Component 4

National Health Coverage Plans, Reimbursements, and Quality

Baccalaureate education includes learning opportunities of healthcare policy, finance, and regulatory environments (AACN, 2008).

For this assignment, you will examine the importance of healthcare coverage (insurance).  You will also examine how reimbursements (payments) from healthcare plans are impacted by quality of care.  Start by describing the purpose and importance of Medicare and Medicaid programs.  Support your position by describing how you agree with or disagree with the purpose and intent of these plans. Next, you will review healthcare coverage options offered by both plans that benefit (facilitate) and hinder (limit) patient’s access to care.  Examples of healthcare coverage (insurance) options that facilitate or limit access include medication coverage, primary care physician office visits, specialist’s physician office visits, emergency care, lab or blood work and diagnostics, wellness care, prevention services, surgery (these are just a few examples). You will also explore the role of Diagnosis Related Groups (DRGs) and charity care within healthcare facilities (hospitals) and explain how charity care impacts the vulnerable or uninsured population.