Does federal government play any role in the policy development process and its relationship in terms of funding?

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Healthcare Programs

Research a local health policy issue that is a hot topic in your state. You can also contact a local county commissioner or state Congressional member in your state to gain insight on the issue or (you may also research local or state government websites or refer to the local news media).

On the basis of your research, answer the following:

· Discuss the implications of the selected issue on the community as a whole.

· Who all are affected by the policy?

· Who are the key stakeholders in the development of the policy? Discuss their individual roles in policy development?

· Explain the roles of those responsible for implementing the policy.

· Does federal government play any role in the policy development process and its relationship in terms of funding? If yes, explain.

· If the federal government is not involved in the policy development process and its relationship in terms of funding, should it be involved? Why or why not?

Research the policy demographics of CHIP in your state. Also examine the adequacy of the CHIP program in your state.

· In your opinion, if Medicaid was meant to cover families living below the poverty line, then what is the purpose of CHIP?

· Illustrate the differences and similarities between the two programs?

· Every state has its own variation of CHIP. What does your state call the program?

· Who all are covered in CHIP and what are the eligibility requirements?

· In your state, if CHIP is meant to cover uninsured children, why are there so many uninsured families with children?

In many national healthcare systems, the providers of care are either subsidized or work directly for government-owned facilities. In the United States, the government-operated programs, such as Medicare and Medicaid, contract with providers. The VA, on the other hand operates its own system of hospitals, clinics, and long-term care facilities. Medicare and Medicaid set the rules regarding which services are offered and the amount to be paid for those services.

· Compare and contrast the VA Health System with Medicare and Medicaid. Describe in detail the similarities and differences.

· What lessons can the programs learn from each other when looking at administration of services and programs offered by recipients? Discuss the implications in terms of access to care, controlling costs, and ensuring quality care.

How, in the American system of politics, can health care get more objective support on behalf of consumers?

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  1. The insurance industry plays a major role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it is a private company or the US government, would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served.  In ACA debates, a “public option” was defeated by lobbyists. Identify some reasons why resistance to a single-payer concept, used in every other developed country, has continued in the U.S.
  2. Almost every medical or technological advance seems to be accompanied by new and vexing ethical dilemmas. Yet, the United States has no structure in place to resolve such issues. Should the federal or state governments take responsibility for ethical decision-making and for protecting the public?  If neither, what might be other options for providing ethical guidelines and oversight?
  3. As strongly evidenced by the ACA and prior legislative attempts to address the problems of the health care system, these attempts are always met by shifting alliances among well financed and, often, self-serving lobbying groups. How, in the American system of politics, can health care get more objective support on behalf of consumers?
  4. Every 10 years, the public health sector creates an elaborate set of targets for health status improvements in the United States.  Healthy People 2010 failed to meet 85 percent of Healthy People 2000’s goals. Is there merit for establishing several hundred more objectives for Healthy People 2020, or are these simply academic exercises? What are your opinions about how to energize the “Healthy People” goals among providers and the American public?

 Discuss the feasibility of providing a solution to the problem or issue in the practice setting.

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This issue will be the focus of the ongoing assignments.

 

TOPIC:

Patient-centered Care and Education

  1. Risks across the life-span
  2. Discharge planning including home environment needs

Write a 950-word reflection to identify your selected issue or problem and provide rationale as to why this is an issue or a problem. The rationale must be supported by valid research findings.

 

* Description of selected topic in the practice setting

* Discuss the significance of the problem to patient-care or clinical practice issue

* Discuss the feasibility of providing a solution to the problem or issue in the practice setting.

 

Format your paper consistent with APA guidelines. Include a minimum of 4 scholarly references.  Research study articles are recommended.

 

Post an assessment of the consequences (on payers, providers, and the general population) of continuing current levels of health care spending in the United States as well as the potential consequences of reducing the level of spending.

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Health Care Spending

 

No one is immune to the rising costs of health care. Consider the following news stories:

“In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job” (Halle & Seshamani, 2009, Introduction, para. 1).

“President Obama’s health care law is putting new strains on some of the nation’s most hard-pressed hospitals, by cutting aid they use to pay for emergency care for illegal immigrants, which they have long been required to provide” (Bernstein, 2012, para. 1).

“Doctors in America are harboring an embarrassing secret: Many of them are going broke. This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists…Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat” (Kavilanz, 2012, para. 1, 2, 5).

In this Discussion, you examine the overall state of health care costs in America, the different factors impacting the finances of health care organizations, and the effect of rising costs on all stakeholders.

 

To prepare:

Review the Learning Resources on the level of health care spending in the United States.

Consider the ramifications of continuing at this level of spending as well as issues involved with reducing spending.

Reflect on which stakeholders (payers, providers, and the general population) should be responsible for making decisions on health care spending.

 

I need to Post an assessment of the consequences (on payers, providers, and the general population) of continuing current levels of health care spending in the United States as well as the potential consequences of reducing the level of spending. Explain which stakeholders should make health care spending decisions and why.

 

And 

 

Read a selection of my colleagues’ responses and Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library. (I will send the responses soon)

Validate an idea with your own experience and additional sources.

 

 

Required Readings

 

Baker, J., & Baker, R. W. (2014). Health care finance: Basic tools for nonfinancial managers (4th ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 1, “Introduction to Health Care Finance” (pp. 3–10)

 

In this chapter, you are introduced to the four key elements of financial management as well as the two types of accounting. These help set the stage for the weeks to come.

 

Chapter 4, “Revenues (Inflow)” (pp. 31–40)

 

This chapter focuses on how health organizations receive revenue for services and highlights the different sources of revenue.

McClellan, M. (2011). Reforming payments to healthcare providers: The key to slowing health care cost growth while improving quality? Journal of Economic Perspectives, 25(2), 69–92.

Copyright 2011 by American Economic Association. Reprinted by permission of American Economic Association via the Copyright Clearance Center.

 

This article discusses the need for cost control in health care costs, as well as the impact for patients, providers, and physicians. The author highlights provider payment reforms that may be key to promoting quality and cutting costs.

Kaplan, R. S., Witkowski, M., Abbott, M., Barboza Guzman, A., Higgins, L. D., Meara, J. G., & … Feeley, T. W. (2014). Using time-driven activity-based costing to identify value improvement opportunities in healthcare. Journal Of Healthcare Management, 59(6), 399–412.

Copyright 2014 by Health Administration Press. Reprinted by permission of  Health Administration Press via the Copyright Clearance Center.

 

This article discusses the importance of better outcomes and lower costs when delivering care to patients.

Miller, H. (2011). Transitioning to accountable care: Incremental payment reforms to support higher quality, more affordable health care. Pittsburg, PA: Center for Health care Quality and Payment Reform. Retrieved from http://www.chqpr.org/downloads/TransitioningtoAccountableCare.pdf

 

This report provides the myriad options for addressing the growing problem of the cost vs. the quality of health care. The paper presents “middle ground” possibilities as part of a payment reform. These include such approaches as “bundling,” “warranties,” and paying physicians based on an entire patient stay.

Dickson, J. K., Bulley, S., & Oliver, D. (2014). Efficiency and perceptions of cost in healthcare. British Journal Of Healthcare Management, 20(5), 222–226.

Nickitas, D. (2013). Health care spending: the cold, hard facts of cost, quality and care. Nursing Economics, 31(1).

 

This article discusses the high cost of health care in the United States and how this spending is adding to the federal budget deficit and impacting the finances of American families.

Alliance for Health Reform. (2013). Cost of health care. In Covering health issues (6th ed.). Washington DC: Author. Retrieved from http://www.allhealth.org/sourcebooktoc.asp?SBID=5

 

This chapter discusses the background behind the rising health care costs, the factors that increase costs, and the consequences of attempting to bluntly cut costs. The chapter suggests some solutions, such as increased cost sharing, changes in provider reimbursement, and investing in health information technology.

Alliance for Health Reform. (2012). Medicare. In Covering health issues (6th ed.). Washington DC: Author. Retrieved from http://www.allhealth.org/sourcebooktoc.asp?SBID=5

 

This chapter provides facts on Medicare and offers some background information on the issues surrounding this program. The chapter also discusses current legislation affecting Medicare and potential results on patients, providers, and physicians.

Alliance for Health Reform. (2012). Medicaid. In Covering health issues (6th ed.). Washington DC: Author. Retrieved from http://www.allhealth.org/sourcebooktoc.asp?SBID=5

 

In addition to providing facts and background information on Medicaid, this chapter discusses many facets of the system, including the spending and “dual eligibles” component. The chapter also includes a discussion of how recent legislation has changed the program.

 

Required Media

Laureate Education (Producer). (2015). Introduction to NURS 6211. Baltimore, MD: Author.

 

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