National Health Coverage Plans, Reimbursements, and Quality

 

 

For this assignment, you will examine the importance of healthcare coverage (insurance). You will also examine how reimbursements (payments) from health plans are impacted by quality of care. Start by selecting two major national (U.S.) insurance health plans. You may choose Medicaid, Medicare, HMO, PPO, or private insurance plans. You can choose your own personal insurance plan if you prefer. You will review coverage options offered by both plans that benefit and hinder patient’s access to care. Examples of coverage options that facilitate or limit access include medication coverage, primary care physicians, specialists, emergency care, lab or blood work and diagnostics, wellness care, prevention services, surgery (these are just a few examples). You will also explore the role of Diagnosis Related Groups (DRGs) and charity care within healthcare facilities and how charity care impacts the vulnerable or uninsured population.

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