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Discussion Of Implementation Of The Affordable Care Act

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    Abstract Health care reform can leave leaders worried about how to implement changes, as depicted in the case study Demonstrating Effective Leadership: Case 19 Strategies for Dealing with Health Care Reform (Buchbinder, Shanks, & Buchbinder, 2014), which discusses the implementation of the Affordable Care Act (ACA) and changing perceptions around this reform. health care is constantly evolving, and the ACA’s goal was to create an opportunity for many who are uninsured to gain affordable coverage. Leaders in the health field are taking on the task of creating a new perception of coverage and an effective way to implement new strategies to accommodate. Those in position of power and leadership are expected to create a positive narrative and move their employees forward to the best of their abilities. The following case study demonstrates how effective leadership can smooth transitions and create a new dialogue in terms of health care reform.

    Demonstrating Effective Leadership The topic of health care coverage in America is one that has been evolving in the last few years. Many Americans today are uninsured for various reasons, some include, high cost, pre-existing medical conditions, and coverage refusal. The Affordable Care Act (ACA) was drafted in hopes of eliminating those constraints and giving Americans a larger opportunity to receive coverage. Though the ACA was not just met with praise but criticism as well, health care leaders are responsible for making this transition within their organizations positive. The following case study examines how a positive leadership outlook and effective strategy can impact a health organization. Case Study: “Demonstrating Effective Leadership: Case Study 19 – Strategies for Dealing with Health Care Reform,” North Eastern Hospital (NEH) CEO, Jim James has been anticipating the toll the ACA will have on the NEH operations and hospital as a whole.

    The ACA was going to bring many uninsured in and offer them coverage options, among the type of people converting would be those who had pre existing conditions insurance would previously deny, healthy individuals who chose to forgo coverage, and those who could not afford health care. Realizing that the ACA was upheld, James immediately began to strategize how to make this transition within his organization seamless. Upon deciding on a set strategy, James conducted thorough research into the ACA and began to feel more comfortable with the newly established law and even could see some positive outcomes. James implored his staff to see the positive in this change as well, with the new coverage many from the community would begin to seek medical attention that was put off for years. He and the staff began to see this as an opportunity to further serve the community and improve their organization overall (Buchbinder, Shanks, & Buchbinder, 2014).

    According to a speech included in journal, in the United States, the cost of health care is more than two times the cost per person than other countries around the world, (Tolan, 2013). This clearly breaks down the need for health care reform and creating more affordable coverage for Americans. With reform comes a shift in policy, strategy, and procedures throughout entire organizations, this is specifically what CEO Jim James was looking to do with the passing of the ACA. He sought new ways to incorporate health care individuals may need, office visits, outpatient centers and introducing potential patients with highly skilled physicians. James now understood the demand for reform and worked hard to find outlets for these changes to encourage growth and strengthen his organization simultaneously. This shift in James’ mindset of how to tackle the implementation of the ACA is a positive display of leadership, showing his staff that some inference is good and that there is ultimately a benefit to this new change.

    He found three specific areas within NEH that will be utilized, giving his staff a certain expectation going into this transition. He demonstrated great leadership as a CEO it is important to not just understand the fine workings of an organization but the overall umbrella that the hospital covers, such as he did with the outpatient and diverse physician network. I find it likely that as a leader James will establish and maintain a strong foundation with his staff, leaders of specific departments, and the new and existing patients within his hospital. He has demonstrated an excitement for this transition and an open mind to the possibilities within his organization (Buchbinder, Shanks, & Buchbinder, 2014).

    Communication within Leadership The chosen article did not specifically cover the communication style of CEO Jim James, however, it was explained that he took time to analyze a situation and develop a plan to introduce his team to. Going to his team with a few well thought out plans is a great quality in a leader, James is giving direction in a time of change and transition. His decision to step back and figure out a plan of action eliminates a large portion of confusion and doubt in what is to come going forward. This line of communication also establishes a clear message to send to the organization and a plan of action. For example, when James at first, was concerned for the future of the NEH under the ACA he, as a leader, chose to explore the opportunities the organization would be presented. With many now insured and seeking health care he narrowed down three specific components to his transitional strategy, then presented his plan to his team, drafting a clear direction and plan of action to come.

    A recent article discussion leadership and communication styles would support James’ communication process, “[A] leader’s preciseness was, together with leader’s supportiveness, the most important predictor of subordinate’s knowledge collecting from a leader” (de Vries, Bakker-pieper, & Oostenveld, 2010). The article found that leaders who obtain and can relay a clear understanding of objectives is important in presenting staff with essential knowledge. Leadership Style While working to resolve the issue described in the case, James had a strong ability to manage professional responsibilities and priorities simultaneously. James’ leadership style is considered transactional leadership, as described in a recent journal article on the effects of leadership styles in the workplace, this is where subordinates depend on their superior’s authority and guidance (Frazier, 2014). This style of leadership places the majority of the pressure on the top, having a direct line of command from top-down.

    This is a strength that James possesses, in dealing with this issue of implementing the ACA, he developed a plan of action for his team and the organization as a whole. James’ leadership skills could benefit from exercising transformational leadership, this is where a leader establishes an environment where workers are encouraged to tackle and discuss solutions to issues amongst themselves (Frazier, 2014). This leadership style reinforces work relationships and teamwork among those not directly in authority. I think the case involving James and NEH could have benefitted from the transformational leadership style as well, giving staff an opportunity to be apart of problem solving would have given them some autonomy and trust. The takeaway to focus on in this case, is the leadership executed by James and the contrasting style described in the research article I found. These two show different sides to leadership, both having positive attributes and a need for improvement.

    There is not one perfect style of leadership, the contrast between these two show that there are many ways to lead successfully, however depending on the situation one might be preferable to the other. Practitioner-Scholar Model Applied to Problem Resolution and Effective Leadership In close analysis of the leadership in this case study, there were positive and negative attributes. Among negative attributes was communication between the CEO and supporting staff, information being withheld at the higher levels, and problem solving limitations. A Practitioner-Scholar Model is an operational model that focuses on the joint effort of knowledge and practical application, this would have attended to the negative attributes discussed above. As previously stated, James’ leadership style is transactional leadership which is on the more traditional side. Fraizer (2014) examined the cognitive leadership differences between physicians and administrators, showing that those in positions of power are less inclined to be influenced by leadership suggestions.

    Had James expanded his leadership style in this situation, more solutions could have been suggested or done so in a more timely manner. The benefit that implementing the Practitioner-Scholar Model is that knowledge at every level is shared, from there practical application of ideas can be used, as well as a sense of inclusion among the team. Managing Ethical Practice, Diversity, and Inclusion as Leaders Practicing good ethics, diversity, and inclusion is an important task all leaders are burdened with. Since the legalization of the ACA in 2104 was common knowledge, there are not any ethical violations or issues that arise from James’ determining the following steps for his organization on his own. However, as a leader James could have done a better job of including those under his leadership.

    The case study did not describe any other inputs or people participating in developing research on areas the ACA could merge with NEH, which brings to the inclusion to the forefront for improvement. Inclusion did not have to be an open forum for the entire hospital, but could have incorporated conversations and ideas with department leaders, heads of staff, and others with womb people report to. This would have been a great time to branch out to other leaders within the organization to come together and develop a strategy for the next steps.

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