Assignment Description:
Financing Healthcare
Consider how compensation for healthcare services shape delivery of care, and reflects policy and policy changes and write a paper that addresses the bullets below. Be sure to completely address each bullet point. There should be four (4) sections in your paper; one for each bullet below. Separate each section in your paper with a clear brief heading that allows your professor to know which bullet you are addressing in that section of your paper. Include a “Conclusion” section that summarizes all topics. This assignment will be at least 1250 words.
This week you will reflect upon accountability in healthcare finance to address the following:
- Discuss the history of private health insurance and manage care and how it involved into a healthcare industry?
- Identify the key federal laws that protect individuals who are enrolled in private insurance.
- Briefly discuss consumer-driven healthcare and the empowerment of the healthcare consumer.
- Explore the opportunities which have emerged for nurses within the private insurance market.
Solution:
Financing Healthcare
The healthcare system in the United States and across the globe has and continues to experience major reforms. As described by Manchikanti et al. (2017), healthcare reform describes the major healthcare policy developments and changes, including private and governmental, that influence the healthcare sector by mainly seeking to increase the population with health insurance coverage and access to healthcare services, providers, and specialists, improve healthcare quality, and ultimately reduce healthcare costs. The purpose of this essay is to discuss healthcare financing, including the history of private insurance and managed care, federal laws for private health insurance (PHI), consumer-driven healthcare (CDH), and emergent nurses’ opportunities within the private insurance market.
History of Private Health Insurance and Managed Care
The origins of private insurance and managed care in the U. S dates back to the 1920s during which hospitals and providers started to provide healthcare services on a pre-paid arrangement (Kongstvedt, 2019). The very first employer-sponsored plan was started in Dallas by a group of teachers based in who collaborated and developed a program in which they would pay insurance premiums to Baylor University Hospital to receive medical services in the future. The program evolved to become Blue Cross. Blue Shield was later created to address the concerns with Blue Cross, including its restriction to covering hospital services only. Many employers in the mining, lumbar, and railway sectors collaborated to provide their employees with physician services in the early 20th century, leading to the development of the National Association of Blue Shield Plans and the merging of Blue Cross and Blue Shield companies to become the present-day Blue Cross Blue Shield (Manchikanti et al., 2017).