Health Care Models And Lean Six Sigma

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Scenario

Imagine that you are tasked with providing a comparison of government and private sector health care models for senior executives at a health care organization. You decided to create a table that compares the differences between both financing models in terms of cost, access, reimbursement, and quality.

You also want to impress upon the senior executives the importance of providing efficient and effective health care, so you will create an infographic designed to introduce them to the application of Lean Six Sigma principles to streamline operations and improve health outcomes. Some examples that you may consider include medical errors, patient wait times, supply chain management, or billing errors.

 

Preparation

The optional resources below will aid you in completing this two-part assignment.

Part 1: Comparing Health Care Models

In Part 1 of this assignment, you will compare the cost, access, reimbursement, and quality of government and private sector models. Choose one government and one private sector model from the list below and begin your research.

  • Government

    • Medicare.
    • Medicaid.
    • Veteran’s Administration.
  • Private Sector

    • Employer Provided Insurance.
    • HMO.
    • PPO.

One of the characteristics that you will consider – quality – should be assessed using the Centers for Medicare and Medicaid Services (CMS) Quality measures. Optional resources to aid your assessment can be found at:

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/National-Impact-Assessment-of-the-Centers-for-Medicare-and-Medicaid-Services-CMS-Quality-Measures-Reports

https://mmshub.cms.gov/sites/default/files/Guide-Quality-Measures-How-They-Are-Developed-Used-Maintained.pdf

HEDIS Measures and Technical Resources

Part 2: Lean Six Sigma Infographic

Choose a health care function to evaluate for efficiency and effectiveness of delivery. You will apply Lean Six Sigma principles by using the DMAIC methodology to present how errors and waste can be reduced in the infographic. Examples might include but are not limited to, areas such as medical errors, patient wait times, supply chain management, or billing errors.

Useful Tools and Resources (Optional)

  • To create your infographic, you can use whatever graphics tool you prefer. One such tool, CanvaLinks to an external site. offers templates that may speed the process.
  • Examples and information on how to create effective infographics can be found on the Internet in places like
  • https://www.businessillustrator.com/what-makes-a-good-infographic/
  • https://6sigma.com/how-dmaic-helps-hospitals-improve-patient-care/
  • https://sixsigmamania.com/?p=669

 

Instructions

Consider the scenario and complete both parts of this assignment using the Week 8 Assignment Template [DOCX] Download Week 8 Assignment Template [DOCX]for comparison of the government and private sector health care financing models. Complete the template using your own words and add three references below the template to support your work. Remember that the deliverables are designed to inform on high-level concepts only. You will submit two separate files for the assignments: a Word file and a pdf file that you download from Canva.

Part 1: Comparing Health Care Models

  1. Compare U.S. government and private sector financing models in the table and include a minimum of four sentences for each criterion:
    • Cost – What the patient pays: premiums, copays, and deductibles.
    • Patient Access – Who is eligible for the plan?
    • Provider Reimbursement – How does the plan reimburse the provider? What are the payment models?
    • Quality – Apply CMS Quality measures and HEDIS measures.
  2. Provide a brief economic analysis of which model promises the highest quality from the patient perspective. Support your assertion with data or examples.

Part 2: Lean Six Sigma Infographic

Create an infographic (using the DMAIC approach – Define, Measure, Analyze, Improve, Control) depicting how Lean Six Sigma would be used to reduce waste and errors in health care for an operation of your choosing. Examples include medical errors, patient wait times, supply chain management, or billing errors. The following resources for DMAIC should be used for selecting your Lean Six Sigma tools and to review how Lean Six Sigma can be used by hospitals to improve patient care.