| Course | HCR 321 Advanced Concepts for Health Care Coordination |
|---|---|
| Module | Module 2 |
| Paper type | Short paper |
| Length | About 389 words, 4 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | BS in Health Care Coordination |
| Updated | October 2026 |
Free sample paper for HCR 321 Module 2
Why Fragmented Care Fails Patients and What Coordination Must Do Instead
Student Name
BS in Health Care Coordination, Arizona State University
HCR 321: Advanced Concepts for Health Care Coordination
Instructor Name
Month Day, Year
Why Fragmented Care Fails Patients and What Coordination Must Do Instead
The Problem: Care in Pieces
A person managing failing heart muscle, diabetes and weakened kidneys at once can easily see a primary care physician, a cardiologist, a nephrologist, a pharmacist and a home health nurse in a single month. Each may do good work, yet no one may hold the whole picture. Bodenheimer (2008) described this as a perilous journey: information fails to travel with patients between primary care and specialists, between hospital and home and between medical and social services, and patients and families are left to fill the gaps.
Why It Matters Most at Transitions
The moment of discharge is especially risky. In a trial of older adults leaving the hospital, those who received comprehensive discharge planning and home follow-up by advanced practice nurses were readmitted far less often within 24 weeks, 20.3 percent compared with 37.1 percent in usual care (Naylor et al., 1999). A transition coach who helped patients and family members manage their own medications, recognize warning signs and keep follow-up appointments also lowered rehospitalization at 30 and 90 days (Coleman et al., 2006). These results show both how much fragmentation costs and how much coordination can recover.
What Coordinated and Integrated Models Add
Coordinated care assigns someone, often a nurse, social worker or care coordinator, to organize services around the patient, share information and follow up. Integrated care goes further, bringing medical, behavioral and social services into shared structures, such as co-located teams or shared records and payment. Both rest on the same idea: the patient's needs, not each organization's boundaries, define the plan.
Not All Coordination Works
The need for coordination does not guarantee that any program will succeed. In 15 Medicare care coordination programs, mostly delivered by telephone, 13 showed no significant change in hospitalizations (Peikes et al., 2009). When the programs were compared, the handful that cut admissions for the sickest enrollees had coordinators who saw patients face to face often, relayed information between physicians, watched medications closely and moved quickly after a discharge (Brown et al., 2012).
Conclusion
Fragmented care puts patients at risk, especially at transitions, and coordinated and integrated models exist to close those gaps. The evidence also teaches that coordination must be designed carefully, with in-person contact, communication and follow-through, to deliver on its promise.
References
Bodenheimer, T. (2008). Coordinating care: A perilous journey through the health care system. New England Journal of Medicine, 358(10), 1064-1071. https://doi.org/10.1056/NEJMhpr0706165
Brown, R. S., Peikes, D., Peterson, G., Schore, J., & Razafindrakoto, C. M. (2012). Six features of Medicare coordinated care demonstration programs that cut hospital admissions of high-risk patients. Health Affairs, 31(6), 1156-1166. https://doi.org/10.1377/hlthaff.2012.0393
Coleman, E. A., Parry, C., Chalmers, S., & Min, S. J. (2006). The care transitions intervention: Results of a randomized controlled trial. Archives of Internal Medicine, 166(17), 1822-1828. https://doi.org/10.1001/archinte.166.17.1822
Naylor, M. D., Brooten, D., Campbell, R., Jacobsen, B. S., Mezey, M. D., Pauly, M. V., & Schwartz, J. S. (1999). Comprehensive discharge planning and home follow-up of hospitalized elders: A randomized clinical trial. JAMA, 281(7), 613-620. https://doi.org/10.1001/jama.281.7.613
Peikes, D., Chen, A., Schore, J., & Brown, R. (2009). Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. JAMA, 301(6), 603-618. https://doi.org/10.1001/jama.2009.126
What the HCR 321 Module 2 instructions ask for
Six short papers carry 300 of HCR 321's 700 points, one in each module from 2 to 7, and this is the first. Module 2 asks you to establish the need for coordinated and integrated care models, answering the questions posted with the assignment in Canvas. The required length sits between 500 and 750 words, or about two to three pages of text before the title page and references. Your instructor expects a minimum of three primary sources on top of the course resources, the course's assignment template and APA 7th edition. Miller's Integrated Care in Action and Smith's Patient Navigation are the assigned texts and give you vocabulary for fragmentation, integration and navigation. Since this paper opens the sequence, treat it as the place where you build the evidence file you will keep using in Modules 4, 6 and 7.
How the HCR 321 Module 2 example is put together
Within the word limit, the sample moves from problem to evidence to solution and then to a caution. It opens with a concrete picture of one patient's many clinicians and a source describing coordination failures, then leans on a pair of transitional care trials to show what fragmentation costs and what coordination can win back. A short section defines coordinated and integrated care, and the paper closes with evidence from Medicare demonstrations that coordination works only with particular features, which keeps the argument honest. Five primary sources exceed the three the syllabus requires, and every claim is tied to one of them.
HCR 321 Module 2 rubric: what earns full marks
Canvas holds the 50-point rubric for this first paper. Graders reward a response that takes each module question in turn, a word count inside the limit, studies and reviews cited accurately rather than websites, course ideas put to work on a real problem and a tidy template with clean APA. Points drop when the paper spills past 750 words, when its evidence is a news story or an advocacy page, when it describes coordination in broad strokes with nothing measured behind it or when a question is left unanswered. Space is the scarce resource here. An opening paragraph that restates the prompt, or a conclusion that repeats the body, takes room that one more piece of evidence could have used, and readers of a 750-word paper notice that quickly. Strong first papers make the harm of fragmentation concrete before they argue for any model.
HCR 321 Module 2 help: mistakes that cost marks
Copy the module's questions into your template as headings, then answer each in a paragraph. Choose primary sources that are studies or reviews, not news stories or organization web pages. With only 750 words, cut background that does not answer a question. Use one strong statistic per point rather than several weak ones. Keep a running list of sources you find, since later papers and the evolving case draw on the same literature. Read the final draft against the word count before you submit. If you are unsure whether a source counts as primary, the desk can help you check.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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HCR 321 Module 2 questions, answered
Where can I find a free HCR 321 Module 2 sample paper?
This page has a full HCR 321 Module 2 sample: a short paper on why fragmented care harms patients and what coordination must do.
How long are HCR 321 short papers?
Four of the six (Modules 2, 4, 6 and 7) cap out at 750 words, with a 500-word floor.
How many sources do HCR 321 papers need?
At least three primary sources in addition to the course resources.
Does care coordination reduce hospitalizations?
Sometimes; in Medicare trials most telephone-based programs did not, but the few that worked for high-risk patients met them face to face and managed their medicines closely.
Which textbooks does HCR 321 use?
Miller's Integrated Care in Action and Smith's Patient Navigation.