HD570 Unit 6 Seminar Reflection Example

The Members Easiest to Move and the Members Most in Need: A Unit 6 Seminar Reflection on Pricing an Outreach Target

[Student Name]

Purdue University Global

HD570: Health Education Leadership and Management

Unit 6 Seminar Reflection

[Instructor Name]

[Date]

The seminar, the classmates and Ashcombe Health Plan's figures are composite; the equity and postpartum care sources cited are real.

The Case

Our seminar used a case drawn from my own department. On postpartum visits the plan trails the state's target by 6.2 points, and about $1.46 million of its quality withhold depends on closing that gap. Health Education will have about 720 hours of outreach next year freed from community classes. Quality Improvement has asked that those hours go to members whose records suggest they will book a visit after a single reminder: those who attended prenatal visits and have a regular clinic.

What I Argued

I argued for the opposite group: members who had no prenatal care at all. The weeks after birth carry real risks, and postpartum care is often the first chance to address conditions that went unnoticed during pregnancy (Tully et al., 2017). Members with no prenatal care are the least connected to the health system and, I said, the people a health education department exists to reach. Equity, as I understood it, meant directing resources toward those facing the greatest disadvantage (Braveman, 2006).

The Challenge

Andre, who manages a quality program at another health plan, asked me to price my position. How many visits would each approach produce with 720 hours?

I had not done the arithmetic. During the break I worked it out with the outreach system's data. Members with prior prenatal care need about one twenty-minute call each, and about a quarter book a visit. With 720 hours, the department could call about 2,160 such members and produce roughly 540 visits. Members with no prenatal care need about three hours of effort each, including repeated attempts, help with transport and a warm transfer to a clinic, and about 15 percent book a visit. With 720 hours, the department could reach about 240 such members and produce roughly 36 visits.

My position was right about who most needed help and wrong to ignore what it would cost, because the same hours that produced 36 visits for the hardest-to-reach members could have produced 540 for others, and the gap in the measure would have stayed open.

Why I Had Not Priced It

I think I avoided the arithmetic because I suspected what it would show. Arguing from values felt safer than arguing from numbers that might weaken my case. Andre's question was not hostile; it simply asked me to do what any manager would have to do before deciding.

I also realized that I had treated the quality measure as the enemy of equity. The measure counts every visit equally. A plan that misses its target loses withhold money that pays for, among other things, my department's staff.

What My Classmates Said

The seminar split. Two classmates who work in community health centers agreed with my original position and warned that measure-driven outreach slowly teaches an organization to ignore its hardest cases. Andre and another classmate from a hospital quality office argued that missing the target would cost the plan money that funds outreach of every kind, so that serving the easiest group first could be the most equitable choice over time. I found both arguments persuasive, which is part of why I ended up with a split rather than a side.

Where I Ended Up

I proposed a split: about 70 percent of the hours, roughly 500, to members likely to respond, producing about 375 visits, and 30 percent, roughly 220, to members with no prenatal care, reaching about 73 of them and producing perhaps 11 visits. The split gives up about 150 visits compared with Quality Improvement's plan, and I said so in the proposal. Quality Improvement wanted all 720 hours for its group. I wanted more for mine. Neither side liked the split, which may be a sign it was reasonable.

I added one condition: the department will track outcomes for the second group separately and report them, so that their needs do not disappear inside a single plan-wide figure.

What I Learned

I learned to price my positions before I argue them, and to show the price to the people I disagree with, since a shared set of numbers turned a debate about values into a discussion about trade-offs. A value that cannot survive its price is a preference, not a plan; a value that survives it, at a known cost, is something a manager can defend. Text reminders could also stretch the first group's hours further (Schwebel & Larimer, 2018), and I will test that before next year.

References

Braveman, P. (2006). Health disparities and health equity: Concepts and measurement. Annual Review of Public Health, 27, 167-194. https://doi.org/10.1146/annurev.publhealth.27.021405.102103

Schwebel, F. J., & Larimer, M. E. (2018). Using text message reminders in health care services: A narrative literature review. Internet Interventions, 13, 82-104. https://doi.org/10.1016/j.invent.2018.06.002

Tully, K. P., Stuebe, A. M., & Verbiest, S. B. (2017). The fourth trimester: A critical transition period with unmet maternal health needs. American Journal of Obstetrics and Gynecology, 217(1), 37-41. https://doi.org/10.1016/j.ajog.2017.03.032