Activity 4Healthcare Delivery and Quality Case StudyLandmark studies To Err is Human (1999) and Crossing the Quality Chasm (2001) from the Institute of Medicine (IOM) identified medical errors are causing harm and death to almost 45,000 Americans and costing over $29 billion every year. Other studies have indicated preventable healthcare associated conditions (HACs) such as infections, sepsis, CHF, and pneumonia are main contributors for increasing the length of patient stays, the cost of care, and the likelihood of mortality (death). Consider the below case study:Margret Spinner-Ramirez is a 66 y/o female Hispanic-American who speaks both Spanish and English fluently. She is retired, lives alone, and has Medicaid as her primary insurance. Ms. Spinner-Ramirez was scratched by a stray cat that she feeds on her back porch daily. She has been cleaning the wound daily; however, after 2 days she went to her local ER for increased pain, redness, and swelling in her left lower leg wound where she was scratched by the stray cat. Ms. Spinner-Ramirez explained she recently had her left knee replaced about 6 months ago and verbalized new difficulty with baring weight on that extremity to the point that she was having to use her cane again. Her vital signs at the ER visit were stable. Her left leg wound was cleaned and redressed. After 5 hours in the ER, Ms. Spinner-Ramirez was discharged to home on oral Keflex for her left lower leg infection and was instructed to call her primary care physician for a follow-up appointment. Five days later Ms. Spinner-Ramirez was taken back to the same ER via ambulance. Her neighbor found her lethargic, short of breath, and was experiencing difficulty being able to move. A CT scan and blood work revealed that Ms. Spinner-Ramirez’s knee replacement in her left leg was infected secondary to the cat scratch. She was admitted as an inpatient for sepsis. She needed to have a second left knee replacement surgery with wound irrigation and debridement, which extended her inpatient stay to 3 weeks. Once she was discharged to home, she required six weeks of IV antibiotics, extensive rehab, and home health. If you were in charge of a healthcare insurance company:Explain why insurance companies (which are considered payers) should or should not pay (reimburse) for injuries, extended costs, readmissions, or death (mortality) from a hospital-acquired infection or medical error. Support your why or why not? Describe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety. Discuss how creating incentives for providers (healthcare organizations) can improve quality and reimbursements (payments) for services/care.Resources:Understanding Health InsuranceWhat's Behind the Health Insurance RankingsHospitals will have to Pay for their MistakesMedical Errors: Focusing More on What and Why, Less on WhoNational Business Coalition on Health: Health Care Purchaser ToolkitAgency for Healthcare Research and QualityAdditional Instructions:All submissions should have a title page and reference page.Utilize a minimum of two scholarly resources.Adhere to grammar, spelling and punctuation criteria.Adhere to APA compliance guidelines.Adhere to the chosen Submission Option for Delivery of Activity guidelines.Submission Options:Choose One:Instructions:Paper2 to 3-page paper. Include title and reference pages.Microsoft PowerPoint Presentation4 to 8 slides. Add title and reference slides.Follow Rules of 7.Other media (Prezi, etc.) presentation4 to 8 slides with speaker notes. Add title and reference slides.Follow Rules of 7.Video Presentation5 to 6-minute video presentation.Attach reference page or include in video.Professional appearance and background.Video submissions must include a script in Word format, submitted through Turnitin for an Originality Report.TableTable with appropriate columns and headers.Include title and reference pages.Graphs or other illustrationsGraphs or illustrations with appropriate labels. Include title and reference pages.PosterPoster utilizing any applicable poster template. Include visual graphics/images/other formats for visual appeal. Include appropriate title and references on poster.Note: Title and reference pages/slides do not count towards the count requirements. Baccalaureate Generalist will discuss the impact of universal health insurance coverage and explain the role of healthcare finance and controlling cost of healthcare services.Description: Healthcare Delivery and Quality Case StudyComponent:Area Gold Silver Bronze Unacceptable Mastery Acceptable DevelopingFully explain why insurance companiesshould or should not pay (reimburse) for injuries, extended costs, readmissions or death (mortality) from a hospital acquired infection or medical error. Support your why or why not answerFully explains why insurance companies should or should not pay (reimburse) for injuries, extended costs, readmissions or death (mortality) from a hospital acquired infection or medical error.Superficially explain why insurance companies should or should not pay (reimburse) for injuries, extended costs, readmissions or death (mortality) from a hospital acquired infection or medical error.Dose not explain why insurance companies should or should not pay (reimburse) for injuries, extended costs, readmissions or death (mortality) from a hospital acquired infection or medical error.Assignment missing or objective missingDescribe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety.Fully describes two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety.Superficially describe 1-2 ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safetyDoes not describe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety.Assignment missing or objective missingDiscuss how creating incentives for providers (healthcare organizations) can improveFully discusses how creating incentives for providers (healthcare organizations) can improveSuperficially discusses how creating incentives for providers (healthcare organizations) canDose not discuss how creating incentives for providers (healthcare organizations) can improve quality and reimbursementsAssignment missing or objective missingquality and reimbursements (payments) for services/care.quality and reimbursements (payments) for services/care.improve quality and reimbursements (payments) for services/care.(payments) for services/care.

Assignment Content Complete the Payment Mode Analysis worksheet.Cite at least three scholarly sources in an APA-formatted reference page.2. Respond to the following in a minimum of 175 words: What are major reimbursement models do you have experience with?What limitations and benefits to quality and patient care do you see from your experience?