Nursing Healthcare Wk3/Dis/

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SELF/PRO

 

PART 1

The Affordable Care Act and the American Health Care Act Compared

The provisions of the Affordable Care Act (ACA) directs all employers to provide minimum value and affordable medical cover to all full-time employees or else be penalized whereas the American Health Care Act (AHCA) removed the penalty on defaulting employers (Conley, Dygert & Sellstrom, 2016). Under the ACA, it is the people’s mandate to buy healthcare coverage whereas the AHCA abolished the penalty requiring individuals to purchase health cover. However, the AHCA issues penalties to individuals who fail to pay their healthcare coverage for more than 63 days in the last 12 months, and youth who are past the age limit under parental cover and did not enroll for health cover of that year (Conley, Dygert & Sellstrom, 2016).

The penalty is a 30% surcharge in premiums, which can last for a period of 12 months (Conley, Dygert & Sellstrom, 2016). On the aspect of coverage affordability, ACA provides for cost-sharing subsidies in low-income families or individuals to allow for exchange plans for up to an average of 70%. The premiums to be paid by such individuals and families have tax reductions to enable low-income earners afford healthcare insurance (Mach, 2017). On the other hand, the AHCA offers credits on the basis of age with fixed amounts such as below 30 years-$2000, 30-40 years-$2500, $3,500-50-60 years, and it faced out credits for people earning incomes that exceed $75,000 (Conley, Dygert & Sellstrom, 2016). The ACA removed additional charges for health status whereas AHCA charges 30% standard rate for people with preexisting health complication for the past 12 months (Mach, 2017).

Opinion on Why AHCA Failed in the first Passage Attempt

The most likely reasons for the failure of AHCA during its first passage attempt were due to its provisions that would impact negatively in low income families and the less-privileged individuals with regard to their preexisting health status. For instance, the AHCA lifted penalties that employers were to be charged if they defaulted paying the compulsory health cover for all their permanent employees. This implies that employees could pay their employees’ cover only when they wished, which could push the burden back to employees. The other reasons are that people with preexisting medical conditions would be required to pay more premiums, and abolished sharing of insurance cover, and charging premiums based on age instead of economic capabilities. This means that you can be charged little premiums even if you earn high, and you can be charged high premiums even if you poor depending on your age.

PART2

Your comparisons of the ACA and AHCA were informative.  How did the mandate for employers to pay for employee’s healthcare insurance affect the employers?

 

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6053 Discussion 1

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As you strive to grow in your leadership skills and abilities, you will find that the context in which you work influences your motivation and areas of focus. In a similar vein, your commitment to developing professionally can contribute toward organizational effectiveness.

To that end, it is critical to recognize the importance of organizational culture and climate. In particular, through this week’s Learning Resources, you may consider several questions: How do an organization’s mission, vision, and values relate to its culture? What is the difference between culture and climate? Moreover, how are culture and climate manifested within the organization?

For this Discussion, you explore the culture and climate of your current organization or one with which you are familiar. You also consider decisions and day-to-day practices and the way they relate to the organization’s mission, vision, and values.

To prepare:

  • Review the information related to planning and decision making in health care organizations presented in the textbook, Leadership Roles and Management Functions in Nursing: Theory and Application. Consider how planning and decision making relate to an organization’s mission, vision, and values, as well as its culture and its climate.
  • Familiarize yourself with the mission, vision, and values of your organization or one with which you are familiar. Consider how the statements and actions of leaders and others within the organization support or demonstrate the organizational mission, vision, and values. In addition, note any apparent discrepancies between word and deed. Think about how this translates into expectations for direct service providers. Note any data or artifacts that seem to indicate whether behaviors within the organization are congruent with its mission, vision, and values.
  • Begin to examine and reflect on the culture and climate of the organization. How do culture and climate differ?
  • Why is it important for you, as a master’s-prepared nurse leader, to be cognizant of these matters?

Post a description of your selected organization’s mission, vision, and values. Describe relevant data, or artifacts, words, and actions of leaders and others in the organization that support, or perhaps appear to contradict the organization’s mission, vision, and values statement. In addition, discuss the organization’s culture and its climate, differentiating between the two. Explain why examining these matters is significant to your role as a nurse leader.

 

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What are three data sources will you use for your AR?

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1. After reading the article by Patel, Smith, Fitzsimmons, Kara & Detmer (2012), reflect on the data collection methods and the analysis strategies that were used to assess the data. Address the following questions in your post:

What were the key data collection methods used, and how did they align with the focus of the research?

What were the analysis strategies used, and how did they align with the type of data that was collected during the study?

What do you feel are the particular strengths of the data collection and analysis of this article? What do you consider the weaknesses of this approach?

References

Patel, N., Smith, R., Fitzsimmons, K., Kara, M., & Detmer, E. (2012). Utilizing goal setting strategies at the middle level: Helping students self-regulate behavior. Networks: An On-line Journal for Teacher Research, 14(2), 1-9.

 

2. Data Collection

As you consider the construction of your data gathering instruments, use the following questions and explanations by Sagor (2011) to guide you.

  • What are three data sources will you use for your AR?
  • Do you need a matrix for data triangulation?
  • Is the process I am using to answer my question clear enough that my students (clients or participants) can understand it?

When collecting and analyzing data, action researchers can do a great deal to ensure the validity and reliability of their findings by using a process called triangulation. The term triangulation refers to the use of multiple independent data sources to corroborate findings. The purpose and necessity of corroboration is the same for the action researcher as it is for the trial lawyer. A trial lawyer knows that to convince a jury of the accuracy of a legal theory, it helps to have more than one witness; the more individual witnesses whose testimony supports the theory, the more credible the theory becomes (Sagor, 2002, p. 16-18).

Educational action researchers usually have a wide variety of data sources available to them. Some of the most common data sources are the following:

Existing data

  • School/teacher records
  • Referrals to the principal
  • Attendance records
  • Tardies
  • Classroom behaviors (talk outs/negative behaviors)
  • Number of detentions (per student)
  • Number of suspensions (per student)
  • Student work/portfolios

Observation data

  • Photographs
  • Videotapes
  • Diaries, logs, journals
  • Rating scales/rubrics
  • Data obtained by shadowing students through the school day

Probes

  • Tests
  • Surveys
  • Interviews
  • Focus groups

You, as the researcher, will describe the instruments and data gathering techniques used. You must establish criteria for selecting the data as they relate to the scope of the problem.

A helpful tool for planning data collection and triangulation is a triangulation matrix—a simple grid that shows the various data sources that will be used to answer each research question. The matrix provides the action researcher with some assurance that the potential for bias (which is always present whenever a single source of data is used) won’t take on undue significance. Figure 2.3 illustrates how a completed triangulation matrix for a study on student editing might look.

Figure 2.3. Triangulation Matrix—Study on Student Editing


Issues to pay attention to when trying to answer research question		 Data Source #1 Data Source #2 Data Source #3
What is the relationship between student enjoyment of writing and the quality of their editing? Student survey Analysis of first, second, and final drafts Comparison with work on previous assignments
In what ways will providing students with a copy of a scoring rubric impact the quality of their finished papers? Student interviews Contrast between revisions made in assignments without rubrics and ones with rubrics Third-party assessments of finished products
To what extent are the finished papers different when students use peer editors? Student interviews Contrast between revisions made in assignments without peer editing and ones completed with peer editing Third-party assessments of finished products

 

 

Adapted from: Sagor, R. (2002). Guiding school improvement through action research. Alexandria, VA: ASCD. pp. 8-16.

Your Task

Submit at least one of the data gathering instruments you have selected, or at least one of the instruments you have constructed along with an explanation. Please be sure to include your explanation for what you have chosen or designed – focus on how you see it connecting to your proposed project/research question. Attach the data-gathering instrument (surveys, pre tests, etc.) to the assignment submission.

Please also include a triangulation chart showing the ideas you have for the remainder of your data collection. You will need to develop the other tools for the final proposal as well, but for this assignment, you are submitting one to show your thinking and to get feedback about your ideas in the triangulation matrix. After you get instructor feedback on this, you can continue to develop your ideas and add them to your AR proposal.

3. Data Analysis

During data analysis, the teacher researcher engages in a systematic effort to search for patterns or trends in the data. There are many ways to accomplish this. Regardless of the particular technique employed, during the analysis phase the researcher tries to systematically cut, sift, and sort the data into piles of like or similar objects. The key purpose of this systematic sorting and categorizing is to assist in answering the following two questions:

  • What is the story told by my data?
  • What might explain this story?

These two questions help us to frame out what can be learned from the data analysis process. While you will not formally implement your proposal during this course, you need to consider how to work with the answers that your data offers. Asking these kinds of questions and exploring the themes that can arise from the work can direct your interpretations. Once the researcher believes the process has resulted in adequate answers to those two questions, it is time for the researcher to take a critical look at the initial AR goal and ask how it may need to be revised based upon the analysis of the data (Sagor, 2002, p. 8-16).

Using the triangulation matrix that you created on #2 as a base, brainstorm some ideas for how you think you would analyze the data that results from your collection methods. Be conscious of the approach that your data suggests (qualitative, quantitative, mixed methods) and make appropriate selections. Share your ideas for the analysis strategies. Be sure to include 2-5 possible themes that you expect to emerge from the data that you would collect. Remember that these are thoughts about where you might end up at the end of the work based on the experiences of others and your familiarity with your context and professional experiences.

References

Sagor, R. (2002). Guiding school improvement through action research. Alexandria, VA: ASCD. pp. 8-16.

 

Note that all should relate to how teachers leadership skills affect students’ motivation.

  • patel_et_al_2014_week_4.pdf

 

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Nursing Healthcare Wk3/Dis/REP

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RI..

The AHCA was written to solve a crisis that doesn’t exist and accordingly accepts sacrifices it doesn’t need to ( Q1,2018). It’s akin to a doctor who wants to amputate a patient’s leg, a reasonable solution if gangrene has set in, but disastrous in case of a botched diagnosis. Everyone will face the specter of getting priced of health insurance altogether if they lose coverage. For them this is functionally a mandate, except instead of a financial penalty the AHCA punishes them by withholding access to care. I think one of the somewhat surprising elements of the bill was the fact that they kept in the essential health benefits, the ten classes of benefits that need to be covered just because it’s covered doesn’t mean that you’re going to be able to afford them. For the people who have coverage, meaning they are in an insurance plan, what is the extent of the out of pocket exposure they have to get the care they need. As it turns out, studies showing better health outcomes for those with insurance looked at individuals having private insurance. On the other hand, multiple studies, assessing the effect of the Medicaid expansion, found no improvement in health outcomes for those on Medicaid.  In fact, other investigations have found worse outcomes for those with Medicaid as compared to those with no insurance at all.

 

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