Health Care Systems: Purposes And The Situation In The U.S. Sample College Essay

Patient Satisfaction and Hospital Incentives

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey can provide decision-makers with information that will impact the amount of Hospital Value-Based Purchasing incentives awarded to medical institutions (McFarland, Ornstein & Holcombe, 2015, p. 503). Thus, the patient-satisfaction indicator is widely used for assessing the level of healthcare services hospitals offer. It often plays an integral role in a hospital’s efficiency outcomes and the quality of healthcare overall.

The dominant perspective on the customer satisfaction indicator is linked to the supposition that if the patient is satisfied, then the healthcare institution was able to provide services at the highest level possible. Furthermore, customer satisfaction is thought to be instrumental in providing useful insights into the reliability of a healthcare institution (AAAHC, 2015, p. 2). However, when it comes to making decisions about awarding hospitals with value-based purchasing incentives, a patient satisfaction survey may not be the most appropriate indicator. Some patients may not be satisfied with the hospital’s services because it lacks funding for purchasing necessary medical equipment. In this case, Value-Based Purchasing incentives should be granted to hospitals that indeed need them, rather than medical institutions that are fully equipped and completely satisfy their patients. Thus, the lack of value can be compensated by adding value to the hospitals rather than punishing them for the under-performance. Medical institutions that satisfy their patients according to the conducted HCAHPS surveys should not be overlooked by the incentives; however, the primary focus should be put on balancing health care services across all levels, not elevating those institutions that perform well at the same time with diminishing the significance of the institutions that underperform.

CJR’s Impact on the Nursing Practice

The new bundled payment for Medicare joint replacements model has encouraged health care providers to improve the coordination and the quality of their services across all levels: from the primary hospitalization to the recovery of the patient. Thus, professionals should come up with various methods of presenting the value that occupational therapy has for achieving complete success in the process of providing care (Bogenrief, 2016, p. 7).

While the new model of Medicare joint replacements will be beneficial in ensuring wide access to health care despite the needs of a beneficiary, it still requires an expansion of healthcare facilities’ revision because many healthcare providers are encouraged to implement financially beneficial services that are unnecessary in a clinical sense (Carter, Garrett & Wissoker, 2015, p. 10). Within the framework of updating the quality of the Medicare-provided services and new models, the largest impact concerning the nursing practice will be placed on additional training of skilled nursing professionals. Along with the Affordable Care Act, nursing practitioners will be able to become more skilled in order to cater to the demands of Medicare.

By means of providing additional training for the already professional personnel as well as by adding new employees into the system of occupational therapy practice and nursing, the Medicare-initiated bundled payment model will bring beneficial results. Since the CJR model requires for the hospitals to be held accountable for the quality and costs of healthcare provision by being put into a frame of a target price for the services, the availability of professional staff will, first of all, reduce the costs. Furthermore, the saved costs can go towards funding training and educational programs for nursing professionals.

Accountable Care and Interprofessional Practice

The changes in the Accountable Care model call for improvements in the sphere of interprofessional practice. Interprofessional practice means collaboration between two or more professionals in order to improve the outcomes of health care. Since the primary focus for health care organizations will always be put on reducing costs and improving the quality of their care, including preventative services, encouraging the collaboration among physicians, hospitals, health care agencies and other institutions will be crucial for maintaining the quality of health care as well as reducing costs. For instance, an Accountable Care Organization that takes participation in Medicare usually creates an array of provider networks that cooperate together in order to make sure that the beneficiaries of Medicare receive the highest quality of services. In the majority of cases, there is a range of available financial incentives available for accountable care organizations that are able to now avoid duplicate services, readmissions, or preventable complications. Such financial incentives usually take the form of shared savings and various bonuses (Nester, 2016, p. 128).

However, it is worth mentioning that physicians are rarely able to offer both educational and clinical services for an improved care model. Thus, a health care facility should develop a new system that benefits cooperation between interprofessional teams and their patients. An interprofessional team is made up of nurses, physicians, health navigators, pharmacists, community health workers, social workers, and other professionals involved in the process of providing high-quality health care services. Lastly, in order to recruit professionals that will work as a part of an interprofessional team, organizations should ensure the provision of immaculate clinical experiences at educational facilities (Nester, 2016, p. 131).


AAAHC. (2015). The Importance of Patient Satisfaction. Web.

Bogenrief, J. (2016). Bundled Payment for Medicare Joint Replacements Starts April 1. OT Capital Briefing, 7.

Carter, C., Garrett, B., & Wissoker, D. (2015). The Need to Reform Medicare’s Payments to Skilled Nursing Facilities is as Strong as Ever. Web.

McFarland, D., Ornstein, K., & Holcombe, R. (2015). Demographic Factors and Hospital Size Predict Patient Satisfaction Variance – Implications for Hospital Value-Based Purchasing. Journal of Hospital Medicine, 10(8), 503-509.

Nester, J. (2016). The Importance of Interprofessional Practice and Education in the Era of Accountable Care. NCMJ, 77(2), 128-132.

Body, Pain, Self, And Sexual Desires As Themes In Poetry

The human body has always been an important topic for people. Its representation and attitude to it changed throughout the history of humanity, and the literature belonging to different epochs proves it. Writers tried to respond to topical ideas and speak about the topic from different perspectives. One of the essential aspects of the theme is the ideas of pain, transformation, sexual desires, maturation, and pleasure, which stay together with the concept of body and self of a person.

In the 20th and 21st century, with the rise of feminist movements and tolerance, poets and writers started to use the topic of the body as a way to attract attention to some disputable issues and represent the women’s attitude to it. At the same time, the motifs of pain, aging, and pleasure also remained topical, which preconditioned the emergence of unique works.

Thus, the poems “Naked Girl and Mirror” by Judith Wright, “Monster Body” by Laura Hershey, and “31-year-old lover” by Kim Addonizio have a similar motif of a human body; however, they touch upon it in different ways. These poems raise the problems of pain, sexual maturation and sensory pleasure, aging, metamorphosis, and body as the representation of self affecting a person and his/her position in society. The diversity of topics associated with the concept of the body demonstrates its scope and importance for the literature and, at the same time, shows that it remains relevant in different epochs. The three selected poems speak about the outlined questions from the modern perspective, helping poets to manifest their ideas and thoughts, which is made through the prism of various physical forms and states.

The poem “Monster Body” by Laura Hershey introduces the concept of the body in pain. The first lines of the work set the mood for the whole story, “I mock the human form” (Hershey 1). The author shows her deep dissatisfaction and disappointment with her shapes and condition, and the poem embodies these thoughts. The vulnerability of the body and pain it might experience become the main problems emphasized by Hershey.

She continues, enumerating the issues “My back’s shell-sharp curve, my thin wrist bone, / limbs that do not twitch beyond the digits; / right lung so different from left” (Hershey 8-10) and finishes saying, “Monster mine, monster body” (Hershey 8-10, 14). The author accepts that she is different, her physical impairments can cause pain and make her feel vulnerable and suffer. However, it is still her body, “one I would not trade./ Not for gold, not for leading roles. (Hershey 15-16). Along with pain, her physical appearance gives her the vision of self, and it is the fundamental thought of the poem.

The work “Naked Girl and Mirror” by Judith Wright discusses some other problems, which are, however, related to the concept of body. It depicts an adolescent girl cogitating about her self-identity and being confused by it. She sees the naked body in a mirror standing for the metaphor of a stripped soul vulnerable to the world and betrayals. In such a way, the text presents the themes of self-esteem and metamorphosis.

The lines “This is not I. I had no body once- / only what served my need to laugh and run” (Wright 1-2) show that the physical appearance is closely linked to inner representations and self. Wright continues descriptions stating, “Smooth once-hermaphrodite shoulders, too tenderly / your long slope runs, above those sudden shy” (Wright 12-13). It shows the confusion and inability to select the right way, which becomes the main idea of the poem and helps to convey the message.

Finally, the poem “31-Year-Old Lover” by Kim Addonizio introduces the theme of sexual pleasure and sensory pleasure. The author introduces detailed descriptions of a male body that are full of eroticism, and sexual desire “the high / tight pectorals, the new dimes of the nipples pressed / into his chest, the fan shape of the muscles underneath” (Addonizio 5-7). These precise descriptions are needed to show that a speaker is attracted by this young body and desires it. At the same time, there is a theme of maturation and aging “He is going to have a gut one day / and wiry gray hairs where the soft dark filaments /flow out of him” (Addonizio 15-17).

The woman is full of regret that she is not young anymore, but she sees sexual contact with a young man as the only way “to have it back” (Addonizio 23). In such a way, the poem revolves around sexuality and views the body as the object of desire.

Altogether, the concept of body has always been topical for the literature. Wright, Hershey, and Addonizio also use this motif in their poems and treat the physical appearance of a speaker differently, which is preconditioned by their motifs and ideas emphasized by their works. They discuss the problems of self, pain, and sexual pleasures, and view them through the prism of physical appearance and shapes. The body remains one of the central topics used by modern writers and helps to convey important messages to readers.

Works Cited

Addonizio, Kim. “31-Year-Old Lover.” The American Poetry Review. Web.

Hershey, Laura. “Monster Body.” Facebook. Web.

Wright, Judith. “Naked Girl and Mirror.” PoemHunter. Web.

How Emails Have Affected Government Agencies

Through e-mails, communication between government agencies has been made easy and faster. Large corporations can also communicate with one another so effectively. The government can now offer its services to the citizens more efficiently and effectively. This is done by having some of its transactions being done online. Likewise, large corporations can also have their services being offered online to make the transaction faster and more efficient. This can involve filling and sending some business transaction forms through e-mail.

The security personnel can also communicate through emails and this can help to improve the security services being offered to the public and also the security of the large corporations. An example of this is the communication between NASA and Mr. Daugherty.

An E-mail has also an impact on accountability in that it can be used to question various actions that a government has undertaken. Also, the government can send its accounts through emails hence enhancing accountability.

On responsibility, emails can be used to make people more responsible for everything they write and send to others. On the other hand, it has led to irresponsibility in the fact that some e-mails have unknown sources hence no one is responsible for such.

On deniability, e-mails have affected it the fact that most commercial e-mails are untraceable and no one can pinpoint the sender of such an e-mail. This spam has led to an increase in deniability. (Mike A.)

An e-mail can be used as evidence to convict. For instance, the e-mails sent by Mr. Daugherty can be used to convict him that he knew everything concerning the shuttle tires and their ability to land even before the space shuttle Columbia was lost on re-entry to the earth’s atmosphere.

On the other hand, e-mail can be used as evidence to defend one’s self. For example, Mr. Daugherty defended himself with the fact that his e-mails were meant to attract technical people to discuss the technical issues in his e-mails. E-mails can thus affect the governance and also the relations between the large corporations either in an advantageous or disadvantageous way.


Mike Adams: Internet Users Must Take Responsibility for Spam Problem: Web.

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