course material

1. Remember to submit your work following the file naming convention
Remember to submit your work following the file naming convention
FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not
necessary to manually type in the file extension; it will automatically append.Start by
reading and following these instructions:Quickly skim the questions or assignment below
and the assignment rubric to help you focus.Read the required chapter(s) of the textbook
and any additional recommended resources. Some answers may require you to do
additional research on the Internet or in other reference sources. Choose your sources
carefully.Consider the course discussions so far and any insights gained from it.Create
your Assignment submission and be sure to cite your sources if needed, use APA style as
required, and check your spelling.Assignment:Financing HealthcareConsider 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.Assignment ExpectationsLength: 1250-1500 words in
lengthStructure: Include a title page and reference page in APA format. These do not count
towards the minimal word amount for this assignment. Your essay must include an
introduction and a conclusion.References: Use the appropriate APA style in-text citations
and references for all resources utilized to answer the questions. A minimum of two (2)
scholarly sources are required for this assignment.Format: Save your assignment as a
Microsoft Word document (.doc or .docx).File name: Name your saved file according to your
first initial, last name, and the module number (for example, “RHall Module
1.docx”)Submission: Submit to the D2L dropbox for grading M7 Assignment UMBO –
3Expert Solution PreviewIntroduction:Financing Healthcare is a crucial aspect of the
healthcare industry since it involves how services are compensated, which can shape the
delivery of care, and it reflects policy and policy changes. Healthcare financing ranges from

2. private health insurance to federal laws that protect individuals enrolled in private
insurance. Nurses also have opportunities within the private insurance market. This paper
addresses the history of private health insurance and managed care, the key federal laws
that protect individuals who are enrolled in private insurance, consumer-driven healthcare,
the empowerment of the healthcare consumer, and the opportunities that have emerged for
nurses within the private insurance market.Section One: History of Private Health
Insurance and Managed Care:The history of private health insurance and managed care
began in the early 20th century when the American Medical Association (AMA) opposed
compulsory health insurance. They argued that it violated the doctor-patient relationship
since the physician-patient relationship was based on trust, privacy, and confidentiality.
However, during the Great Depression and World War II, employers began offering health
insurance as a benefit to attract workers. This led to the proliferation of health insurance
plans, and by 1954, over 80% of Americans had some form of coverage.Managed care
emerged in the 1970s as a response to the rising costs of healthcare. Managed care
organizations (MCOs) sought to control healthcare costs by limiting patient choice, reducing
reimbursement to providers, and enhancing the quality of care through utilization review,
quality assurance, and disease management. MCOs were successful in controlling healthcare
costs, but they had negative consequences, such as increased bureaucracy, reduced
physician autonomy, and lower quality of care.Section Two: Federal Laws that Protect
Individuals Enrolled in Private Insurance:The Affordable Care Act (ACA) of 2010 is a federal
law that protects individuals who are enrolled in private insurance. The ACA has four key
provisions that protect consumers. The first provision is the prohibition of denial of
coverage based on pre-existing conditions. The second provision is the annual and lifetime
limit on coverage. The third provision is the establishment of health insurance marketplaces
where individuals can purchase health insurance plans. The fourth provision is the creation
of subsidies to offset the cost of health insurance premiums for low-income
individuals.Another federal law that protects individuals enrolled in private insurance is the
Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. COBRA provides eligible
employees and their families the right to continue health insurance coverage for a limited
time after their employment has ended. COBRA also covers individuals who have
experienced a reduced work schedule or job loss.Section Three: Consumer-Driven
Healthcare and the Empowerment of the Healthcare Consumer:Consumer-driven
healthcare is a healthcare delivery model in which individuals have greater control over
their healthcare decisions, such as choosing their healthcare providers, treatments, and
insurance plans. Consumer-driven healthcare is based on the principles of transparency,
competition, and accountability. The goal of consumer-driven healthcare is to empower
consumers to make informed decisions about their healthcare and to increase the quality of
care while reducing costs.The empowerment of the healthcare consumer is essential in
consumer-driven healthcare. Empowered consumers are those who have the knowledge
and skills to make informed decisions about their healthcare. Empowered consumers are
knowledgeable about their healthcare needs and preferences, healthcare quality, healthcare
costs, and the available healthcare options.Section Four: Opportunities for Nurses in the
Private Insurance Market:Opportunities for nurses in the private insurance market have

3. emerged due to the increasing demand for healthcare services and the shortage of
healthcare professionals. Nurses can work in various roles within the private insurance
market, such as case managers, utilization reviewers, and quality assurance coordinators.
Nurses in these roles work to ensure that patients receive high-quality and cost-effective
care. Nurses can also work as liaisons between healthcare providers and health insurance
companies.Conclusion:In conclusion, healthcare financing plays a crucial role in the
healthcare industry, and it can shape the delivery of care. Private health insurance and
managed care emerged in the early 20th century and the 1970s, respectively, and have
since evolved. Federal laws, such as the ACA and COBRA, protect individuals enrolled in
private insurance. Consumer-driven healthcare and the empowerment of the healthcare
consumer are increasingly becoming essential components of the healthcare industry.
Finally, nurses have several opportunities within the private insurance market and can
contribute significantly to the quality of care provided.#Remember #submit #work #file
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