Financing
Healthcare
Consider
how compensation for healthcare services shape delivery of care, and reflects
policy and policy changes and write a paper that addresses the bullets below. Be
sure to completely address each bullet point. There should be four (4)
sections in your paper; one for each bullet below. Separate each section in
your paper with a clear brief heading that allows your professor to know which
bullet you are addressing in that section of your paper. Include a
“Conclusion” section that summarizes all topics. This assignment will be at
least 1250 words.
Reflect upon accountability in
healthcare finance to address the following:
Discuss the
history of private health insurance and manage care and how it involved
into a healthcare industry?
Identify the
key federal laws that protect individuals who are enrolled in private
insurance.
Briefly
discuss consumer-driven healthcare and the empowerment of the healthcare
consumer.
Explore the
opportunities which have emerged for nurses within the private insurance
market.
M7
Assignment UMBO – 3
M7 Assignment PLG – 4
M7 Assignment CLO – 1, 8
MODULE 7 OVERVIEW : Healthcare Finance and
Private Health Insurance
Consumers of healthcare are expected to pay for goods and
services at the time of service (Nickitas, Middaugh, & Feeg, 2019). Today,
mostly due to the Affordable Care Act, private insurers are aimed more at
managing populations than underwriting risks (Nickitas, Middaugh, & Feeg,
2019). Nurses are in the forefront and directly tied to patient outcomes that
impact healthcare reimbursement. This week’s module examines healthcare costs
and financing and how they impact healthcare providers and consumers. The
history of how private health insurance and managed care evolved will be
discussed. The impact of consumer-driven healthcare and the role nurses play in
empowering healthcare consumers will be a primary focus.
Module Goals
·
Explain how private health insurance and
manage care involved into a large healthcare industry.
·
Analyze the cost of care across hospitals,
pharmaceuticals, and healthcare providers and how it is impacted by the
Affordable Care Act.
·
Describe the fundamental processes of
managed care accountability efforts.
·
Identify the key federal laws that protect
individuals who are enrolled in private insurance.
·
Articulate consumer-driven healthcare and
empowerment of the healthcare consumer.
·
Discuss the emerging nursing practice
changes in a market-driven healthcare system.
Goals Alignment:
University Mission-Based Outcomes – 3
Program Learning Goals – 4
Course Learning Objectives – 1, 8
Professional Standards:
Essential V: Healthcare Policy, Finance, and Regulatory
Environments – Healthcare policies, including financial and regulatory,
directly and indirectly, influence the nature and functioning of the healthcare
system and thereby are important considerations in professional nursing
practice.
Nickitas, D. M., Middaugh, D. J., & Feeg, M. D.
(2019). Policy and politics for nurses and other health professionals:
Advocacy and action. (3rd ed.). Sudbury, MA: Jones and Bartlett
Publishers. (additional learning material will be posted to who gets the contract.
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Healthcare
Consider
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