Health Care Model Essay Assignment

HCA 807 Week 7 Health Care Model Essay Assignment

ORDER NOW FOR CUSTOMIZED, INSTRUCTION-COMPLIANT PAPER – Health Care Model Essay Assignment

With all of the conversation and controversy surrounding health care structures and governance, it is critical for health care leaders to articulate a thoughtful position regarding an optimal model of health care that is based in sound research, best practices, and one’s personal philosophy of health care. The model must optimize quality of care while also balancing financial requirements and organizational sustainability. In this assignment, you will articulate such a model.

General Requirements:

Use the following information to ensure successful completion of the assignment:

• Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment.

• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

• You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

Directions:

In a paper of 1,500-1,750 words, articulate a research-based model of health care structure and governance that optimizes quality of care while also balancing financial requirements and the sustainability of the organization. Include the following in your model:

1. A brief research-based statement of your personal philosophy of health care.

2. An articulation of a research-based, optimal model of health care structure and governance.

3. A brief, research-based rationale for the health care model articulated above. The rationale should describe how the model optimizes quality of care and balances that with financial requirements and organizational sustainability.

4. A proposal of how the health care model articulated above can be operationalized in a real-world setting.

HCA 807 Financial Structures of Health Care Example Paper

The financial structure of health care organizations has been long debated and the question to whether finance has a direct result on the health care organization and the service it provides is still at the forefront of national interest. Some believe that the financial structure of an organization leads to financial awareness, ultimately leading to service efficiency. On the other hand, some believe finance has far too much influence on the structure of health care and directly effects quality of care and patient safety. Furthermore, there are those that heavily advocate for either for-profit or nonprofit health care structures, each having their own rationale for financial health care structures and the role they play. The purpose of this paper is to examine the financial structures of health care, an analyzation of internal and external financial structures, the financial effects of the Affordable Care Act, how finance may affect quality of care and patient safety, and how ethics plays a role in health care finance.

Internal and External Financial Structures

The financial structure, or capital structure of a health care organization refers to the mix of equity and dept used to finance operations. Within this structure comes internal and external financial structures and both for-profit and nonprofit health care services use similar frameworks to develop their financial structure (Cummins & Weiss, 2016) with each playing a major role in the operation of each health care facility and how they are able to deliver service and influence the organization. In general, health care is either paid for by government programs to include Medicare and Medicaid, private health insurance plans which are usually paid through employers, private health insurance plans, and an individual’s own personal out-of-pocket funds. Internal financial structures may include the resources obtained by savings, revenues, or liquidation of assets (Hsiao, 2017). In contrast, external financial structures include the funds that are obtained from outside of the organization. Furthermore, unlike external financing, internal financing consists of the profits retained by the organization for investment (Vassall & Martínez-Álvarez, 2011).

The Financial Effects of the Affordable Care Act

With the overhaul and adaption of the ACA in 2010, comes the possibility of universal health care and was the most important piece of health care reform since the introduction of Medicare and Medicaid in 1965 (Kominski, Nonzee, & Sorensen, 2017). The Congressional Budget Office (CFO), examined the costs, savings and impact on the economy which the Patient Protection and Affordable Care Act (Public Law 111-148) and the Health Care and Education Reconciliation Act (Public Law 111-152) has directly influenced. According to the CBO, as of 2019 the ACA has reduced the budget deficit by $143 billion. In addition, the ACA’s biggest savings come from assuring the 95% of citizens had access to health care. Furthermore, the ACA made preventative health care affordable for the previous 33 million people without coverage thus reducing emergency room visits that ultimately slowed the increase of health care costs (Kominski, Nonzee, & Sorensen, 2017).

To get more specific on how the ACA has saved money, we can analyze a number of financial effects of the ACA. First, Medicare payments were reduced by $335 billion since its adaption which included $196 billion annual update reductions and $136 billion savings by reducing Medicare Advantage programs (Hwang et al., 2019). The ACA also was able to charge drug companies $107 billion dollars by charging fees to help cover the “Doughnut hole” in Medicare Prescription Drug Part D benefits (Shaw, 2018). Finally, the ACA imposed an excise tax on high premium insurance plans, adding $32 billion, an increase tax on those high-income families, adding $210 billion, and a tax to employers, adding $65 billion (Hwang et al., 2019).

The Financial Effect on Quality of Care

Because of the ever-changing structure and evolution of the financial structures of health care, there are many potential influences and how they may affect quality of care and patient safety. Policy and planning for financing within a health care system are usually concerned with how funding is made available and allocated, this funding then has a direct effect on the quality of the health services being delivered. A fundamental increasing challenge in today’s health care system is how to improve the delivery of health services and improved patient outcomes all while trying to optimize optimal financial outcomes. (Hussey, Wertheimer, & Mehrotra, 2013). Ultimately, health care is a business and if funding is not available for equipment, staff, research, and services, then obviously patient quality of care and safety will be directly affected.

Ethical Concerns Surrounding Health Care Finance

The ethical concerns surrounding finance within the health care industry are becoming increasingly more discussed and are at the forefront of national debate. The United States is unique in that we are one of the most powerful countries in the world, yet our population does not have access to affordable health care. Both the European Union and the United Nations recognize health care as a basic human right (Jones & Kantarjian, 2015) yet the U.S. is still far behind most all other first world countries when it comes to access, quality, and price of health care. According to the Southwestern’s Center for Patient-Centered Outcomes Research, financial strain is the single most important factor on whether patients choose to get health services and research shows that many of those low-income patients will forgo health care in order to afford basic life expectancies such as rent and groceries (Lagasse, 2018).

Conclusion

This paper hoped to contrast between for-profit and nonprofit health care structures, an analyzation of internal and external financial structures, the financial effects of the Affordable Care Act, how finance may affect quality of care and patient safety, and how ethics plays a role in health care finance. The financial structure of health care organizations has been long debated and the question to whether finance has a direct result on the health care organization and the service it provides is still at the forefront of national interest. This paper discussed financial structures and how health care is funded; whether this be by government programs to include Medicare and Medicaid, private health insurance plans which are usually paid through employers, private health insurance plans, and an individual’s own personal out-of-pocket funds. The Affordable Care Act was discussed and how The Congressional Budget Office (CFO), examined the costs, savings and impact on the economy which the Patient Protection and Affordable Care Act (Public Law 111-148) and the Health Care and Education Reconciliation Act (Public Law 111-152) has directly influenced. This paper discussed the ever-changing structure and evolution of the financial structures of health care and the many potential influences associated and how they may affect both quality of care and patient safety. Finally, the ethical concerns surrounding finance within the health care industry are were discussed with this topic becoming increasingly more discussed and being at the forefront of national debate. In conclusion, this paper examined the financial structures of health care, an analyzation of internal and external financial structures, the financial effects of the Affordable Care Act, how finance may affect quality of care and patient safety, and how ethics plays a role in health care finance.

Reference

Cummins, J. D., & Weiss, M. A. (2016). Equity Capital, Internal Capital Markets, and Optimal Capital Structure in the US Property-Casualty Insurance Industry. Annual Review of Financial Economics, 8(1), 121–153. https://doi.org/10.1146/annurev-financial-121415-032815

Hussey, P. S., Wertheimer, S., & Mehrotra, A. (2013). The Association Between Health Care Quality and Cost. Annals of Internal Medicine, 158(1), 27. https://doi.org/https://dx.doi.org/10.7326%2F0003-4819-158-1-201301010-00006

Hsiao, W. C. (2017). Why Is A Systemic View of Health Financing Necessary? Health Affairs, 26(4), 950–961. https://doi.org/10.1377/hlthaff.26.4.950

Hwang, T. J., Jain, N., Lauffenburger, J. C., Vokinger, K. N., & Kesselheim, A. S. (2019). Analysis of Proposed Medicare Part B to Part D Shift with Associated Changes in Total Spending and Patient Cost-Sharing for Prescription Drugs. JAMA Internal Medicine, 179(3), 374. https://doi.org/10.1001/jamainternmed.2018.6417

Lagasse, J. (2018). Financial strain has major impact on patients’ healthcare decisions, research shows. Healthcare Finance, https://www.healthcarefinancenews.com/news/financial-strain-has-major-impact-patients-healthcare-decisions-research-shows

Jones, G. H., & Kantarjian, H. (2015). Health care in the United States—basic human right or entitlement? Annals of Oncology, 26(10), 2193–2195. https://doi.org/10.1093/annonc/mdv321

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual Review of Public Health, 38(1), 489–505. https://doi.org/10.1146/annurev-publhealth-031816-044555

Shaw, D. (2018). Coverage of Novel Therapeutic Agents by Medicare Prescription Drug Plans Following FDA Approval. Journal of Managed Care & Specialty Pharmacy, 24(12), 1230–1238. https://doi.org/10.18553/jmcp.2018.24.12.1230.Health Care Model Essay Assignment

Vassall, A., & Martínez-Álvarez, M. (2011). The health system and external financing. Health Systems in Low- and Middle-Income Countries, 193–217. https://doi.org/10.1093/acprof:oso/9780199566761.003.0077.Health Care Model Essay Assignment