WGU D513 Task 1: Latest Update with Complete Solution

Population Health Management A. Create a population risk assessment summary of Corazon y Alma Health in Miami-Dade County, Florida that includes the following: The target population for Corazon y Alma Health is the pregnant population, with a large percentage of people living below the poverty level. Due to living below the poverty line, 11.4% of births are covered by emergency Medicaid (Corazon y Alma profile, n.d.). A significant concern for Miami-Dade County is the quality and access to prenatal care. Prenatal care improvements are needed because they are limited due to social, financial, and geographic obstacles. Early education, language barriers, transportation, and finance all play a part in the concerning data. With the high rate of preterm births (17.8%) and c sections (48.6%). As the children grow, there is a significant number of children with heart defects and asthma. Census profile: (Census profile: Miami-Dade County, FL., n.d.). B. Write a recommendation for a value-based payment model that Corazon y Alma Health in Miami-Dade County, Florida should adopt to support the implementation of the proposed prenatal service line. I recommend that Corazon y Alma Health use the comprehensive care payment and value-based payment model. They should implement this into the prenatal service line because it creates a total cost of care for the population. Fee levels are adjusted to keep the price within budget; fees can be adjusted up or down depending on the care. This model has been used in Minnesota and has caused providers to reduce costs without decreasing the quality of care. Women needing prenatal care are a large community; an overall cost would help many individuals. There would not be a surprise fee for standard prenatal care, encouraging individuals to keep their appointments. Regular care can prevent complications that can result in preterm birth and C-section. (Miller, H. 2009). Financial Feasibility C. Conduct a financial feasibility analysis for the proposed service line by doing the following: 1. Discuss how variance analysis could help mitigate any risks associated with the rollout of the new service line at Corazon y Alma Health in Miami-Dade County, Florida Variance analysis will provide valuable information and guide what question to ask if information is inadequate. It will help identify the problem without accusing any individual. This allows for minimizing or correcting the problem. Implementing the comprehensive care payment will require changes to organizational structure, internal processes, method coordination, quality measurement, and reporting systems. (Miller, H. 2009). Changes like this cannot happen instantly; variance analysis will allow for an ideal transition with a better chance of success. (Reiter, K. L., & Song, P. H., 2021). The Pro Forma operating budget shows that the new service line will have net patient revenue on $6,378,750. Then the net patient revenue minus the charity care and deductions is $6,375,000. There will need to be a revenue variance analysis to identify what changes need to be made. The Pro Forma operating budget shows that the value-based payment model will work. There is a 2% increase in the ratio analysis. There is a significant profit margin that will benefit the staff and the organization. (Pro Forma Operating Budget. n.d.). Two funding options for the prenatal service line would be grant-based funding from federal and/or state health departments and the organization's fundraising. The organization doing the fundraising requires a strategy and a lot of commitment. (County health rankings & roadmaps. 2016 February 4). Must ensure the right donors and corporations are there. With grant-based funding, it is essential to be aware of deadlines, but federal and state agencies will participate in health improvement initiatives. Two financial effects on Corazon y Alma Health would be the innovation strategy and operating costs. The innovation strategy is to address the healthcare gap at Corazon y Alma Health. Many in the community live below the poverty line. This affects not only their financial but also their transportation. Implementing telehealth can help provide care through the prenatal service line. Operating costs for the prenatal service line will initially be higher. Still, they will decrease because access to care will improve, decreasing the number of high-risk patients. The state of Florida could implement limitations and guidelines on the state Medicaid. Improving access to care for individuals with Medicaid. (Value-Based Care in State Medicaid Programs, n.d.). In addition, the Center for Medicare and Medicaid Services can help because they are establishing a value-based purchasing by 2030. This will cause a reeducation in healthcare costs and an increase in the quality of care. Also, other insurance companies follow the example and utilize VBP. 2. Explain how the projected operating budget for the proposed prenatal service line at Corazon y Alma Health in Miami-Dade County, Florida supports your choice of a value-based model. 3. Discuss two potential funding options for the prenatal service line, including how these options could secure funding for the prenatal service line. 4. Discuss two anticipated financial effects on Corazon y Alma Health in Miami-Dade County, Florida by using the strategy and finance dimension of Miller’s impact assessment framework. 5. Identify two existing regulatory agencies that could significantly affect operations at Corazon y Alma Health in Miami-Dade County, Florid