Create a 2–3-page internal memo for a risk-management team. Summarize a risk financing issue for a

  

Create a 2–3-page internal memo for a risk-management team. Summarize a risk financing issue for a selected organization in the memo.Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in a sequence.Financial risk-management helps reduce the financial impact of risk. It also determines the best approach for handling adverse situations from a financial standpoint. Health care leaders must have a solid understanding of the basics of regulation, government and public risk sharing, and also the era of ACOs.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:Competency 2: Apply a risk-management model or framework to a specific risk-management priority.Identify key performance indicators and measures associated with a specific risk-management issue.Discuss strategies used to identify risk financing issues in a selected organization.Provide recommendations for risk financing options related to an identified financial risk issue.Competency 4: Analyze applicable legal and ethical institution-based values as they relate to quality assessment.Summarize the legal and ethical financial risk obligations of an accountable care organization.Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.Prepare a professional memo summarizing a risk financing issue for a specified organization.
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7/14/2019
Risk Financing Scoring Guide
Risk Financing Scoring Guide
CRITERIA
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Identify key
performance
indicators and
measures
associated with a
specific riskmanagement issue.
Does not identify
key performance
indicators and
measures
associated with a
specific risk
management
issue.
Identifies key performance
indicators and measures
associated with a specific
risk management issue, but
the key indicators or
measures are either
incomplete or flawed.
Identifies key
performance
indicators and
measures
associated with a
specific risk
management
issue.
Identifies key
performance indicators
and measures associated
with a specific risk
management issue and
cites appropriate current
literature to support the
identification.
Discuss strategies
used to identify risk
financing issues in a
selected
organization.
Does not discuss
strategies used to
identify risk
financing issues
in a selected
organization.
Discusses strategies used
to identify risk financing
issues in a selected
organization, but the
discussion is either
incomplete or flawed.
Discusses
strategies used to
identify risk
financing issues
in a selected
organization.
Discusses strategies used
to identify risk financing
issues in a selected
organization and outlines
challenges to
implementing those
strategies.
Provide
recommendations
for risk financing
options related to an
identified financial
risk issue.
Does not provide
recommendations
for risk financing
options related to
an identified
financial risk
issue.
Provides recommendations
for risk financing options
related to an identified
financial risk issue, but the
recommendations are
either incomplete or flawed.
Provides
recommendations
for risk financing
options related to
an identified
financial risk
issue.
Provides
recommendations for risk
financing options related
to an identified financial
risk issue and supports
the recommendations
with citations from the
literature.
Summarize the legal
and ethical financial
risk obligations of
an accountable care
organization.
Does not
summarize the
legal and ethical
financial risk
obligations of an
accountable care
organization.
Summarizes the legal and
ethical financial risk
obligations of an
accountable care
organization, but the
summary is either
incomplete or flawed.
Summarizes the
legal and ethical
financial risk
obligations of an
accountable care
organization.
Summarizes the legal and
ethical financial risk
obligations of an
accountable care
organization and
describes the internal and
external contexts for
those obligations.
Prepare a
professional memo
summarizing a risk
financing issue for a
specified
organization.
Does not prepare
a professional
memo
summarizing a
risk financing
issue for a
specified
organization.
Prepares a memo
summarizing a risk
financing issue for a
specified organization, but
with some errors or lapses.
Prepares a
professional
memo
summarizing a
risk financing
issue for a
specified
organization.
Prepares a professional
memo summarizing a risk
financing issue for a
specified organization that
is concise, complete, and
convincing.
https://courserooma.capella.edu/bbcswebdav/institution/MHA-FP/MHA-FP5014/190700/Scoring_Guides/a02_scoring_guide.html
1/1
Overview
Create a 2–3-page internal memo for a risk-management team. Summarize a
risk financing issue for a selected organization in the memo.
Note: The assessments in this course build upon each other, so you are strongly
encouraged to complete them in a sequence.
Financial risk-management helps reduce the financial impact of risk. It also
determines the best approach for handling adverse situations from a financial
standpoint. Health care leaders must have a solid understanding of the basics of
regulation, government and public risk sharing, and also the era of ACOs.
By successfully completing this assessment, you will demonstrate your proficiency
in the following course competencies and assessment criteria:



Competency 2: Apply a risk-management model or framework to a specific riskmanagement priority.
• Identify key performance indicators and measures associated with a specific
risk-management issue.
• Discuss strategies used to identify risk financing issues in a selected
organization.
• Provide recommendations for risk financing options related to an identified
financial risk issue.
Competency 4: Analyze applicable legal and ethical institution-based values as they
relate to quality assessment.
• Summarize the legal and ethical financial risk obligations of an accountable
care organization.
Competency 5: Communicate in a manner that is scholarly, professional, and
consistent with expectations for professionals in health care administration.
• Prepare a professional memo summarizing a risk financing issue for a
specified organization.
Content
There is a constant tension between the management of medical errors and the
improvement of the quality of care. You may be asked to participate in riskmanagement and risk financing activities in your role as a health care leader.
If a risk management team asked you to research and summarize financial risks in
your organization today, would you know the following:


What information to include?
What format to use?
How to present alternatives and make a recommendation?
How to locate credible data from which the issue is to be evaluated?
Read further in the Assessment 2 Context (This is attached) document, which
contains important information on the following topics:
• Regulations.
• Risk Management.
• Risk Sharing.
• Risk Financing.


Questions to Consider
As you prepare to complete this assessment, you may want to think about other
related issues to deepen your understanding or broaden your viewpoint. You are
encouraged to consider the questions below and discuss them with a fellow
learner, a work associate, an interested friend, or a member of your professional
community. Note that these questions are for your own development and
exploration and do not need to be completed or submitted as a part of your
assessment.
Imagine that a supervisor enters your work setting accompanied by an unexpected
visitor from CMS. Your supervisor introduces you to the Medicare surveyor, who
will be interviewing you.
What is the risk-management process in your organization?
What criteria would you use to determine how well your organization is
performing as an ACO?
• What data or resources would be helpful to you?
• How would you explain the concepts of risk management and risking financing
activities to your subordinates?
• How would you explain a risk financing continuum to your subordinates?


Assignment Instruction
Note: This assessment must be completed before starting Assessment 3.
Preparation
Imagine yourself in the role of a risk manager. Select a topic related to risk
financing and identify a risk financing issue. This issue may be from a selected
organization or from your workplace. As an example, you might select the issue
of financing potential malpractice suits at a medical clinic. Refer to the Suggested
Resources to ensure that you have a solid understanding of the financial
dynamics related to this type of issue.
Instructions
Memo – Risk Financing Issue
Create a 2– 3-page internal memo. Follow the steps below and include them in
the memo:
Concisely describe the issue and the organization.
Summarize the legal and ethical financial risk obligations of an ACO.
Describe how you would identify and manage risk financing issues within this
organization. Support your choice of strategies with relevant resources.
• Recommend two or three of the best options for risk financing for this issue, as it
relates to the organization in question.
• Include at least three APA-formatted in-text citations and accompanying
congruent APA-formatted references. Your sources can be a course textbook,
assigned reading, or any other scholarly source.



Additional Requirements





Written communication: Written communication should be free from errors that
detract from the overall message.
Memo format: Format your memo so that it reflects the professional standards
of your organization or accepted standards of a professional memo in the
industry.
Length of paper: 2–3 double-spaced pages for the written portion of the
assessment.
Number of resources: A minimum of three resources.
Font and font size: Times New Roman, 12 point.
Assessment 2 Context
Regulations, Risk Management, Risk Sharing, and Risk Financing
Leading in today’s ever-changing health care industry requires constant adjustment to
emerging laws, regulations, and industry standards. Organizations must quickly and
effectively reposition to meet new, existing, and emerging laws. Two examples of laws that
have driven a multitude of new and sometimes confusing regulations are the Patient
Protection and Affordable Care Act of 2010 and the Healthcare Insurance Portability and
Accountability Act of 1996.
The shift to electronic health records is another example of the need to create new structures,
processes, and policies to meet legal and regulatory requirements. Government surveying
bodies and industry accrediting bodies assess basic compliance as well as best practices.
Effective leadership is not only necessary for the pursuit of excellence, but also for
organizational survival.
Policy changes drive regulatory requirements and, consequently, requirements for provider
organizations that depend upon Medicare and Medicaid as reimbursement sources.
In The New England Journal of Medicine article, Inglehart (2011) creates a context for the
health care environment relating to regulations, risk management, and risk sharing:
One of the hottest issues debated within the administration was whether ACOs should
bear financial risk in their quest to achieve savings. CMS supported awarding a bonus
to an ACO when its stated goals were achieved but imposing no penalty if it failed in
that regard for the first 2 years. This approach (used in Medicare’s Physician Group
Practice [PGP] demonstration) is designed for start-up ACOs, while they gain
experience.
After White House intervention, a second, two-sided approach to risk was added to the
rule, aimed at larger medical groups with stronger management structures. Such
groups could choose to bear some of the financial risk, which currently Medicare totally
assumes, in exchange for modestly higher bonuses if they succeed.
CMS is uncertain how many large groups will opt for this at-risk approach. A
companion program offering even greater risk sharing is expected to be tested by
CMS’s innovation center, and it may have more appeal to integrated systems that
already accept capitation payments or other larger risk-sharing arrangements.
Risk Management
Risk management has taken an increasingly important role in organizational viability.
Conditions of participation for government-supported programs, standards for provider status
required by insurance companies, and quality metrics requisite for industry accreditation must
all be considered within the context of the organization’s directional strategy. It is wise to
revisit the vision, mission, and directional strategy of an organization when considering how
to assess and manage risk, as well as how to become a top-performing organization.
There is an ever-present tension between management of medical errors and the
improvement of quality of care. The goal is to determine how to assess risk, manage it, and
create a culture of patient safety.
MHA-FP5014 Assessment 2 Context
1
Assessment 2 Context
Risk Financing
Risk management entails prevention of adverse consequences and minimization of negative
effects from accidental loss. Risk financing refers to reducing the financial impact of risk, as
well as determining the best approach, from a financial standpoint to handling adverse
situations.
Risk financing means looking at the operations of the organization as well as determining
what financial preparation is needed to ensure a minimal financial loss. Concepts such as
risk pooling, purchasing insurance, and taking risk reduction measures are key to financial
preparation in risk management.
Risk financing may include all aspects of both legal protection and compliance with
government regulations. It is important to note that many health care organizations have legal
obligations to carry liability insurance under either their accreditation or license type as a
means of financial loss protection. Some key concepts relating to risk financing include:
1.
2.
3.
4.
5.
Identifying and managing a risk financing issue.
Examining issues related to risk financing.
Analyzing existing organizational structures.
Determining the best risk financing options for a specific organization.
Understanding various insurance types related to financial risk reduction and asset
protection for a health care organization.
While health care leaders may expend great effort to avoid liability, it is wise and realistic to
plan for human error. Inadequate risk financing exposes organizations to losses that can
potentially threaten future viability.
References
Inglehart, J. K. (2011). The ACO regulations – Some answers, more questions. New England
Journal of Medicine, 364(17), e35.
MHA-FP5014 Assessment 2 Context
2
Running head: RISK FINANCING MEMO
1
Risk Financing Memo
Name
Capella University
Healthcare Quality, Risk, Regulation, and Compliance
Assessment 2
Date:
RISK FINANCING MEMO
2
Memo
To:
From:
cc:
Date:
Re:
Identified Risk Performance Indicators and Measures
[Identify key performance indicators and measures associated with a specific riskmanagement issue.]
Strategies Used to Identify Risk Financing Issues
[Discuss strategies used to identify risk financing issues in selected organization.]
Recommendations for Risk Financing Options
[Provide recommendations for risk financing options related to an identified financial risk
issue.]
Legal and Ethical Financial Risk Obligations
[Summarize the legal and ethical financial risk obligations of an accountable care
organization.]
RISK FINANCING MEMO
3
References

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