National Health Coverage Plans, Reimbursements, and Quality

Order Description

Examine the importance of healthcare coverage (insurance). You will also examine how reimbursements (payments) from health plans are impacted by quality of care. Start by selecting two major
national (U.S.) insurance health plans. You may choose Medicaid, Medicare, HMO, PPO, or private insurance plans. You can choose your own personal insurance plan if you prefer. You will review
coverage options offered by both plans that benefit and hinder patient’s access to care.

Write an introductory paragraph that describes the importance of healthcare coverage (insurance). End with a clearly worded purpose statement.
Healthcare Coverage and Vulnerable Populations
Discuss two ways healthcare coverage would be beneficial (helpful) for the vulnerable/ uninsured populations.
Select a Major Healthcare Plan – (Label heading with the name of the plan Ex: Preferred Provider Option Plan)
Summarize two care options provided by the plan that facilitates access for the patient. Summarize two care options that limit access to care for the patient.
Select a Second Major Healthcare Plan – (Label heading with the name of the plan)
Summarize two care options provided by the plan that facilitates access for the patient. Summarize two care options that limit access to care for the patient.
Diagnosis Related Groups
Describe the purpose of Diagnosis Related Groups (DRGs). Explain the impact of DRGs on length of stay and payment of services. Discuss how payments for DRGs are now impacted by quality of care.
Charity Care
Describe the role of charity care within an acute care health facility (hospital). Discuss how vulnerable populations and the uninsured are helped (impacted) from the charity care provided by
healthcare facilities (hospitals). Explain how charity care can benefit the facility.