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HW: Part III of FINAL EXAM!: Your COMPLETE LITERATURE REVIEW (W. 9)

Exam Content

1.

Top of Form

This is part of your final exam!

In class, we learned that the Literature Review includes:

· Introduction (6 sentences taught in this week’s lesson)

· Review of Literature 

· Analysis of Literature (use your EXCEL worksheet to compare and contrast what is the same and what is different among: WHY, HOW, and WHAT)

For  this submission:  You will submit your completed Literature Review (all three sections) in a PDF document.

Submission Requirements: 

 

1. Submit your assignment into the CHECK YOUR SIMILARITY HERE folder

1. Evaluate EVERY highlighted text EXCEPT the References Page and in-text citations to ensure it links only back to  your own work.

THEN

1. Paste your written text into this FREE AI Text Detector: https://www.scribbr.com/ai-detector/

1. Take a screenshot of your text and the percentage. Your percentage MAY NOT EXCEED 25%. You might need to take multiple screenshots if your document is over 500 words. 

1. Attach your screenshot(s) WITH your assignment submission.

Bottom of Form

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1

4

Racial Disparities in Healthcare among Pregnant Women in the United States

Tamifer Lewis

Public Health, Monroe College, King Graduate School

KG604-144: Graduate Research and Critical Analysis

Dr. Manya Bouteneff

December 4, 2022

Literature Review

Introduction to the Literature Review

Research suggests that racial disparities in healthcare among pregnant women persists in the United States (Zhang et al. 2013). Due to this continuous occurrence, it is vital to examine the factors that contribute to the adverse outcomes in maternal health. The literature review contained only research articles about factors that impacted and influenced disparities in pregnancy outcomes. Factors that were reviewed were socioeconomic status, public health insurance, race/ethnicity, and poverty status. The literature review was conducted using EBSCO Host and ProQuest databases from the Monroe College Library. The search terms used to compile pertinent articles were racial disparities maternal health, adverse pregnancy outcomes, and maternal health outcomes.

Review of the Literature

Adverse Pregnancy Outcome Factors

Darling et al. (2021) conducted a study between 2001 and 2018 to examine the efficiency of qualified interventions in preterm birth, small for gestational age, low birth weight, neonatal death, cesarean deliveries, maternal care satisfaction, and coast effectiveness programs. A systematic review was used to collect data from the United States, France, Spain, and the Netherlands. The studies consisted of mostly non- Caucasian women from low-income population ranging from 12 to 46 years of age and being between 20 to 32 weeks’ gestation. Interventional programs were implemented into three categories: group prenatal care, augmented prenatal care, or a combination of both group and augmented prenatal care (Darling et al. 2021). The researchers found that certain interventions, such as prenatal care and augmented care, or a combination of both, may decrease adverse outcomes in small-for-gestational-age and preterm birth, and could aid in increasing maternal care satisfaction. Interventions that worked on enhancing coordination of care were found to result in providing more effective cost savings. The researchers also found disparities in the quality of access to care in the vulnerable population. There was insufficient evidence of suitable quality to confirm that the interventions were successful at enhancing clinical outcomes in prenatal care for at risk populations (Darling et al. 2021).

Similar observations were made in a study conducted by Nichols and Cohen (2020), between 2006 and 2018 to examine the methods used to improve the results of maternal mortality in California. The study was conducted using a scoping review to evaluate research on women and maternal health in the United States. The researchers used information from the US Maternal Fetal Medicine Network to measure the percentage of studies where pregnant women, women, and children were the main focus. The researchers also reviewed documentation on healthcare policies and practices from California’s public health department, healthcare foundation, and Maternal Quality Care Collaborative. Nichols and Cohen (2020) found that although the health of fetus and children could be adversely affected by the health of the mother, the majority of maternal programs in the United States places emphasis on the child. The researchers also found four areas of concern in women health experiences, both in pre and postnatal care. The problem areas entailed inadequate investment in women’s health, inefficient quality of care and avoidable caesarean delivers, expanding disparities in minority women and women living in rural areas, and contradictory collection and distribution of data (Nichols and Cohen, 2020).

Approaches to Improving Pregnancy Outcomes

In contrast to the preceding studies, Zhang et al. (2013) conducted a study between 2005 and 2007 to calculate the excessive rate of unfavorable outcomes in pregnancy within racial and ethnic groups. The study also aimed to measure the possibility of Medicaid savings that are linked to paid maternal care claims resulting from the inequalities that contribute to unfavorable maternal outcomes. A cross-sectional study using Medicaid Analytic eXtract (MAX) data was used to gather pregnancy outcome information from inpatient hospitals from 14 states (Florida, Alabama, Arkansas, North Carolina, Georgia, Louisiana, Kentucky, Mississippi, Maryland, Missouri, Tennessee, South Carolina, Virginia, and Texas). The study consisted of a little over 2 million patients who were insured with Medicaid and had a delivery code of maternal delivery stay. Zhang et al. (2013) found that, with the exception of gestational diabetes, African American women showed the worst outcomes out of all unfavorable pregnancy outcomes. These disparities are postulated as being multi-factorial, having causes stemming from complicated experiences with racism, poverty, and complex healthcare interactions. It was also found that women covered under Medicaid health insurance were more likely to have consistency in care from prenatal care through delivery compared to their counterparts. However, due to participation in Medicaid programs being influenced by reimbursement rates, some providers may choose to stop accepting Medicaid patients because of reimbursement delays and low payment rates, which could contribute to negative birth outcomes (Zhang et al. 2013).

Analysis of the Literature

In the United States, the persistence of maternal mortality continues to be a problem area in public health. The contributing factors that impact pregnancy outcomes persist in burdening the U.S., leading to poor healthcare quality, and increasing health disparities. The studies used in this literature review each used a different form of research methodology to collect data, including systematic and scoping reviews and cross-sectional studies. Similarly, Darling et al. (2021), Nichols and Cohen (2020), and Zhang et al. (2013) have emphasized the correlation between race/ethnicity and financial status playing a part in influencing quality of care, access of care, and pregnancy outcomes in pregnant minority women. To mitigate the disparities in maternal health Darling et al. (2021) and Zhang et al. (2013) suggested that interventions should be inspected and geared towards determining and eradicating the racial and ethnic disparities that affect pregnancy-related outcomes. Whereas Nichols and Cohen (2020) suggested focusing on exploring the distinctive experiences of particular at-risk subgroups of women, such as women in prison, who are of childbearing age, and the pregnant women who are less likely to pursue prenatal care, such as undocumented women.

References

Darling, E. K., Cody, K., Tubman-Broeren, M., & Marquez, O. (2021). The effect of prenatal care delivery models targeting populations with low rates of PNC attendance: A systematic review. Journal of Health Care for the Poor and Underserved, 32(1), 119-136. https://www.proquest.com/scholarly-journals/effect-prenatal-care-delivery-models-targeting/docview/2507722229/se-2

Nichols, C. R., & Cohen, A. K. (2021). Preventing maternal mortality in the United States: Lessons from California and policy recommendations. Journal of Public Health Policy, 42(1), 127-144. https://doi.org/10.1057/s41271-020-00264-9

Rabin, R. C. (2019, May 8). Huge racial disparities persist in pregnancy-related deaths, and are growing. New York Times, A20(L). https://link.gale.com/apps/doc/A584694288/ITOF?u=nysl_me_moncol&sid=bookmark-ITOF&xid=b9422ff9

Zhang, S., Cardarelli, K., Shim, R., Ye, J., Booker, K. L., & Rust, G. (2013). Racial disparities in economic and clinical outcomes of pregnancy among Medicaid recipients. Maternal and Child Health Journal, 17(8), 1518+. https://link.gale.com/apps/doc/A344827866/PPNU?u=nysl_me_moncol&sid=bookmark-PPNU&xid=51747d52

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Submit the final version of your narrative essay here.

Remember to:

· Have a cover page

· Have 5 paragraphs

· Use correct spelling, punctuation, narrative, and verb tense

· Use transitions

· Use a thesaurus to elevate and diversify your vocabulary

· Each body paragraph should have a subtopic and focus

· Each paragraph should have a topic sentence and concluding sentence

· Use descriptive details (such as what did you see/hear/taste/feel/smell? Who is in your story? Where is your story? What happened in the story? etc.)

· Make sure each paragraph has 5 sentences minimum

Student own experience

My experience interviewing for the American interview

You making the appointment for the visa going to the appointment.

What happened before the visa what events happened how did u feel etc

Visa interview how did you feel, how long was the appointment

Results and what you learned from the process

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Ella Schultz

Identifying Data

Ella Schultz is a 16-year-old White female of German decent. She was raised in Ohio. Ella’s family consists of her father, Robert (44 years old), and her mother, Rose (39 years old). Ella currently resides in a residential group home, where she has been since she ran away from home. Ella has been provided room and board in the residential treatment facility for the past 3 months. Ella describes herself as bi-sexual.

Presenting Problem

Ella has been living homeless for 13 months. She has been arrested on two occasions for shoplifting and once for loitering (as a teen in need of supervision) in the last 7 months. Ella has recently been court ordered to reside in a group home with counseling. She refuses to return home due to the abuse she experienced. After 3 months at Teens First, Ella said she is thinking about reinitiating contact with her mother. She has not seen either parent in 6 months and missed the stability of the way her family “used to be,” although she is also conflicted due to recognizing the instability of her family. Ella is confused about the path to follow.

Family Dynamics

Ella indicates that her family worked well until her father began drinking heavily about 3 years ago. She remembers her parents being social and going out or having friends over for drinks, but she never remembered them becoming drunk. Then, her father lost his job as an information technology (IT) support professional and was unable to find meaningful work. He took on part-time jobs at electronics stores, but they left him demoralized. Her parents stopped socializing, and then her father was fired from his last job because he arrived drunk. Ella’s father would regularly be drunk by the time she arrived home from school.

When Ella started having trouble in school, her father would berate her when she came home if she didn’t study immediately. Then, he would interrupt her studies by following her around and verbally abusing her. Soon after, he began hitting her or throwing objects at her. Once she went to the emergency room for stitches on her brow when she was struck by a drinking glass her father threw. She was able to convince the emergency room (ER) staff, however, that it was a bike accident, as she was known as an avid biker around her community, often riding to and from school and elsewhere.

Ella’s mother did not witness these events, as they often occurred before she returned from work, and her father might be passed out by this time. Ella reports that her mother was in denial about her father, often pretending there was no issue. When Ella tried to report the abuse, her mother took her father’s side. Finally, after the stitches, Ella confronted her mom with her father present. Her father denied it, flew into a rage, and then physically abused both Ella and her mom.

The next day, Ella’s mom acted as if nothing happened. After the abuse quickly escalated in the next week, to the point where she could no longer hide it or cover it up,

Ella fled home and has been homeless since. She left a note before leaving for school one morning and did not return home.

Educational History

Ella attends school at the group home, taking general education classes for her general education development (GED) credential. Shortly after her father lost his job, Ella began experiencing learning disabilities. Her difficulties began in math, where she had difficulty sorting and making sense of numbers. Then she began to fall behind in her reading. Her grades went from a B average to consistent D’s. Some of Ella’s Instructors began to raise the issue of a possible learning disability. A counselor made an appointment to discuss possible causes, but Ella left school and home just prior to that meeting, and did not attend.

Employment History

Ella reports that her father was employed as an IT support professional at a bank. When the bank downsized and closed many branches, her father was laid off. He was unable to secure another IT support position, as many companies had begun outsourcing this work to contractors or overseas. He began to work part-time retail jobs at consumer electronics stores but quickly became demoralized and lost a series of those jobs. Her mother works as a full-time home health aide.

Social History

Ella reports that the homeless encampment (where she wound up for a long stretch) had a group of teens that stuck together for protection and to shield themselves and each other from certain bad choices. It was at this time that Ella reports she became bisexual, seeking out and bonding to a group of women who were able to avoid being exploited for human trafficking.

The encampment group did still engage in risky behavior, however, including frequent shoplifting and other theft to secure food, supplies, etc. Likewise, although Ella reports that she did not engage in prostitution, she did engage in unprotected sex with one woman whose sexual history may have included prostitution or intravenous drug use. Thus Ella contracted a sexually transmitted infection (STI) in one instance.

Ella reports she might consider trying to go home if she knew her father was no longer there, despite feeling betrayed by her mother. She would also be willing to reconcile and attend therapy with her. However, Ella feels that her mother, who comes from a very religious family (though does not practice much now), would ultimately reject her due to her bisexual identification.

Ella also feels a strong bond to the group of teens and women with whom she stayed in the homeless encampment. She reports that she misses them and wishes she could see them—especially one teen in particular named Marisol. She says she considers these women to be as much, if not more, her family as her biological family.

Mental Health History

Ella began counseling to address the abuse in her history. In her initial reports, as detailed above, she cites mostly verbal and psychological abuse with only two instances of physical abuse. She denies any sexual abuse.

When Ella recounts the physical abuse specifically, however, she shows added signs of acute distress and trauma. The physical harm caused by the event that triggered her leaving was reportedly significant—bruising on both arms, a split lip, a bloody nose, and a bump on the head—all from punches—as well as bruises on her leg from being kicked. She did not seek medical help and avoided as much social contact as possible the day she ran away, so as not to encourage inquiries about her home situation.

Ella does have positive memories of what she calls “the before time,” and she shows a desire to return to that time. She worries for her mom, despite feeling betrayed by her. The last time she did have contact with her mom, she promised to leave her dad, but Ella does not know if this ever occurred.

Legal History

Ella has been arrested three times, twice for shoplifting and once for vagrancy. Citing the abuse she reported at home and the fears she felt, Ella was mandated to services at the Teens First agency, unlike her prior arrests when she was sent to detention.

Alcohol and Drug Use History

Ella denies any alcohol or drug use while living homeless. She reports the homeless encampment (where she wound up for a long stretch) had a group of teens that stuck together and were able to shield themselves from certain bad choices.

Medical History

During intake, it was noted that Ella showed signs of living homeless, including carrying all her possessions in one bag, signs of malnourishment, feet with heavy callouses, and clothing in disrepair. She did not show signs of drug use or self-harm. The STI she contracted was diagnosed upon intake, and she received antibiotics for treatment.

Strengths

Ella is resilient in learning how to survive in a difficult situation. She was able to avoid the more severe negative outcomes, such as human trafficking and drug use. She is able to form beneficial bonds for protection and support.

Father: Robert Schultz (44 years old)

Mother: Rose Schultz (39 years old)

Daughter: Ella Schultz (16 years old)

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Analysis of Theory Worksheet

Use this worksheet to help you apply a theory as a lens to the case study for your assignments. Fill in the column on the right with all applicable information, and then consider it a reference for how to apply the theory. You must submit this worksheet, where indicated, in applicable assignments. Then you will compile the worksheet for your Theories Study Guide (that you can use for the licensure exam) at the end of the course.

Name of theory
Author or founder
Historical origin of theory
Basic assumptions
Underlying assumptions
Key concepts
Foci/unit of analysis
Philosophical or conceptual framework
Strengths of theory
Limitations of theory
Common criticisms
When and with whom it would be appropriate to use the theory/model
Consistency of theory/model with social work principles
Identification of goodness of fit with ethical principles
Ways in which theory/model informs research methods
Implications for social work practice

1

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Assessment 2

Assessment Brief

Introduction

The assessment assesses learning outcomes 2 and 3 of the 3 module learning outcomes of this module, which are that on successful completion of the module students will be able to:

· Demonstrate an understanding and use of the appropriate analytical techniques to be applied to business case development and Investment appraisal; the raising of finance and the distribution of funds to investors;

· Communicate financial information, analysis, issues and recommendations clearly and concisely.

The Question

Background information

Smart Home Plc (a fictional company) is a UK incorporated and UK tax resident technology company focussing on the manufacture and retail of internet enabling devices for homes.

The business has been conducting Research and Development on a new smart watch and now needs to make a decision whether to go ahead with launching the product and determining what is an appropriate price for it.

You are the Business Manager responsible for the product launch and the CEO has asked you to prepare a report on the investment in the new product. With the Finance Manager on leave for the next 3 weeks, you are on your own for the presentation.

You have been given the following information from various teams in the organisation.

R&D Team

“We’ve spent quite a lot on developing this project – £450,000 – and it would be a shame if we didn’t get it to market. I would estimate that we would need to spend around and other £60,000 on research costs to get it to a position where it is ready to launch”.

The production department:

“I’ve looked into the production of the smart watch and we will need to purchase a new machine to manufacture at the scale we want which will which will cost us £1,500,000. We have spare capacity in current staff to run the machine, but we will need to hire a “Specialist Supervisor” for the machine – I asked the HR team to let me know what the salary for that person would be, but they haven’t got back to me yet. The machine will last for around 5 years – you need that for your depreciation calculations right?”

The Marketing director

“I’ve done some research on the potential pricing of the watch and likely customer targets and worked with someone in the finance team to look at pricing. I think our wholesale sales price should be £150 per watch over the course of the whole 5 years. The cost of the raw materials makes up 40% of the sales price. My team have estimated that sales for the first 5 years should be as follows:

Year 1	10,000 watches
Year 2	12,500 watches
Year 3	15,750 watches
Year 4	15,750 watches
Year 5	12,350 watches

After 5 years we think that the tech will have advanced beyond this and the product will no longer be attractive so we are assuming that the life of this project will probably only be until then before we need to make a new investment, and we are constantly innovating other projects. The machine will not have any scrap value at this stage.

We’re planning an advertising and marketing campaign costing £545k in year 1 to get started and these costs will the same in in year 2 and 3, and fall to £190k in years 4 and 5. Oh, and HR have just confirmed that the Supervisor salary and benefits will start at £36k in year 1 but we expect inflationary rises to be 3% year on year. That includes our National Insurance costs”

You have investigated how to calculate an appropriate cost of capital (WACC) and gathered the following information:

· The market value of the shares is £2.75 per share and there are 5.5 million ordinary shares in issue. Dividends are expected to continue at 30p per share for the foreseeable future

· The company has £10m in irredeemable loan capital with an interest rate of 7% and it is currently quoted at £95 per £100. The tax rate is 20%.

The business has previously been using an estimated Weighted Average Cost of Capital of 20% and the management team would like to see your calculations using the WACC you have calculated and the original estimate of 20%.

Your task

In the absence of the Finance Manager the CEO wants you to make a presentation to the Board about whether the project should go ahead. The Board are not finance people but are very interested in the techniques that are used to appraise investments and so would like a comprehensive explanation of how you came to your conclusion. In particular they would like you to include the following:

1. Executive summary

2. A projected cash flow for the project over its 5 year life

3. An explanation of cost of capital including:

a. What is Weighted Average Cost of Capital (WACC)?

b. What do we use WACC for?

c. Your calculations of the WACC of capital for the business showing each of the individual components.

4. A financial evaluation of the project using the NPV and Payback Period Methods including:

a. Your calculations of NPV and Payback period for the project using WACC (the detail should be in the Appendix of the report and should be calculated in Excel)

b. Your calculations of NPV and Payback period for the project using the previous business cost of capital of 20% (the detail should be in the Appendix of the report and should be calculated in Excel)

c. A decision as to whether the project should go ahead and your justification for this decisions

5. An explanation of the benefits and limitations of the 4 main investment appraisal techniques.

6. An explanation of the different types of funding available to a company (Long term, short term, equity and debt and others), the advantages and disadvantages of each and a detailed explanation of what a bank might look at in deciding whether to make a loan to a company and the steps they might take for extra protection on the loan repayment.

7. Conclusion

Your report should have an executive summary at the start and a conclusion at the end and you should conclude on the viability of the project at the current cost of capital and the situation if cost of capital were 20%.

Structure of the report

The report should be prepared in PowerPoint and should contain the following slides:

· Executive summary ( A summary of your proposal in a page)

· Introduction

· Calculation and critical evaluation of WACC (detailed calculation may be shown in an Appendix)

· Projected cash flow

· Calculation of NPV and PP (detailed calculation may be shown in an Appendix) using the WACC

· Calculation of NPV and PP (detailed calculation may be shown in an Appendix) using a cost of capital of 20%

· Explanation of and critical evaluation of the 4 main capital investment appraisal techniques

· Critical explanation of different forms of funding for companies

· Conclusion

· Appendices – detailed calculations and references

The Powerpoint file should be uploaded to Turnitin. A template is provided but you should feel free to adapt and personalise this.

Assessment Marking Scheme  

The assessment is marked out of 100.

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Master of Business Administration

Assignment Submission Form

Module Code:	MN7029SR
Module Title:	Financial Decision Making
Assessment Title:	Assessment 2: Individual Work
Lecturer Name:
Student ID Number:
Student Name:
Assessment due date:	25 June 2024
Student Declaration:	By submitting this assignment, I/ we confirm that I/we have not sourced or used any information from any online ‘essay’ provider nor any other third party not acknowledged in my/our assignment. I/ We declare that the work submitted is my/our own. Students should note that the University has a formal policy on plagiarism which can be found at https://student.londonmet.ac.uk/your-studies/student-administration/rules-and-regulations/academic-misconduct/

Guildhall School of Business and Law

Feedback/Feedforward Coversheet

MN7029SR Financial Decision Making	Academic Year 2024/25 Assessment 2 Individual Assignment
First Marker:
Second Marker:
Title of presentation:
Assessment criteria	Level of achievement	Marks to be awarded	First Marker	Second Marker
Calculation and explanation of WACC for the company	15 m
A projected cash flow for the project	15 m
Calculation of NPV and Payback Period using the WACC you have calculated	15 m
Calculation of NPV and Payback Period using a 20% cost of capital	15 m
A decision as to whether the project should go ahead and your justification for this decision	5 m
An explanation of the benefits and limitations of the 4 main investment appraisal techniques	10 m
An explanation of the different types of funding available to a companies (Long term, short term, equity and debt and others), the advantages and disadvantages of each and a detailed explanation of what a bank might look at in deciding whether to make a loan to a company and the steps they might take for extra protection on the loan repayment.	15 m
Your report and presentation: executive summary, professionalism, summary recording, logical flow and conclusion	10 m
Total	100 m

Areas for Improvements
From First Marker
Knowledge and understanding
Analysis and evaluation
From Second Marker
Knowledge and understanding
Analysis and evaluation
Agreed Marks First Marker’s marks /date Second Marker’s marks/date

Please upload the Turnitin Report

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reply 1 

 

I have a strong interest in the real-world uses of biostatistics to evaluate and enhance healthcare quality as I begin my career in the field. The required external quality review procedures for Medicaid managed care organizations and prepaid inpatient health insurance are one topic of special attention. I studied the EQRO report for my state, which I got from the official government website, to learn more about this topic.

A fascinating feature of the EQRO research examined Medicaid members’ patterns of healthcare consumption, with a particular emphasis on preventative care services, using statistical approaches. The research analyzed and aggregated preventive care use rates across several demographic groups using descriptive statistics, and the results showed notable differences. Interestingly, the use of preventive care was more common among older persons and non-minority groups than among younger people and members of certain racial/ethnic minority groups. This emphasizes how critical it is to implement focused interventions to close these gaps, enhance all Medicaid beneficiaries’ accessibility to preventive treatment, and improve their overall health outcomes (Ireys & Krissek, 2008).

Medicaid members of all ages, genders, and racial/ethnic origins were included in the EQRO study. A wide range of socioeconomic backgrounds, cultural connections, and health literacy levels were represented in the research population. Cultural factors played a significant role in the study’s consideration of the potential effects of communication styles, healthcare preferences, and language barriers on the use of preventive care. It was essential to take these cultural factors into account in order to guarantee the precision and tactfulness of data gathering and analysis (Bethancourt et al., 2003; Smedley, Stith, & Nelson, 2003).

It is crucial to comprehend the variety of statistical techniques used in the EQRO report because it provides insight into the ways in which various groups get preventative treatment. Managed care companies and state health officials may greatly benefit from the report’s insights about the healthcare habits of Medicaid members, which are obtained via the use of inferential statistics and the summarization of use rates across demographic categories. In order to enhance overall health outcomes and lessen inequities, managed care organizations may use the report as a standard for performance evaluation, identify care obstacles, and implement customized interventions (Smith et al., 2015). Conversely, state health authorities may use the results to guide resource allocation plans and policy choices that seek to improve healthcare accessibility and quality for all populations (Jones & Brown, 2019).

If I were speaking on behalf of the managed care company, I would use this data to create focused campaigns that would encourage members to use preventative care more often. Creating outreach initiatives that are culturally appropriate, increasing access to preventative care in underprivileged regions, and encouraging partnerships with neighborhood groups are a few possible strategies. We may endeavor to enhance the health and well-being of our participants and thus contribute to improved community health outcomes by proactively addressing inequities in preventive care.

 

reply 2 

 

After collecting data, the data needs to be organized and then described by computing averages (Salkind & Frey, 2022). A toolkit to help state Medicaid agencies on how to use external quality review organizations (EQROs) to help improve the quality of preventative and developmental services for children that are enrolled in Medicaid (Krissik et al., 2008). In California the EQRO prepares the annual independent external quality review and technical reports. The California Department of Health Care Services (DHCS) provides a number of reports within the 2022-23 External Quality Review Technical Report (n.d.). Identifying barriers and strategies can help advance equity, by creating quality improvement initiatives by acknowledging that what gets measured gets improved (O’Kane, 2021).

Locate a section of the report that used statistical methods and summarize the methods and results.

The report used various statistical methods to evaluate the performance of Medi-Cal managed care plans. Statistics was used to summarize the data and provide an overview of the performance measures, while also observing changes in performance measure over time. For example, the report provides measurements on immunizations for adolescents from 2020- 2022; where it found the measurement rate in 2020 at just over 43% but lower each following year with a 2021-22 rate difference of 0.74 (The California Department of Health Care Services, 2024).

Include the target subjects or participants and possible cultural factors (e.g., customs, preferences, communication styles, or heritage).

The report focuses on Medi-Cal managed care plans and their enrollees. Specific populations such as children, adults, seniors, and those with disabilities are included in the analysis. The National Committee for Quality Assurance (NCQA) required race and ethnicity for additional measures (The California Department of Health Care Services, 2024).

Include data analysis tools used and how this report can make an impact on health care.

The report uses Healthcare Effectiveness Data and Information Set (HEDIS) which provide performance rates of managed care plans during the reporting year and trends using the previous years’ data, while also comparing to aggregated rates to national benchmarks (The California Department of Health Care Services, n.d.). In addition, the report uses Consumer Assessment of Healthcare providers and Systems (CAHPS) survey, Encounter Data Validation (EDV) study reports, Managed Care Accountability Sets (MCAS), and health disparity reports (The California Department of Health Care Services, 2024). By using these tools, both DHCS and Medi-Cal managed care plans can better understand where to focus their resources to continue improving the quality of care that is provide to the patients.

After reviewing the information, determine why it would be of interest to managed care organizations and the state health organization.

There are a number of reasons why the information in the EDRO report should be of interest to managed care organizations (MCOs) as well as state health organizations. The report provides detailed analysis of the quality, access, and timeliness of care that is provided by MCOs.  The EQRO also provides compliance reviews. There are also performance measures that are validated, ensuring that the data reported by the MCOs is accurate and reliable.

If you were representing the managed care organization, explain how you would use this information to improve your enrollees’ health status.

The report provides recommendations for improving the quality strategy of DHCS, and it would benefit MCOs to align their practices with the state goals to help improve overall care to all their enrollees.

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