COMPETENCIES
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3042.2.2 : Communication and Collaboration Methods
The graduate recommends methods of organizational communication to increase effectiveness of interpersonal communication, collaboration, and problem-solving among healthcare organizational stakeholders.
3042.2.3 : Human Capital Management
The graduate manages human relations within healthcare organizations using methods, techniques, and financial factors.
3042.2.4 : Data Methodologies
The graduate assesses a variety of analytical data methodologies to promote and advance organizational healthcare.
3044.2.4 : Fiscal Management
The graduate manages healthcare organizational sustainability and productivity by using fiscal management tools, principles, and strategies.
3045.2.1 : Data Application
The graduate evaluates the value, source, and appropriate application of the data that will affect risk, compliance, quality, policy, populations, finance, and economic factors within a healthcare organization.
3045.2.6 : Using Predictive Analytics and Other Forecasting
The graduate examines how future trends in healthcare delivery are anticipated through predictive analytics and other types of forecasting techniques that will improve healthcare outcomes while reducing costs.
INTRODUCTION
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In Task 1, you reviewed the data for Tupelo and Tupelo City Multispecialty Center (TCMC) and focused on gaps in mental health, including substance use disorders and mental illness. In Task 2, you selected a new target population for analysis and created a target patient population profile based on the “County Health Rankings” and “U.S. Census Data” web links. In this task, you will explore chronic care strategies as part of your population health initiative, as well as apply these strategies to address barriers to care and cultural aspects of the target population from Task 2. You will also develop strategies to ensure sustainability and improve the experience of care.

Note: Task 1 and Task 2 should be completed in full before attempting this task.
SCENARIO
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As an administrator at the organization of your choice, you are responsible for proposing a plan to improve the population health of the target population and chosen organization from Task 2. Within this proposal, you should address the concerns of various stakeholders in the implementation, financial considerations, and feasibility of a population health model. This proposal could be the model for a larger-scale population health initiative in your area.
REQUIREMENTS
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Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Apply Wagner’s chronic care model to your population health initiative by doing the following:
1. Describe two care strategies for each of the six elements of the chronic care model (CCM) that can be customized to improve patient care for your target population.
2. Explain how care coordination, including reducing care fragmentation, would specifically address one critical healthcare risk identified in Task 2 part A1 for your target population.
3. Discuss the benefits of a patient-centered medical home (PCMH) in supporting health outcomes for any one of the critical healthcare risks identified in Task 2 part A1.
4. Analyze the anticipated impact these strategies from part A1 will have on healthcare outcomes and the overall health of the target population.

B. Create a sustainability strategy by doing the following:
1. Describe your incentive plan for the successful participation of internal and external stakeholders in the implementation of the population health model.
2. Discuss how the mitigation of financial risk would further influence stakeholder engagement.
3. Discuss the potential positive and negative impacts of your population health model, using the attached “Miller’s Impact Assessment Framework.”
4. Evaluate your identified organization’s ability to support the strategies in your population health initiative based on your responses in Task 2 and parts A and B1–B3 of this task.

C. Reflect on your responses from Task 2 and this task and discuss how your population health initiative aligns with the triple aim model of healthcare.

D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

E. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
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A1. CARE STRATEGIES:
NOT EVIDENT
A description of care strategies is not provided. APPROACHING COMPETENCE
The described strategies are not related to the chronic care model, or the strategies are not feasible or would not improve patient care for the target population. Or there are not 2 care strategies for each of the six elements of the chronic care model. COMPETENT
The described strategies are related to the chronic care model, and the strategies would feasibly improve patient care for the target population. For each of the six elements of the chronic care model, 2 care strategies are provided.
A2. CARE COORDINATION :
NOT EVIDENT
An explanation of care coordination is not provided. APPROACHING COMPETENCE
The explanation of how care coordination, including reducing care fragmentation, would specifically address 1 critical healthcare risk identified in Task 2 is not plausible or convincing. Or the explanation excludes elements of care coordination or reducing care fragmentation. COMPETENT
The explanation of how care coordination, including reducing care fragmentation, would specifically address 1 critical healthcare risk identified in Task 2 is plausible and convincing.
A3. BENEFITS OF PCMH:
NOT EVIDENT
A discussion of the benefits of a patient-centered medical home in supporting health outcomes is not provided. APPROACHING COMPETENCE
The discussion of the benefits of a patient-centered medical home in supporting health outcomes is not specific to any 1 of the critical healthcare risks identified in Task 2. Or the provided benefits are not plausible, or fewer than 2 benefits are provided. COMPETENT
The discussion of the benefits of a patient-centered medical home in supporting health outcomes is specific to any 1 of the critical healthcare risks identified in Task 2. The provided benefits are plausible.
A4. ANTICIPATED IMPACT :
NOT EVIDENT
An analysis of the anticipated impact of the strategies is not provided. APPROACHING COMPETENCE
The analysis of the anticipated impact of the chronic care strategies is poorly reasoned or not relevant to the healthcare outcomes or overall population health. Or the anticipated impact is not realistic. COMPETENT
The analysis of the anticipated impact of the chronic care strategies is well reasoned and relevant to the healthcare outcomes and overall population health The anticipated impact is realistic.
B1. INCENTIVE PLAN:
NOT EVIDENT
A description of an incentive plan is not provided. APPROACHING COMPETENCE
The described incentive plan for internal and external stakeholders is not feasible or is not supported with logical strategies to increase stakeholder buy-in. Or the description does not address incentives for both internal and external stakeholders. COMPETENT
The described incentive plan for internal and external stakeholder participation is feasible and well supported with logical strategies to increase stakeholder buy-in. The description addresses incentives for both internal and external stakeholders.
B2. MITIGATION OF RISK:
NOT EVIDENT
A discussion of the mitigation of financial risk is not provided. APPROACHING COMPETENCE
The discussion does not effectively address how mitigating financial risk can further influence stakeholder engagement. COMPETENT
The discussion effectively addresses how mitigating financial risk can further influence stakeholder engagement.
B3. IMPACTS OF HEALTH MODEL:
NOT EVIDENT
“Miller’s Impact Assessment Framework” is not provided. APPROACHING COMPETENCE
“Miller’s Impact Assessment Framework” is incomplete, or the discussed positive and negative impacts of the proposed population health model are implausible or illogical. COMPETENT
“Miller’s Impact Assessment Framework” is complete, and the discussed positive and negative impacts of the proposed population health model are plausible and logical.
B4. ABILITY TO SUPPORT CHANGE :
NOT EVIDENT
An evaluation of the identified organization’s ability to support strategies from the population health initiative is not provided. APPROACHING COMPETENCE
The evaluation does not logically address the identified organization’s ability to support strategies from the population health initiative or does not reasonably align with the responses in Task 2 and parts A and B1–B3 of this task. COMPETENT
The evaluation logically addresses the identified organization’s ability to support strategies from the population health initiative and reasonably aligns with the responses to Task 2 and parts A and B1–B3 of this task.
C. REFLECTION:
NOT EVIDENT
A reflection of the candidate’s responses from Task 2 and the current task is not provided. APPROACHING COMPETENCE
The reflection does not relate to the candidate’s responses from Task 2 and the current task, or the discussion is flawed or ineffective in addressing how the health initiative aligns with the triple aim model of healthcare. COMPETENT
The reflection relates the candidate’s responses from Task 2 and the current task to effectively address how the population health initiative aligns with the triple aim model of healthcare.
D. APA SOURCES :
NOT EVIDENT
The submission does not include in-text citations and references according to APA style for content that is quoted, paraphrased, or summarized. APPROACHING COMPETENCE
The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized but does not demonstrate a consistent application of APA style. COMPETENT
The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style.
E. PROFESSIONAL COMMUNICATION:
NOT EVIDENT
Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic. APPROACHING COMPETENCE
Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective. COMPETENT
Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.
WEB LINKS
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Country Health Rankings
US Census Data
SUPPORTING DOCUMENTS
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Miller’s Impact Assessment Framework.docx