07 Oct The subject The definition of social determinants
The subject The definition of social determinants that determine health, by the Centers for Disease Control and Prevention (CDC), include: Biology and genetics, sex and age. Individual behavior, Social environment. Physical environment and Health services. The World Health Organization in 2016 suggest that several factors that are combined affect health and wellness of individuals and communities. Health is determined by individual circumstances that include: where we live, condition of our living environment, genetics, income, education level and personal relationships with friends, family have impact on health. Access to care, food, housing and transportation are equally important in determining health and wellness. This week the meaning of health and its influence on communities and specific patient populations are identified. The social determinants of health that are used to discern health promotion and disease prevention initiatives will be reviewed. As you move through your readings and assignments, be able to articulate an overview of MACRA legislation that will provide incentive based reimbursement based upon ensuring optimal patient centered outcomes. Recognize the changes in health care practice and policy based upon the financial burden of multiple chronic conditions (MCCs), and lastly be able to describe the role of the Affordable Care Act to promote access to care and provider accountability to ensure safe and effective health care for all Americans Your Learning Objectives for the Week: • Analyze theoretical models appropriate for use in existing and emerging healthcare systems • Formulate the selected theoretical frameworks in an analysis of health policy • Evaluate contemporary health policy issues in the United States and, where appropriate, globally with emphasis on political, social, economic, and cultural factors shaping health disparities. Health Promotion and Disparities (web pages) Health promotion, like health and health disparities, has been defined in many ways. Per the World Health Organization (2014), health promotion is the “process of enabling people to increase control over their health and its determinants, and thereby improve their health.” This definition includes screening, education, programs for behavioral change, and increasing patient involvement in their own care. Prevention—Prevention represents a series of strategies and interventions to either deter or minimize the consequences of disease or injury, at a population level. Due to the amount of resources which are spent on preventable injuries and illnesses, the ACA has a huge focus on prevention. The Agency for Health Research and Quality have enacted initiatives in Shared Decision Making, Self-Management, Literacy Tools and more to support prevention practices between providers and patients. Screening— The United States Protective and Safety Task Force (USPSTF), determines the recommendations and evidence for screening in the US – USPSTF is housed under the Agency for Health, Research and Quality. Behavior Change—Behavioral change is at the basis of most intervention programs. Behavioral change includes physical, psychological, cultural, religious and other factors not always easy to influence. Additional Materials Centers for Disease Control and Prevention definition of health determinants: Healthy People 2020 World Health Organization definition of health determinants Affordable Care Act Legislation Agency for Health, Research and Quality: Shared Decision Making Self-Management Literacy Tools Team STEPPS United States Protective and Safety Task Force (USPSTF) Multiple Chronic Conditions (web page) In 2010, at the same time of the signing of the Affordable Care Act, the US Department of Health and Human Services, the Center for Disease and Prevention and the Centers for Medicare and Medicaid directed the Multiple Chronic Conditions (MCC). initiatives. Currently, 3 out of 4 Medicare beneficiaries have more than 2 concomitant chronic conditions. 66% of US health care expenditures are spent on MCCs. The fourth Title of the Affordable Care Act is focused on chronic conditions. The new era of quality and value care is a direct result of the nation’s direction in reducing exacerbations in MCCs that require excessive use of hospital and financially burdens the US health care system The Centers for Medicare and Medicaid in 2013 released new incentive payments for primary care providers who provide continuous chronic care management for their patients. 24/7 patient access to his or her health care provider. Providers are required to communicate at least 20 minutes a month with the patient – this can occur by telephone, text or email. The other incentive is the transitions in care. This initiative provides coordination and continuity in care between care settings – reducing fragmented and costly care. Additional Materials Centers for Medicare and Medicaid Services, Multiple Chronic Conditions Multiple Chronic Conditions Resource Center Chronic Conditions Management (CCM) Issued key provisions to the MACRA (web page) April 27th, 2016 executive notice by the US Department of Health and Human Services issued key provisions to the Medicare Access and Summary CHIP Reauthorization Act of 2015, (MACRA). MACRA replaced the 1997 Sustainable Growth Rate formula for determining Medicare reimbursement. MACRA provides a new approach in Medicare reimbursement based on value and quality care. MACRA legislation is guided by the Quality Payment Program, directing two paths for Medicare reimbursement: The Merit-based Incentive Payment System (MIPS), or the Advanced Alternative Payment Model (APM). Nurse Practitioners, require knowledge and information to prepare for MIPS and APM to begin January 1, 2017. The implementation of these reimbursement and practice changes are led by a unified framework called the Quality Payment Program (CMS, 2016b). The two paths of care include:The Merit-based Incentive System (MIPPS) or Advanced Payment Models (APMs). Each of these reimbursement tracks provide incentives when providers, practices, organizations or health systems demonstrate and meet or exceed the quality and value metrics uniquely determined by type of practice and patient care population served. MACRA, changes the way Medicare will reward providers for value over volume. MACRA provides incentive payment for providers through MIPS and bonus payment for provider participation in eligible APMs Additional Materials Reauthorization Act of 2015, (MACRA) Centers for Medicare and Medicaid Services: Quality Payment Program Reports of Healthy People 2020 (web page) The Centers for Disease and Prevention (CDC) has created Healthy People, to provide the US with a science-based national agenda. Healthy People 2020, includes over 1,200 objectives in 42 Topic Areas. Tis 10-year agenda is used in the US to guide national health promotion and prevention efforts. Healthy People provides the US Department of Health and Human Services with benchmark data to monitor progress over time Agency for Health Research and Quality produces annual health disparity reports. Investigate the most recent report from the AHRQ link provided. Additional Materials Healthy People 2020 Agency for Health, Research and Quality 2015 Health Disparities Report Question: Perform a comprehensive review of the literature that supports the use of primary vs, secondary sources of evidence. Utilize the weblinks provided in this module to support your written assignments in this course Submission Details: • Submit your document to the Submissions Area by the due date assigned on Tuesday. N.B: I placed the order with 5 pages and I choose essay to cover all the areas requested, because she did not say what is it. I do not know how many pages yet. I left message to the prof. I will let you know when I get her feedback. Dear writer, do you have a number where I can communicate with you please? Thank you.
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