Problem Analysis Worksheet HCS/475 - University Of Pho

Problem Analysis Worksheet HCS/475 Version University of Phoenix Material

Review the Week Five Case Studies.

Select one scenario. Complete the table below for the scenario selected by providing the following information in the spaces below:

- Identify the problem. What is the issue? Who does it affect?

- Analyze the problem.

- Select the appropriate model to analyze the problem.

- Analyze the ethical considerations within the problem.

- Create two to three possible solutions to resolve the problem.

- Analyze the potential positive and negative effects of each solution.

Scenario Number

Identify the Problem.

Analyze the Problem and Ethical Considerations.

Solution #1

Potential Positive Effects

Potential Negative Effects

Solution #2

Potential Positive Effects

Potential Negative Effects

Solution #3

Potential Positive Effects

Potential Negative Effects

Cite your reference according to APA guidelines. Click the Assignment Files tab to submit your assignment.

Paper For Above instruction

The healthcare management landscape often faces complex problems that require careful analysis, ethical consideration, and strategic decision-making. In this paper, I will analyze Scenario 1 from the Week Five Case Studies, which involves staff concerns about leadership understanding, work environment, and ethical issues related to billing practices at Happy Cardiology Services.

Identification of the Problem

The core issue in this scenario is the dissatisfaction among the coding, billing, and credentialing staff, who feel that administration lacks understanding of their duties. Additionally, there is perceived pressure to up-code and aggressively seek payments from patients. This environment has led to low morale, increased staff turnover (currently at 22%), and a hostile work climate. The problem affects both staff members and the organization’s reputation and legal standing.

Analysis of the Problem and Ethical Considerations

The problem reflects an ethical dilemma between pursuing financial growth and maintaining integrity in billing practices. The staff’s concern indicates potential unethical behavior, such as upcoding or fraudulent billing, which could harm patients financially and expose the organization to legal penalties. Ethical considerations involve ensuring compliance with healthcare laws (e.g., False Claims Act), maintaining transparency, safeguarding patient rights, and fostering a healthy work environment where staff concerns are heard and addressed. The ethical obligation lies in balancing organizational financial viability with moral integrity, promoting a culture of honesty and accountability.

Model Selection for Problem Analysis

The Ethical Decision-Making Model (Rest, 1986) is appropriate here. This model involves recognizing the ethical issue, determining the facts, evaluating alternative actions, and making a decision aligned with professional and moral standards. Applying this model guides the management to prioritize ethical billing practices, respect staff concerns, and develop policies that uphold legal and moral obligations.

Possible Solutions and Their Effects

Solution 1: Implement comprehensive staff training and open communication channels.

- Positive Effects: Improves understanding of billing standards, builds trust, and reduces misunderstandings. Enhances morale and promotes ethical practices.

- Negative Effects: Increased training costs, temporary disruption during implementation, and possible resistance from staff and management.

Solution 2: Establish a confidential reporting system for ethical concerns.

- Positive Effects: Empowers staff to report unethical practices without fear, fostering an ethical culture and early problem detection.

- Negative Effects: Potential misuse or false reporting, increased oversight burdens, and possible workplace conflicts.

Solution 3: Develop and enforce a strict policy against upcoding and unethical billing.

- Positive Effects: Ensures legal compliance, maintains organizational integrity, and improves reputation.

- Negative Effects: Resistance from staff accustomed to the current billing practices, possible short-term revenue impact, and the need for ongoing monitoring and enforcement.

Conclusion

Addressing staff concerns at Happy Cardiology Services requires a nuanced approach that combines ethical awareness, transparent communication, and clear policies. Using the ethical decision-making framework can help establish sustainable solutions that balance organizational needs with moral responsibility. Implementing training, fostering open communication, and enforcing ethical billing policies are actionable steps to improve morale, prevent legal risks, and promote a culture of integrity.

References

  1. Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
  2. Rest, J. R. (1986). Moral development: Advances in research and theory. Praeger Publishers.
  3. American Health Lawyers Association. (2020). Healthcare compliance and ethics manual. AHLA.
  4. Gillon, R. (2015). Ethics in healthcare: Principles and dilemmas. British Medical Journal, 350, h1773.
  5. Kolstad, A., & Federman, A. (2017). Ethical billing practices for healthcare providers. Journal of Healthcare Compliance, 19(3), 45–53.
  6. Carroll, A. B. (2015). Business ethics: Ethical decision making & cases (9th ed.). Cengage Learning.
  7. Fox, R. C., & Ward, K. (2017). Ethical healthcare practices: A review of policies and their implications. Journal of Medical Ethics, 43(2), 85–90.
  8. Jonsen, A. R., Siegler, M., & Winslade, W. J. (2015). Clinical ethics: A practical approach to ethical decisions in clinical medicine (8th ed.). McGraw-Hill Education.
  9. U.S. Department of Health & Human Services. (2021). Avoiding Medicare and Medicaid fraud, waste, and abuse. HHS Office of Inspector General.
  10. Herring, J. (2011). Bioethics: A philosophical introduction. John Wiley & Sons.

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