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Phases of Medicare Part D

Medicare Part D has 4 different phases that each member passes through during each year. Each of these phases have different coverage benefits for the member. It is important to understand these phases to know the financial impact that your health expenses can have on you and also when you should opt for that elective surgery.

1. Deductible Phase

This is the first phase and in this phase, the member is responsible for the entire dollar amount of the medication/s up to the Plan’s deductible amount. For example, the Plan’s deductible amount is $400. The member goes to the pharmacy to pick up his/her medication and the total cost of the medication is $600. The member will have to pay the entire amount up to the plan deductible which in this case means the member will have to pay $400 for the deductible phase. The remaining $200 goes into the next phase called the Initial Coverage Phase. If the total cost of the drug is less than the Plan’s deductible amount, then the member pays the full amount and remains in the deductible phase. For example, at the pharmacy, the total cost of the drug is $300 and the Plan’s deductible is $400. The member would have to pay the full cost of the drug $300 and would remain in the deductible phase. The next time the member picks up a medication, the remaining deductible would be $100 after which the remaining amount goes into the Initial Coverage Phase.

Please note that some plans may choose not to have a deductible phase and in that case, when the member goes to pick up their medication at the pharmacy, they start off the year being in the Initial Coverage Phase. The standard deductible amount for 2021 is $445.

2. Initial Coverage Phase

In the Initial Coverage Phase, the member pays a fixed copay or a coinsurance, depending on the plan. The standard coinsurance for the Initial Coverage Phase is 25% which means that the member pays only 25% of the drug cost in this phase and the remaining 75% is paid by the plan. For example if the member already met the deductible amount and is in the Initial Coverage Phase, and goes to pick up a medication that costs $100, the member would only be required to pay $25 for the medication.

Two dollar amounts that the plan keeps a count on is the total drug cost and the amount the member paid (True Out of Pocket TROOP). In the deductible phase, these 2 values would be equal due to the fact that the member pays the total drug cost until the deductible is met. So the total drug cost would be equal to the TROOP in the deductible phase. In the initial coverage phase, since the member is only paying 25% of the total drug cost, the TROOP would be 25% of the total drug cost.

The member remains in the initial coverage phase until the total drug cost accumulates to $4,130 for the year 2021. Once the total drug cost accumulates to $4,130, the member moves into the next phase known as the Coverage Gap Phase

3. Coverage Gap Phase

Once the member enters the Coverage Gap Phase, as the name suggests, there is a gap in coverage resulting in the member responsible for 95% of the total drug cost and the plan responsible for only 5%. In lay man terms, this phase is also called the ‘Donut Hole’ phase of coverage.

This may sound like a very high member responsibility in the coverage gap phase however this is not the case. Manufacturers for brand drugs are required to provide a discount to Medicare beneficiaries of 70%. This means that out of the 95% member responsibility in this phase, there is a 70% Manufacture discount resulting in a member pay of 25%. The plan counts the Manufacture discount as part of the TROOP. To put this in perspective, if the member picks up a brand medication in the coverage gap phase that costs $100, the manufacture discount would be $70, Member pay $25 and the TROOP that the plan keeps track of would be $95.

The member remains in this coverage gap phase till the TROOP reaches $6,550 for 2021. Note that the member moves on from this phase once the TROOP reaches the designated dollar amount and not the total drug cost as for the previous phases.

4. Catastrophic Coverage Phase

Once the member reaches this phase, the member is only responsible for 5% of the drug cost. This is the final phase and the member remains in this phase for the rest of the year. Once the year is over, the cycle repeats and the member starts back in the deductible phase and moves through these phases again.

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Do these 4 things during Quarantine!

Do these 4 things during Quarantine!

In todays world, quarantine has become a part of traveling. If you travelled recently abroad or even domestically, it is recommended to quarantine for at least 10 days. The Centers for Disease Control CDC recommends quarantine for 14 days to prevent the spread of COVID-19. This process of quarantine may take a toll on your physical and mental health, which is why I wanted to discuss some ways to spend quarantine that can keep you active and alert and keep everyone safe. 

Here are just a few of the activities you can do while during quarantine.

  1. Watch a movie or tv series

Now might be a good time to catch up with that movie you really wanted to watch but didn’t have time for. Sit back and relax and sign up for your favorite streaming service to watch all the shows you’ve been missing. 

2. Read a book

If you are into books, or even if you are not, now might be a good time to start reading that novel that’s been on the bookshelf for years. Or maybe pull out your kindle book and download an ebook of your choice. They’re tons of free ebooks available that will keep your mind occupied for hours and even days.  If you are a professional, it might be a good idea to read up on latest advances in your field, which would help you professionally. For any reason, pack your book with you on your travels to stay busy during quarantine.

3. Exercise

Never had time for the gym? Or too lazy for the gym? We have all had that moment. Well guess what. During quarantine, we have the time and we are not so lazy. It’s time to make those stretches and lift those weights and get some cardio in there. Staying physically active and fit is very important to remain healthy during quarantine. It refreshes the body and keeps us from getting bored.

Photo by Li Sun on

4. Social Media

Remember all your friends that you never had time to reach out to. Hop on to social media and connect with friends and family. Social distancing does not mean social media distancing! Call you friends and family and maybe even video call them. The more connected you feel, the less if would feel like a quarantine and more like home. If you have a lot of common friends, get on together in a group video call and connect. 

These activities will make quarantine go by really fast and keep you busy through out while keeping you productive and active. You can also add these activities to your daily routine even if you are not in quarantine.

Origin of the Corona Virus

In 1937, coronaviruses were first described as an infectious bronchitis virus suffered by birds that could devastate poultry stocks. Viruses are now the source of the common cold in 15% to 30% of all cases. In the past 70 years, researchers have discovered camels, goats, cats, dogs, horses, rabbits, pigs, rats and turkeys infected with coronaviruses.

A novel coronavirus strain—SARS-CoV-2—was first identified in December 2019 in Wuhan, a town in China’s Hubei province with 11 million, following a pneumonia outbreak without an exact cause. The virus has spread over 200 countries and territories across the world and was identified on 11 March 2020 by the World Health Organisation (WHO) as a pandemic.

As of 4 January 2021, there were 83,322,449 laboratory-confirmed cases of coronavirus disease 2019 (COVID-19) worldwide, with 1,831,412 recorded deaths. On 16 March 2020, the number of cases and fatalities outside of China exceeded those in the region.

To date, more than three million people worldwide have been infected with COVID-19, more than two hundred thousand have died, and millions have been financially and emotionally affected. Our frontline employees are charged with continuing to work to fulfill our public health and safety needs. During this ongoing pandemic, frontline staff and health workers struggle to take care of their patients and the general population while still dealing with their physical fatigue, tension, worry and anxiety.

In the context of the global catastrophe triggered by the COVID-19 pandemic, we are mindful that the first line of protection against this pandemic is health professionals. Unfortunately, due to the shortage of biosafety devices, shortages of infection management services, lack of appreciation schemes and job benefits, and eventually physical and psychological violence and prejudice by patients, which affects their mental well-being, they confront this health emergency with inadequate working conditions. There are well-known job background stressors that can be recognised as psychosocial labour influences. Because of insufficient knowledge regarding the infection, the continuous treatment of patients with COVID 19, heavy workload, frequent vulnerability to crucial incidents such as mortality, apprehension of becoming contaminated and infecting their family and the impact for their wellbeing, its symptoms could be reflected as fatigue, depression, anxiety. Therefore, in a community without mental disorders, reports have confirmed the prevalence of psychological signs, such as depression, anxiety, posttraumatic stress and regression of those who have a mental disease.

Suppose without providing the basic requirements to monitor, reduce and cope with extreme. Even permanent pandemic effects, COVID-19, bring health workers vulnerability to be physical, biological, and psychological hazards. In that case, it may be regarded as an occupational disorder because of the manifestations of occupational danger and its psychological consequences.

The severe psychosocial consequences of this pandemic on health workers are apparent, and they are specifically related to working environments. Therefore, if their working environments are inadequate, they will place the wellbeing of their families at risk and, as a consequence, the impact on their mental health will be exacerbated. It is essential to consider that several findings have shown that preparation in biosafety systems, the proper execution of infection prevention protocols, as well as personal protective equipment and acknowledgment of their efforts

Research centered on identifying preventive factors that will assist health workers’ efficiency and facilitate their adaptation, considering the intense physical and emotional need for their services in periods of crisis. However, this tolerance and resistance potential is attributed to the security and help offered by providing appropriate working environments, with a decline in psychosocial risk factors.

As a result, it is significant to remain mindful of the unique concerns of healthcare personnel and to incorporate crisis-focused and post-trauma treatment psychological recovery programs, as well as to make administrative and operational improvements and provide a coordinated and quality health system, maintaining its continuity and response capability despite the crisis.

The role of Leadership in Healthcare

Leadership is important for the organization of any company, especially in the healthcare field. The quote that speaks out to me the most is by John Quincy Adams in Josephson, (2011) “If your actions inspire others to dream more, learn more and become more, you are a leader.” I always believe in inspiring others and empowering them to grow and progress. Leaders are at a position which is best suited to help people achieve their maximum potential. 

As mentioned by Roddick (1991), we would need to lead in a way that we expect to be led ourselves. This approach is very important as it gives us an insight into our own performance as leaders. According to Asamani, Naab & Ansah (2016), a leader needs to display multiple styles of leadership depending upon the situation. These quotes highlight examples of successful leadership strategies that need to be taken into consideration for different circumstances. 

In the field of healthcare, leadership skills are extremely important as we are dealing with the health of patients and it is important that both healthcare workers and patients both trust their leadership. It is important that we value the views of employees and lead by example as mentioned by Roddick (1991). The mentioned quotes give us strategies that can be used to lead and help maximize the potential of employees. These employees will then be empowered to perform and connect and improve overall health outcomes. 

Diversity and inclusion are very important in any organization and even more in the field of healthcare. Each individual brings unique experiences to the table and this unique experience becomes even more valuable with a diverse employee population. Along with this, a diverse employee population is better able to reach out to the community and engage and educate them to improve health outcomes. We must follow the approach of a servant leader which would empower individuals to be outspoken and provide valuable feedback and ideas. Employees should be encouraged to share their experiences with others. 


Josephson, M. (2011). More business & leadership quotes [Web log post]. Retrieved from

Roddick, A. (1991). Body and soul: Profits with principles, the amazing success story of Anita Roddick & the Body Shop. Danvers, MA: Crown

Asamani, J.A., Naab, F., & Ansah Ofei, A. M. (2016). Leadership styles in nursing management: Implications for staff outcomes. Journal of Health Sciences, 6(1) Retrieved from,

Is your coworker abusing company facilities?

For any organization to succeed, the employees as well as leaders must have an ethical approach. An ethical challenge that I have encountered in my professional life is that of waste and abuse. One of my coworkers would constantly use printer paper to print large numbers of pages for personal use using the company printer. The content of the printed pages would include tickets, documents, articles and even books. I always found that very inconsiderate and was not quite sure if I should be talking to him about it or if I should let my supervisor know. I was a bit confused if this would amount to a breach of any of the company’s policies. 

The code of ethics that I selected is from the Centers for Disease Control and Prevention (CDC) website. Point number eleven clearly mentions that employees shall disclose fraud, waste and corruption. A company’s policy of disclosure of any waste and abuse is very important for the sustainability of an organization. The government sustains billions of dollars in losses due to fraud, waste and abuse in relation to Medicare services (Chen, Blumenthal, & Jena 2018). 

The factors that contributed to this issue is the fact that there is no system in place that can monitor the content being printed by employees. Due to the lack of monitoring there is a potential for abuse as in this situation. Although the effect on the organization is minimal, abusing the facility of a printer does lead to a small amount of loss to the company and it poses more of an ethical issue with the employee having the potential to misuse other facilities also. 

The issue can be resolved by adhering to the code of conduct. The actions of the employee should be reported to the supervisor so appropriate action can be taken to prevent further waste and abuse. As mentioned by Chen, Blumenthal, & Jena (2018), Medicare attempts to control frauds, waste and abuse by similar policies of disclosure. 

As a leader, I can support the process by promoting a culture of open communication and preventing any retaliation at workplaces. A compliance department can be set up that can take in complaints of compliance and waste anonymously to prevent any retaliation. My current workplace does have a compliance department which is what I had used to resolve this issue without being identified. 

References: (2019). CDC Ethics Home Page. [online] Available at: [Accessed 21 Mar. 2019].

Chen, A., Blumenthal, D. and Jena, A. (2018). Characteristics of Physicians Excluded From US Medicare and State Public Insurance Programs for Fraud, Health Crimes, or Unlawful Prescribing of Controlled Substances. JAMA Network Open.

How to prevent Absenteeism in the Healthcare Field (Case Study)

Employee attendance is an issue that affects all businesses, small or large. One way to solve this issue is to incentivize perfect attendance, as indicated in this case study, Case 12- A Lottery for Employee Attendance, (Buchbinder, Shanks, & Buchbinder, 2014).The Nursing Home Administrator was able to decrease absenteeism from 33% to 6% by incentivizing perfect attendance, (Buchbinder, Shanks, & Buchbinder, 2014). This did however result in a draw back of CNA’s showing up sick to work so they can get the incentive. This case analysis will analyze the method used by the Nursing Home Administrator and also provide evidence based suggestions on preventing CNA’s from showing up to work when they are sick. The paper will show the importance of collaboration and communication in solving issues that may arise.

Absenteeism On Weekends And Holidays

Absenteeism is a major problem in the healthcare field around the world. Employees will take days off around holidays and on weekends for a variety of different reasons. According to Ramadhan, & Santoso, (2015), the reasons for absenteeism in a study conducted in Indonesia have been found to be for valid medical reasons with a doctor note, other commitments, religious holidays, social interactions among others. In order to address these issue we must analyze these reasons for absenteeism.

At a given point in time, there will be a few employees that would be on a valid medical leave.  They would have a note from the doctor or other medical documentation. According to Hefner, Miley & Fikfak (2018), the most common medical reason that may affect health workers are musculoskeletal disorders. They are at an increased risk of developing musculoskeletal disorders due to long working hours and the ergonomics of the workplace (Hefner, Miley & Fikfak, 2018). The leadership team should ensure proper ergonomics of the workspace to reduce the number of people on medical leave. 

Companies usually have employees from a diverse background. People of different traditions and religions come together with a common goal of improving healthcare. With this diversity comes the issue of religious and traditional holidays that may not be incorporated in the company’s calendar. When individual religious and traditional holidays are not taken into account, employees tend to take these days off, resulting in absenteeism. Organizations should engage and communicate with employees to determine their preferred holidays. For example, many Muslim employees may be willing to work on Christmas, if allowed to take off on Eid, the Islamic equivalent of Christmas.

Another major reason for employee absenteeism is unwarranted absences. This can happen due to emotional exhaustion. Healthcare workers often work long hours of overtime and are expected to bear additional burden. This leads to mental exhaustion. According to Vignoli, Guglielmi, & Violante (2016), it can be concluded that there is a relationship between emotional exhaustion and absenteeism. Due to this reason, any intervention on the part of leadership should focus on the emotional health of employees as well as work life balance. 

Increased Dissatisfaction Among The Employees Who Pick Up The Extra Work Due To Absenteeism Of Others

As a consequence of absenteeism, the work is then picked up by the employees who are present. This added work on responsible workers leads to burnout of the employees that do show up to work.. According to George, & Reyes, (2017), a negative relationship has been established between burnout amongst nurses and  emotional exhaustion. This would reduce job satisfaction and good employees end up searching for other jobs (George, & Reyes, 2017). This negatively affects the company as they  not only lose good employees, but they also have to undergo increased cost to hire new employees, who will again go through the same problem. 

Another issue that arises with selected employees taking on work of absent employees, is the development of segregation and disharmony between employees, resulting in reduced communication and teamwork (Hartgerink, Cramm, Bakker, Eijsden, Mackenbach, & Nieboer 2014). In order to deliver better patient outcomes in the health field, collaboration and inter professional communication is essential. According to Hartgerink, Cramm, Bakker, Eijsden, Mackenbach, & Nieboer (2014), working with a variety of professionals to reshape patient care still remains a challenge. Since healthcare does require a multi disciplinary approach, it is important that this segregation among employees does not develop to maintain a high standard of patient care.

In the case study, the Nursing Home Administrator went with the strategy of incentivizing perfect attendance of the Certified Nursing Attendants. This step was taken after communicating with the Administrator in Training, demonstrating inter disciplinary communication. This consultation resulted in the development of the incentive strategy. The strategy resulted in an effective communication of the issue and was successful in addressing the issue. Taking into account the fact that the Nursing Home Manager reached out to the Administrator in Training to discuss the issue, it can be deduced that this leader is likely to maintain relationships with other leaders. It is evident that the leader is open and clear in communication. 

The first step that should be done in conflict resolution is open communication. According to Johansen (2014), having a work environment that lacks communication will result in conflict and stress. To counter this, it is necessary to promote an environment of open communication. In the case study, the Nursing Home Administrator uses the strategy of inter departmental communication, by reaching  out to the Administrator in Training and discussing the issue with that department.

  The leader in this case study approached the situation in a very positive and intellectual manner. Scholarly articles were consulted to find an appropriate solution to the issue identified. Consultations with other departments is definitely a strength and an area that needs growth is to study the complete outcomes of the suggested change as in this case, the implementation of the incentive, ended up creating another problem of employees showing up ill. The lesson that can be taken away from this case is the fact that by consulting other departments and utilizing scholarly articles and other information available, it is possible to resolve difficult  issues effectively with communication and collaboration. 

The scholar-practitioner model is a model in which a practitioner applies scholarly knowledge in their practice. It allows theories which have been extensively researched to be combined with the experience of the practitioner to solve problems or to increase and improve efficiency. This case study is an excellent example of how the scholar-practitioner model has been effectively used to address the issue of decreased attendance. The Nursing Home Administrator utilized research and scholarly articles to come up with a solution for absenteeism and was successful in achieving the outcome. 

The leader in this case came up with a very ethical approach. Instead of mandating attendance, the Nursing Home Administrator incentivized perfect attendance. This created a desire in the employees to be at work instead of the administration having to take adverse action against employees. A key lesson that this case provides for leaders is that with collaboration and communication across different departments and disciplines, effective solutions can be obtained for complex issues. 

This case describes a situation in a nursing home where the administrator introduced a lottery system to address the issue of absenteeism around weekends and holidays. The absenteeism was causing increased dissatisfaction among workers that had to pick up the extra work of the absent employees. The contributing factors of this absenteeism was analyzed and suggestions to overcome these issues were discussed based on scholarly evidence. The leaders approach using the scholarly-practitioner model is also reflected in this case study. The importance of communication and collaboration was established.


Buchbinder, S. B., & Shanks, N. H. (Eds.). (2012). Introduction to health care management (2nd ed.). Burlington, MA: Jones & Bartlett. (Buchbinder 46)

Buchbinder, S. B., Shanks, N. H., & Buchbinder, D. (2014). Cases in health care management. Burlington, MA: Jones & Bartlett Learning.

George, R., & Reyes, M. E. S. (2017). Burnout as a predictor of quality of life among selected filipino nurses. Indian Journal of Health and Wellbeing, 8(7), 691-696. Retrieved from

Hafner, N. D., Milek, D. M., & Fikfak, M. D. (2018). Hospital staff’s risk of developing musculoskeletal disorders, especially low back pain. Zdravstveno Varstvo, 57(3), 133-139. doi:

Hartgerink, J., MS, Cramm, J., P., Bakker, T., P., van Eijsden, A., MSc, Mackenbach, J., P., & Nieboer, A., P. (2014). The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients. Journal of Advanced Nursing, 70(4), 791. doi:

Johansen, M. L. (2014). Conflicting priorities: Emergency nurses perceived disconnect between patient satisfaction and the delivery of quality patient care. Journal of Emergency Nursing, 40(1), 13-19. doi:

Know why your staff members are not at work. (2011, Jul 06). The Star Retrieved from

Ramadhan, A. P., & Santoso, D. (2015). Health workers absenteeism: Indonesia urban public health centres. Journal of Public Health, 23(3), 165-173. doi:

Revuelta, J. F. R. (2014). Nursing presenteeism. patient safety implications. possibilities of control and reduction/Presentismo en enfermería. implicaciones en seguridad del paciente. posibilidades de control y reducción. Enfermería Global, 13(3), 374-383. Retrieved from

Vignoli, M., Guglielmi, D., Bonfiglioli, R., & Violante, F. S. (2016). How job demands affect absenteeism? the mediating role of work-family conflict and exhaustion. International Archives of Occupational and Environmental Health, 89(1), 23-31. doi:

Your Guide To Masks

These guidelines can be found on the CDC Website.

CDC recommends that people wear masks in public settings, like on public and mass transportation, at events and gatherings, and anywhere they will be around other people.

How to Select

When selecting a mask, there are many choices. Here are some do’s and don’ts.DO choose masks that

DO choose masks that have 2 or more layers of washable, breathable fabric graphic.

Have two or more layers of washable, breathable fabric

DO choose masks that completely cover your nose and mouth;

Completely cover your nose and mouth

DO choose masks that fit snugly against the sides of your face and don't have gaps.

Fit snugly against the sides of your face and don’t have gapsDO NOT choose Masks that

DO NOT choose masks that are made of fabric that makes it hard to breath, for example, vinyl

Are made of fabric that makes it hard to breathe, for example, vinyl

DO NOT choose masks that have exhalation valves or vents which allow virus particles to escape

Have exhalation valves or vents which allow virus particles to escape

DO NOT choose masks that are intended for healthcare workers, including N95 respirators or surgical masks

Are intended for healthcare workers, including N95 respirators or surgical masks

Special Considerations

Gaiters & face shields

graphic of a man wearing a gaiter

Wear a gaiter with two layers, or fold it to make two layers

graphic of a woman with a face shield

Not recommended: Evaluation of face shields is ongoing, but effectiveness is unknown at this time.Glasses

Graphic of a woman with black framed glasses and red mask

If you wear glasses, find a mask that fits closely over your nose or one that has a nose wire to limit fogging.Children

graphic of girl wearing a pink mask

Find a mask that is made for children to help ensure proper fit

graphic of a boy wearing a blue mask

Check to be sure the mask fits snugly over the nose and mouth and under the chin and that there are no gaps around the sides

graphic of a girl wearing a blue mask

Do NOT put on children younger than 2 years oldCold weather gear

girl sitting on bench with scarf and mask on

Wear your scarf, ski mask or balaclava over your mask

girl sitting on bench with scarf

Scarves, ski masks and balaclavas are not substitutes for masks

How to Wear

Wear a mask correctly and consistently for the best protection.

  • Be sure to wash your hands or use hand sanitizer before putting on a mask.
  • Do NOT touch the mask when wearing it. If you have to often touch/adjust your mask, it doesn’t fit you properly, and you may need to find a different mask or make adjustments.

For more information, visit our How to Wear Masks web page.Do wear a mask that

Do wear a mask that: Covers your nose and mouth and secure it under your chin; Fits snugly against the sides of your face.
  • Covers your nose and mouth and secure it under your chin.
  • Fits snugly against the sides of your face.

How NOT to wear a mask

elderly woman with mask around her neck

Around your neck

man with mask on forehead

On Your forehead

man with mask under nose

Under your nose

man with mask on face but without his mouth covered

Only on your nose

man with mask on chin

On your chin

woman with mask hanging from ear

Dangling from one ear

man with mask hanging on arm

On your armHow to Take off a Mask

graphic of a man wearing an orange mask

lite icon

Carefully, untie the strings behind your head or stretch the ear loops

graphic of hands holding an orange mask

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Handle only by the earloops or ties

graphic of the inside of an orange mask

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Fold the outside corners together

graphic of a person cleaning their hands

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Be careful not to touch your eyes, nose, and mouth when removing and wash hands immediately after removingHow to Clean

Washer and dryer - dryer has regular laundry including face masks

Reusable masks should be washed regularly. Always remove masks correctly and wash your hands after handling or touching a used mask.

  • Include your mask with your regular laundry
  • Use regular laundry detergent and the warmest appropriate water setting for the cloth used to make the mask
  • Use the highest heat setting and leave in the dryer until completely dry