There are a plethora of health care economic and financial policies in effect at both the state and federal levels. Each policy has implications that are relative to consumers, providers, and insurers. The purpose of the Key Assignment is to expand on a policy that has yielded negative implications (for the consumer, provider, or insurer) and provide recommendations to alleviate or eliminate such negative implications. The outcome of the Key Assignment will be a draft article for possible journal consideration.
The comprehensive tasks of the Key Assignment require the development of a draft article pertinent to the elected policy. Throughout the course, you will formulate a detailed background of your selected topic, describe the positive and negative implications from your selected topic relative to the consumer, provider, and the insurer, make recommendations for future guidelines to reduce negative implications, and you will write a conclusion that summarizes the aforementioned requirements.
Approved Research Topics:
- Minnesota and North Dakotas rate equalization policy for skilled nursing facilities limits private pay reimbursement equal to Medicaid reimbursement. This shifts the medical cost from the consumer to the provider.
- The Emergency Medical Treatment and Active Labor Act (EMTALA) prevents hospitals from refusing patients who are unable to pay. This shifts the medical cost from the consumer to the provider.
- With a population segment aged 65 and older rapidly increasing, Medicare spending is expected to dramatically increase; however, a small remaining workforce arguably cannot cover the cost. This shifts the medical cost from the insurer (government) to the consumer.
- Health care services are finite and scarce. The Quality Adjusted Lift Years (QALY) model emphasizes providing coverage to individuals aged 1540 because this age group is the most able to contribute to society. This shifts the medical cost from the provider to the consumer.
- The Patient Protection and Affordable Care Act (PPACA) aims to bridge the underinsured and uninsured gap in the United States by mandating that individuals obtain health insurance. Depending on circumstance, this shifts the medical cost from the insurer (government) to the consumer, or in some instances, the employer.
Complete the following:
- In an essay of 1,0002,000 words, describe the positive and negative implications to the following:
- The consumer, provider, and insurer
- Service delivery, reimbursement, performance, and quality