Key Research Topics
I.
Financing
– Those who pay for health care services.
a. Government – largest provider of health are
i. Medicare/Medicaid/VA System
b. Employers – offer health care benefits to their employees
i. Premium assistance through a private company
ii. Self-insured
iii. Employer/Employee share the costs
c. Workers Compensation – law
i. Federal law requires employers to carry
ii. Employer pays
d. Self-pay – individuals pay for the cost of their own health care
i. Companies offer their own self-insurance
e. Related legislation
Driving Questions: How does health policy affect financing? How does the Balanced Budget Act affect financing?
II.
Delivery
– Who provides the healthcare, and where is it delivered?
a. Who:
i. MDs
ii. Nurses
iii. Certified Nurse Practitioners
iv. PT/OT/ST
v. PAs
vi. Other ancillary providers
b. Facilities:
i. Hospitals
ii. Offices/Outpatient
iii. Labs
iv. Pharmacy
v. Medical equipment
vi. Managed care facilities
vii. Integrated systems
c. Related legislation
Driving Questions: How is licensure granted for health care professionals and for facilities? How do HIPAA, the Joint commission, and OSHA affect providers and facilities?
III.
Reimbursement
– Payment for services provided.
a. Government – taxpayer dollars
i. Medicare – Parts A, B, C, and D
ii. Medicaid
iii. VA
b. Private Insurance
c. Self-pay
d. Workers Compensation
e. Types of Reimbursement:
i. FFS 100% - Traditional or Negotiated
ii. Medicare – RBRVS
iii. Capitation – HMOs; referrals from PCP
f. Related legislation
Driving Questions: What is the difference between prospective payment systems and retrospective payment systems? What is the impact each has on stabilizing or destabilizing health care costs? How are various health care settings reimbursed?
IV.
Environmental Impact
a. Political
b. Social
c. Economic
Driving Question: How do the political/economic/social environments in the U.S. affect the way health care is delivered?
V.
Rural Access to Health Care – Choose 1 state
a. Level of access to health services, health professionals, and other community-based health services
b. National Rural Health Association findings
c. Public policy and legislation
d. Regulations
Driving Question: Why are rural counties in poorer health? Why are rural areas disadvantaged in terms of health care delivery and related health care services?