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Pages:
2 pages/≈550 words
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Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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Topic:

Healthcare Spending

Essay Instructions:

Paying for health care consists of multiple approaches by insurance companies, state and federal governments, public payers, private payers, and the uninsured. Changes in payments for health care services occur as legislative changes are made, as well as changes to the Affordable Care Act (ACA).
Analyze how health care providers receive payment by health care users
Include the following aspects in the assignment:
Ø Explore at least three types of health care providers.
Ø What type of services does each health care provider provide (hospitals, nursing homes, home health care, MDs, APRNs).
Ø Describe three types of healthcare users (private payers, public payers, and the uninsured).
Ø Provide a listing of how each provider gets paid by users (insurance plans, self-pay, government agency pays).
Ø Investigate several complicating factors in the actual financing of care of health insurances.

Essay Sample Content Preview:

Health Care
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An analysis of how health care providers receive payment from health care users.
First, the first payment option, a fee-for-service provider payment mechanism, can be defined as a payment method based on the service unit's unit of service. An alternative approach is the capitation payment method. It can be defined as a fixed payment to health care providers to benefit a defined population for a specific period, such as five months.
Another method is a case-based payment mechanism, which involves making payments to the hospital, according to inpatient discharges. The prices are based on a predefined resource required and also clinical conditions. The global budget mechanism is another method used. It is defined as a mean cash sum, made in advance and intended to make a payment on all costs of services provided in the future and is usually approximated for one year ahead (Pourfallah,2012).
Types of healthcare providers and services provided
Primary Care
A primary care provider is a qualified individual who provides services to the users for checkups and health problems. The list can include (Anselmi,2018):
* Medical doctors who are concerned with internal medicine, pediatrics, or even family practices.
* Gynecologists are doctors specializing in women’s health, wellbeing, and prenatal care, and their services are relied on by most women.
* A physical assistant will, in conjunction with a doctor, provide the defined services to the victims.
Nursing Care
* The government licenses licensed practical nurses as primary caregivers to the sick.
* Registered nurses are graduates of the nursing field, have attained all relevant qualifications by the state board examination, and are licensed by the country.
* Advanced practice nurses have gained exemplary nursing professionalism and experience beyond all registered nurses' nec...
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