Researched Answers





The PRECEDE-PROCEEDmodel can assist in identifying determinants of behaviors, especiallyrisk factors that can lead to incidences of cardiovascular diseases.The model, designed by Green and Kreuter (1993) can provide acommunity-based strategy for health promotion and education byemphasizing on the results at the onset of program development, andrealizing that the determinants that are necessary to an outcomeshould be evaluated before a health intervention can be developed.Since the model begun as evaluation model then later evolved into aplanning model, evaluation are embedded in all phases of the planningmodel (Green and Marshall, 1991).

The first component(PRECEDE) is developed to help the user identify the particulardemands of the specified population and the most successful means ofaddressing these demands. The other component (PROCEED) incorporatesthe evaluation and implementation of the health promotion programthat is developed (Green and Marshall, 1991). The directionalframework allows the users to plan appropriate process, impact andoutcome evaluations to assess the different aspects of the program.The PRECEDE-PROCEED model can guide HSO/HS governing bodies andmanager through a process that begins with desired results anddevelops backward to identify a mixture of approaches to achieve theobjective. Through this way, it will encourage managers andfacilitate a more comprehensive and systematic planning of publichealth program.

Part II

Medicaid managed care arrangement are envisioned to bring efficiencyto the program and to save money. As state use of managed carearrangement has developed, the current hybrid system has developed asa result of a variety of institutional and economic factors(Grabowski 2007). Medicaid providers have been historicallyunderpaid, and this fact has created administrative challenges forthe state agencies. Consequently, many commercial managed care planswithdrew from the state also of significance is the inherent conflictbetween the managed care plans’ goal of managing risk andMedicaid’s mission of being an insurer of last resort. This hasforced many states to customize their managed care arrangement and tonegotiate with one or a few entities to serve a vulnerablepopulation. The lack of competition traditionally linked with privatesecure managed care arrangements has created unique challenge for thestate officials seeking to make the Medicaid program more efficientand has directly resulted in the current range of managed carearrangement. Because of the lack of competitive markets and the lackof participating providers, state Medicaid agencies have been forcedto customize their contracting arrangements to serve the population.


The Department ofHealth and Human Services (HHS) is the key agency in U.S accountablefor guarding the health of all Americans and availing demanded humanservices to these needs. As one of the largest federal department,HHS is propelled by five significant objectives.

The first goal ofHHS is to transform health care (HSS, 2013). This goal is emphasisedafter President Barrack Obama presented the Patient Protection andAffordable Care Act (Affordable Care Act) in 2010. This Act hassignificantly helped HHS modernize the healthcare system so as toimprove patient outcome, improve accountability and efficiency,ensures safety of patients, motivate share responsibility andtransform the nation towards a high-value health care system. Astronger health care system will enhance the ability of the nation toprovide extra health care capacity when demanded.

The second criticalmission of HHs is to develop scientific innovation and innovation byworking across government and with non-governmental stakeholders(HSS, 2013). The aim of stakeholder participation is to promotebetter mechanism to measure and assess programs and improve outcomeas well as promoting knowledge about works in addition todisseminating why it works. These goals are achieved by regulatingscience, speeding scientific discovery process, fostering innovationand increasing understanding of what works in public health.Consequently, this will create a more efficient government bybreaking down barriers to innovation.

The third mission ofHHs is to promote the American people’s safety, health andwellbeing (HSS, 2013). More importantly, HHS has invested in kids byemphasizing on prevention. HHS has implemented strategies in responseto public health challenges such as family disruption, teenpregnancy, poverty, trauma and increased population of the olderadult. These strategies are envisioned to strengthen the family andimprove the outcome of the community, family and the children.Strategies such as early childhood programs support childhooddevelopment in the community and the family while fostering schoolreadiness. Such programs including the youth development strategieshave emphasized on the unique demands of the vulnerable populationthrough research, evidence-based strategies, coordination of programsand development of policy.

The fourth goallinked to HSS is the improvement of efficiency, transparency andaccountability of HH programs (HSS, 2013). HHS has a commitmentdeveloping a precedented level of openness in its undertaking. Morespecifically, it works to ensure the public trust and setting thefoundation for system transparency, collaboration, and publicparticipation. This goal is envisioned to strength the democracy andpromote efficiency and effectiveness in government.

Finally, HHS seeksto improve the America’s health and human service infrastructure aswell as a workforce (HSS, 2013). While the demand for healthcareservice is increasing, shortage of critical health care workers isprojected to increase in near future. Through affordable care act,HHS will address these workforce-related issues. Affordable Care Actequips HHS to increase the supply of public health professional so asto prepare America for health emergencies.


Department of Health &amp Human Service (2013). The fiscal year2013: Summary of performance and financial information. Retrievedfrom

Grabowski, D. C. (2007). Medicare and Medicaid: Conflictingincentives for long-term care. The Milbank Quarterly 85(4):579-610

Green, L., &amp Marshall, W. (1991). Health promotion planning:An educational andenvironmental approach. MountainView, CA: Mayfield Publishing.

Johnston J. M., &amp Romzek, B. S. (1999). Contracting andaccountability in state Medicaid Reform: Rhetoric, theories, andreality. Public Administration Review, 59, 383-399.

Milligan Jr., Charles J. and Woodcock, Cynthia H. (2008). Medicareadvantage special needs plans for dual eligible. A Primer. Universityof Maryland, Baltimore County.