Discussion Background:

When you think of a quality-improvement program, what thoughts come to mind? If you're like most, you automatically think those programs are about minimizing variations, or even eliminating them. And although that response may be appropriate in industry, it is not always applicable in health care environments. Variations in the medical field are managed rather than eliminated (Joshi et.al, 2014). For instance, you can compare different medical practices and locations to determine whether variations are warranted or unwarranted. Making a distinction between the terms warranted and unwarranted is necessary. One is based on patient-related factors and is part of providing both personalized and appropriate evidence-based patient care. The other is based on quality-of-care concerns for hospitals and health care systems that include inefficient care and cost implications, as well as differences in care between geographic regions and health care providers (Gauld et al., 2011). Additionally, reducing variation, which very often results in a reduction of cost of care, can be achieved through the use and implementation of change theories.

This week, you will specifically analyze diverse Medicare reimbursements affected by variation and variations in medical practice and discover evidence-based models to implement health care quality improvement.

Learning Objectives

Students will:
- Analyze variation issues that affect Medicare reimbursements
- Recommend strategies for overcoming variation issues

Discussion Topic: Variations in Quality of Medical Practice

Variations, too much or too little in health care, are an indication of poor quality in medical practice and often raise questions about the quality and efficiency of the use and allocations of resources, and they have important implications for health care and health policy.
In this Discussion, you will conduct an evaluation of the variation of issues affecting Medicare reimbursements to determine warranted or unwarranted variations. You will provide an analysis of those variation issues that may affect reimbursements and recommend ways to overcome the issue(s).

To prepare:
Read/review the Dartmouth Atlas Data document, containing key statistics per state, and the Learning Resources related to variations in quality in medical practices.

Dartmouth Atlas Data document (Excel spreadsheet)

Note: For this Discussion you are required to complete your initial post before you will be able to view and respond to your colleague's postings. Begin by clicking on the "Post to Discussion" link and then select "Create Thread" to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

The Discussion:
In an attempt to figure out why there is a tremendous difference between Medicare reimbursements between states, data were pulled from the top and the bottom of the list that include the following information adjusted for price, age, sex, and race. The 90th percentile group is at or above $10,578, and the 10th percentile group is at or below $7,497.

Post a cohesive response to the following:

Using the Excel spreadsheet (Dartmouth Atlas) and other Resources for the week, post your analysis of the variation issues that may affect diverse Medicare reimbursements and why. Recommend strategies for overcoming the issues.

Note: Local governmental differences are not a valid reason.

Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.