1. What is a PCMH? What is the main distinction between a PCMH and an ACO. How does a practice/facility become PCMH certified? How does PCMH certification impact the expected level of quality care that the practice/facility is expected to meet? 2_What does reliability mean to you? In your experience, what healthcare process have you found to be reliable? What process have you found to be unreliable? Explain what is different about the reliable process versus the unreliable process. 3_Review the Case Study referenced in Chapter 9 of your textbook (pp 231-232). Consider the failed improvement project when answering the following questions: a. What process changes could be implemented to achieve 80-90 percent reliability in preventing and managing heel ulcerations? b. What process changes could be implemented to reach 95 percent reliability in preventing and managing heel ulcerations? c. If process changes are made to achieve 80 to 90 percent reliability, how would you measure the effectiveness of these changes? d. If process changes are made to achieve 95 percent reliability, how would you measure the effectiveness of these changes? 4_ACOs are one of several innovative ways that CMS has utilized to help manage utilization and cost with a primary focus on those on Medicare, aged 65+. Based on the additional readings from this unit, summarize the original ACO model as it was created by CMS Innovation. Now, research the new Pathways to Success ACO Model. How is this model different from the original legacy Medicare Shared Savings Model? Discuss how the look of ACOs might change over the next few years based on your review of current literature. 5_What are the core key principles of Utilization Management? Why are authorizations for services so very important to ensure payment for services? Discuss the pros and cons of utilization management and how it impacts facilities providing quality care to patients.