understand; text does not flow; includes unsupported conclusions and assertions. Multiple mechanical errors; much of the report is difficult to understand or the text does not flow; student fails to follow the formatting instructions. Weight: 25% 5. Clarity, Logic, Writing Mechanics, Grammar, and Formatting. Weight: 10% © 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. JWI 570 – Assignment 2 (1252) Page 5 of 5
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Compliance with Medicare and Medicaid Billing and Coding Regulations: Addressing
Challenges in Cost, Quality, and Access to Care

Name
Institution
Course
Instructor
Date

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Compliance with Medicare and Medicaid Billing and Coding Regulations: Addressing
Challenges in Cost, Quality, and Access to Care
Executive Summary
The organization is a mid-sized healthcare organization that is located in Las Vegas and
provides primary care, specialist visits, inpatient and outpatient services, and urgent care. It treats
a large number of patients, and many of them are the Medicare and Medicaid beneficiaries,
which makes this healthcare organization an important provider for these categories of patients.
The organization has a well-articulated policy on quality care delivery particularly for the
patients under the government sponsored programs. However, it is currently facing a regulatory
problem in billing and coding patients under Medicare and Medicaid. The internal audit ...

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