Discussion: Number & Mix of Patients
Discussion: Number & Mix of Patients
Week 6 assignment Each week, you are required to enter your patient encounters into CORE. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using this template . The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Submissions Area. When submitting your note, be sure to include the reference number from CORE. Submission Details: By the due date assigend enter your patient encounters into CORE and complete at least one SOAP note in the template provided. Name your SOAP note document SU_NSG6340_W6_SOAPLastName_FirstInitial.doc. Include the reference number from CORE in your document. Submit your document to the Submissions Area by the due date assigned.
These differences in
patient mix, practice style, and proportion of practice devoted to specialty medicine may help explain some or all of the cost differentials between family physicians and general internists.
For example, Medicare claims may not include many factors that influence the cost of medical care, including specialty location,
patient mix, other demographics, and practice costs.
The survey is conducted between 2 and 42 days after discharge using one of four approved survey modes: mail only, telephone only, mail with telephone follow-up of nonrespondents, and active Interactive Voice Response; scores are adjusted for survey mode and
patient mix (also known as case mix) (Elliott et al.
I suspect my short-list approach to coding creates the impression that my
patient mix is of low complexity.
Perhaps more importantly at this time, many hospitalists are subsidized by a health plan or the hospital where they work because their
patient mix tends to include a high proportion of uninsured people.
Evolution of hospitalist practice raises questions, challenges
Table 3: Estimated Revenue Budget and Reimbursement Rates Source Visits Patient Mix Reimbursement Rate Medicaid 10,690 40% $65 Medicare 5,345 20% $62 Third Party Insurance 2,672 10% $45 Self-Pay 8,017 30% $35 Total 26,724 100%
Lastly, rather than traditional physician practices which served a median of 7% self-pay and 0.1% charity care and professional courtesy care patients in 2001 (MGMA, 2002a), federal Community Health Centers (CHCs) have a more similar
patient mix(Forrest & Whelan, 2000; McAlearney, 2002) and would be a better comparison group for ANMC.
* As you abide by an admissions policy aimed at ensuring the optimal blend of targeted
patient mix available in your marketplace, you can allow the facility to operate uninterruptedly at a high occupancy rate.
* Achieving (within a range) estimates of service utilization for a particular physician or practice site based on an actuarial analysis of the physician’s
patient mix using the variables of sex, age, and severity of illness.
Bradley and Gehlbach[12] reported on the involvement of the Duke-Watts family medicine program with two prepaid plans in 1983-1984, and the resultant changes in the clinic’s
patient mix, clinical practice profile, financial, status, and educational programs.
With risk adjustment, differences in
patient mix across hospitals can be taken into account such that hospitals caring for sicker patients are not unfairly penalized for their higher admission rates.
So if you’re going to put out how many knee surgeries someone is doing or how many Mohs surgeries someone is doing and you’re just basing it on one payer, depending on somebody’s
patient mix you could miss the vast majority of what they’re doing,” Dr.
Participation for MSN
Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Participation Guidelines
Each weekly threaded discussion is worth up to 25 points. Students must post a minimum of two times in each graded thread. The two posts in each individual thread must be on separate days. The student must provide an answer to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week. If the student does not provide an answer to each graded thread topic (not a response to a student peer) before the Wednesday deadline, 5 points are deducted for each discussion thread in which late entry occurs (up to a 10-point deduction for that week). Subsequent posts, including essential responses to peers, must occur by the Sunday deadline, 11:59 p.m. MT of each week.
Direct Quotes
Good writing calls for the limited use of direct quotes. Direct quotes in Threaded Discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the Grammar, Syntax, APA category.
Grading Rubric Guidelines
| Performance Category | 10 | 8 | 6 | 4 | 0 |
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Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions. | - Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
- Evaluates literature resources to develop a comprehensive analysis or synthesis.
- Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
| - Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
- Evaluates information from source(s) to develop a coherent analysis or synthesis.
- Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
| - Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
- Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
- Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
- Demonstrates little or no understanding of the topic.
| - Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
- Information is taken from source(s) without any interpretation/evaluation.
- The posting uses information that is not valid, relevant, or reliable
| - No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
- Information is not valid, relevant, or reliable
|
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| Performance Category | 10 | 8 | 6 | 4 | 0 |
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Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations | - Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
- Applies concepts to personal experience in the professional setting and or relevant application to real life.
| - Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
- Applies concepts to personal experience in their professional setting and or relevant application to real life
- Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
| - Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
- Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
- Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
| - Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
- Posts are superficial and do not reflect an understanding of the lesson content
- Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
| - Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
- No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
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| Performance Category | 5 | 4 | 3 | 2 | 0 |
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Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) | - Exceeds minimum post requirements
- Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
- Replies to a post posed by faculty and to a peer
- Summarizes what was learned from the lesson, readings, and other student posts for the week.
| - Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
- Replies to a question posed by a peer
Summarizes what was learned from the lesson, readings, and other student posts for the week. | - Meets expectations of 2 posts on 2 different days.
- The main post is not made by the Wednesday deadline
- Does not reply to a question posed by a peer or faculty
| - Has only one post for the week
- Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
| - Does not post to the thread
- No connections are made to the topic
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| Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point |
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| Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition | - 2-3 errors in APA format.
- Written responses have 2-3 grammatical, spelling, and punctuation errors.
- Writing style is generally clear, focused, and facilitates communication.
| - 4-5 errors in APA format.
- Writing responses have 4-5 grammatical, spelling and punctuation errors.
- Writing style is somewhat focused.
| - 6-7 errors in APA format.
- Writing responses have 6-7 grammatical, spelling and punctuation errors.
- Writing style is slightly focused making discussion difficult to understand.
| - 8-10 errors in APA format.
- Writing responses have 8-10 grammatical, spelling and punctuation errors.
- Writing style is not focused, making discussion difficult to understand.
| - Post contains greater than 10 errors in APA format.
- Written responses have more than 10 grammatical, spelling and punctuation errors.
- Writing style does not facilitate communication.
- The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
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| 0 points lost | | | | -5 points lost |
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Total Participation Requirements per discussion thread | The student answers the threaded discussion question or topic on one day and posts a second response on another day. | | | | The student does not meet the minimum requirement of two postings on two different days |
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Early Participation Requirement per discussion thread | The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | | | | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |
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NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Wednesday. Any assignments and all discussion requirements must be completed by 11:59 p.m. MT Wednesday of the eighth week.
