Healthcare Financing and Policy in The US

Future issues and concerns related to healthcare financing in the United States

Primary healthcare financing goals in the US healthcare system include access, affordability, and equity. The US lags in terms of healthcare access compared to other developed nations. National statistics show a staggering 28.7 million people (8.9%) were not insured by 2016, and the figure is estimated to rise to 37.9 million people (10.6%) by 2028 (Shrank et al., 2021). Changes targeting to increase healthcare access will stay even if the Affordable Care Act (ACA) is repealed. Care is also shifting from inpatient to outpatient settings to reduce care costs. Also, healthcare billing is moving from traditional methods, such as individual providers, to a flat rate uniform across all care providers.

How might healthcare policy inform healthcare financing and its impact on the quality of health?

Many policy priorities can help the healthcare system attain the system goals above. They include insurance expansion, a shift to value-based care, incorporating home-based care, making drugs affordable, and hiring a high-value healthcare workforce (Shrank et al., 2021). These policy priorities are within the healthcare financing and cost domain and are most promising in helping the US healthcare system attain affordability, access, and equity.

Effects of value-based purchasing on healthcare providers and how they can ensure viability in the new value-based paradigm.

According to Penner (2016), value-based purchasing incentivizes healthcare staff to avoid medical errors. This is because unnecessary medical costs that may raise prices are punishable. Besides, the savings element in value-based purchasing arrangements incentivizes providers to avoid unnecessary mistakes and expenses.

It would be prudent to provide services customized to the local population to ensure the viability of the value-based system at Sunnyside Nursing Home. A commitment to the purchasing objectives will help patients to access quality care.

Would you consider new technologies for Sunnyside to employ to reduce readmissions?

Virtual treatment techniques such as video calls and telemedicine can reduce hospital admissions. Some patient admissions are made to ensure constant instructions are provided. With video calls, patients can make inquiries from the comfort of their homes—also, automatic follow-up systems aid providers in following up on patients who just had surgeries.

References

Penner, S. J. (2016). Economics and financial management for nurses and nurse leaders. Springer Publishing Company.

Shrank, W. H., DeParle, N.-A., Gottlieb, S., Jain, S. H., Orszag, P., Powers, B. W., & Wilensky, G. R. (2021). Health Costs And Financing: Challenges And Strategies For A New Administration. Health Affairs, 40(2), 235–242. https://doi.org/10.1377/hlthaff.2020.01560

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Healthcare Financing and Policy in The US

Required Readings

Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders (3rd ed.). New York, NY: Springer Publishing.

Chapter 15, “Health Policy and Future Trends” (pp. 447–457)

To Prepare:

Review the Sunnyside Nursing Home Revenue Plan.
Familiarize yourself with the information found on the Overview of Terms tab.
Review the Sunnyside Nursing Home CMS Discount Revenue media piece in the resources to assist you in calculating the few missing cells in the Revenue Plan.
Study the completed Revenue Plan tab to see the impact of the Medicare changes.
The AHCA NJ tab lists the projections for long-term care in New Jersey, where Sunnyside is located. Review the information, especially in the 85+-year-old column, to see any impact on nursing home demand in New Jersey.
The American Health Care Association (AHCA) website has several resources to guide healthcare planning in the United States: https://www.ahcancal.org/research_data/Pages/LTC-Patient-Projections.aspx Download and analyze the Long-Term Care (LTC) Patient Projections report for your state. Look for your state to view the impact of the aging population. Pay specific attention to the 85+ trend.
Complete the remaining calculations in the Sunnyside Nursing Home Revenue Plan.
Based on the information in the report from AHCA and the spreadsheet, what recommendation would you make regarding the future census planning at Sunnyside?

Post a comprehensive response to the following:

What are some future issues and concerns related to healthcare financing in the United States?
How might healthcare policy inform healthcare financing, and what might that mean for the quality of health?
How will value-based purchasing affect healthcare providers? Review the information in the Sunnyside Case Study to guide this response. How can a healthcare provider ensure viability in the new value-based paradigm?
Would you consider new technologies for Sunnyside to employ to reduce readmissions?