Racial Disparities in Health Care: The Effects of the Affordable Care Act

Rationale

When I worked for the Federal government, everything I did had to be summarized into a 1 pager. One project I worked on for 2.5 years had to be written up in a 1 page document. It was SO HARD for me to do! The reason for the 1 pager is that no boss has time to read more than a page or 2. It is an important life skill for you to "get out of the weeds" and provide your boss with just the most salient, and most top-line information they need to know in a concise manner. This will require you to synthesize information and make critical decisions on word choices and information priority.

Executive Brief

For this Executive Brief, please choose the ONE topic and scenario that interests you the most. This brief will require you to synthesize a large amount of information into a 1-2 page document (This may seem difficult – but you’ll be fine!).

It will also require original thought to incorporate some of the economic concepts/words/terms we have learned about in class and determine next steps or implications for the organization. However, this is a critical skill and ability for all healthcare managers to have. You will have to do this again in your career.

Topics:

1) Challenges that Critical Access Hospitals Face when Adopting Electronic Health Records

You are an intern at a Critical Access Hospital (CAH) in a rural part of Florida. CAHs, which are small and most always in rural areas, are run and managed on extremely tight budgets and this CAH is no different. This semester you are assisting the CEO with various tasks. The hospital has made the decision to invest and adopt an electronic health record (EHR) system. However, the resources required to have adequate broadband, employee training, and technical support for the EHR are concerning, especially in rural areas. The CEO wonders if other CAHs have infrastructure and economic challenges with health information technology like her CAH is facing. You decide to write an executive brief to describe the challenges that CAHs face when adopting health information technology like EHRs.

2) Weight-Loss Reduction Programs: What works?

You are an intern at a health insurance company in Orlando, Florida. This health insurance company’s beneficiaries are mostly working adults ages 18-64 and their dependents (spouses and children). This semester you are an assistant in the business planning office. The insurance company that you are working for has seen a marked increase in beneficiaries that have high BMIs, and are obese. You know that obesity is highly associated with sleep apnea, metabolic syndrome, diabetes, cancer and a host of other costly conditions. This, in turn, will affect the bottom-line profits of the company. Your boss wonders what kind of weight loss programs are effective and provide the biggest return on investment. His goal is to make the beneficiaries healthier to secure strong profits for the company. You decide to write an executive brief to describe some weight loss initiatives and motivation techniques to help your boss decide what to offer to beneficiaries.

3) Racial and Ethnic Disparities: Did the Affordable Care Act Reduce them?

This semester you are working as an intern for a public health department in Orlando, Florida. The director of the public health department explains that there are differences in health outcomes among racial and ethnic minority groups, especially among those that are uninsured. You are aware that health insurance is a key variable to improve health outcomes. This is because without cost-sharing, healthcare costs can be unaffordable, and people are unable to seek out the care they need. The Affordable Care Act (ACA) that was passed expanded insurance coverage in several ways. Some of these include Medicaid expansion, young adult coverage up to age 26, and consumer protections including pre-existing conditions. The director wonders if all these changes resulted in a reduction of racial and ethnic disparities in the US. You decide to write an executive brief to highlight changes in racial and ethnic disparities in healthcare post-ACA.

Background Materials:

1) Challenges that CAHs Face when Adopting Electronic Health Records

a) Progress And Challenges: Implementation And Use Of Health Information Technology Among Critical-Access Hospitals

b) CAH to CAH: EHR implementation advice to critical access hospitals from peer experts and other key informants.

c) Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist.

d) Rural Policy Brief: RUPRI Center for Rural Health Policy Analysis (Links to an external site.)

e) Why are Rural Communities Different? (Links to an external site.)

2) Weight-Loss Reduction Programs: What works?

a) CNN Article (Links to an external site.)

b) Enrolling People With Prediabetes Ages 60-64 In A Proven Weight Loss Program Could Save Medicare $7 Billion Or More

c) Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.

d) Factors associated with participant retention in a clinical, intensive, behavioral weight management program.

e) Managed Care Magazine Article (Links to an external site.)

3) Racial and Ethnic Disparities: Did the Affordable Care Act Reduce them?

a) Uninsurance Disparities Have Narrowed For Black And Hispanic Adults Under The Affordable Care Act.

b) Health Care Disparities in the Post–Affordable Care Act Era.

c) Racial Differences in Awareness of the Affordable Care Act and Application Assistance Among Low-Income Adults in Three Southern States.

d) Racial and ethnic disparities in services and the patient Protection and Affordable Care Act (Links to an external site.)

e) Robert Wood Johnson Foundation Health Policy Snapshot (Links to an external site.)

Instructions

Please choose the one scenario/topic that interests you the most. Then read all the background information to craft your brief. If there is a broken link, please try the UCF library or scholar.google.com to find the document, but also let me know!

Your brief will include four main sections and be 1-2 pages long:

1. The issue. In this section, you will include a concise description of the economic issue and why your boss at your internship needs to know the information you’ll be providing.

2. The background. In this section you will include information about the origin and background of the economic issue. The section sets the context for the information in the memo.

3. The discussion. In this section you will discuss the economic issue and describe the implications for your internship location and present your recommendations for next steps. Bullet points may be used here, but make sure they are appropriate for the context.

4. The references. Please put in APA format and cite in the document properly per the APA guide in the module.

Additional Instructions:

Make sure you write professionally. Check out the common writing mistakes guidance in the module.

Do not use contractions (don’t like, can’t decide, isn’t a good idea)

Single spaced

Do not write in the first person (for example: I wanted to write this brief, I think it is a good idea to, etc…).

All references must be in APA format. The format is included in the module.

Read and cite (use!) all the background materials you are given. You will need to synthesize the literature (using your brain!).

Make sure you include at least 5 vocabulary words from the book in your brief

Use the template provided in the module for full points.

The total length should be 1-2 single-spaced pages including single-spaced references

Do not quote. There is very rarely a need to quote anything in professional writing. Instead, please synthesize the information and cite the references.

GRADING CRITERIA:

Grading:

Download and use template provided (I have included examples) and single space document (40 pts)

Write at a college level (thoughtful and professional) (30 pts)

References (both in-text and at the end)are in APA format (20 pts)

Writing style is professional (no quotes, no contractions, no first-person) (20 pts)

Incorporate 5 health economic terms from the textbook (15 pts)

Brief and references are single spaced and are 1-2 pages in length (15 pts)

Brief synthesizes (USE!!) all 5 references provided for the scenario (10 pts)

I have an email that better explains this assignment. if there is an email I can send you the instructions

The Issue

In the United States, lack of health insurance can spell out severe health outcomes. Uninsured individuals are less likely than their insured counterparts to receive basic medical care and advanced care for preventable and chronic conditions. As a result, uninsured Americans are liable to get sicker and die prematurely from preventable diseases. Health insurance is highly correlated to demographic factors such as income, education, and environmental disadvantage. Unfortunately, African Americans and Hispanic citizens are likely to face the brunt of poor policy-making in the health sector. The outcomes for Blacks and Hispanics are dire. More than 47 million Americans are unable to access basic healthcare due to lack of insurance. Of these, approximately 75 percent are likely to be minority ethnic groups. Other than that, the challenges created by medical uninsurance significantly affect the economy. A study by Abdus, Mistry, and Selden (2015) reports that disparities faced by minorities increased the total direct health cost by $229.4 billion and more than $1 trillion in indirect costs. These costs would have been eliminated through the provision of equitable health care policies. 

The Background

The modern medical care system can trace its roots to the mid-1920s. From this early period, Medicare began evolving to a necessity that many households could not afford. The Blue Cross medical health system was developed in response to the challenges in early medical care. The Blue Cross health insurance system worked by providing quasi-insurance to citizens in return for tax breaks for hospitals from the government (Stepanikova and Cook, 2008, p.920). The private sector realized the profitability of this system and ventured in as insurance service providers. For a while, the system worked with minimal challenges. However, the rising cost of medical care due to expensive technologies, increasing incidence of chronic diseases, and low income among households made the health insurance system made the system difficult to preserve. Currently, the industry faces a great crisis with employers reducing health-care benefits, and hospitals failing to serve low-income and uninsured patients.

The Discussion Unfortunately, due to a myriad of historical and demographic reasons, African Americans and Hispanic residents are on the bottom tier concerning socioeconomic status. Adepoju, Preston, and Gonzales (2015) report that nearly 26 percent of African Americans and 35 percent of Hispanics do not have medical insurance. This predicament puts them at greater risk of premature mortality than their white counterparts who have higher incomes and hence access to healthcare. The American Public Health Association recognizes the challenges that lack insurance harbors to the population and is in the process of eliminating the disparities. The Affordable Healthcare Act (ACA), commonly known as ObamaCare, is one such system…

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