Finan

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.