Class 7 Unit 4 Discussion (L)

11/8/17, 12(51 PMSample Content Topic

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Financial Models Of Reimbursement And Effects On Patients And Healthcare Providers The United States healthcare system is like a patchwork quilt. There are public and private third-party payers, cash payments, co-pays, deductibles, out-of-network treatments, in-network treatments, dental coverage, no dental coverage, uncovered drugs, generic drugs, Medicaid, Medicare, Workers' Compensation, the No-Fault system, managed care, PPO's and now, the Affordable Care Act. How the advance practice nurse fits into all of this, as well as the physician and other health care providers, can be complex.

There is an opportunity for the advance practice nurse to move into a position of providing some of the services that had formerly been provided by primary care physicians. There are gaps in care. These gaps can be filled by the nurse practitioner or the advance practice nurse.

There are a number of provisions in the Affordable Care Act where interdisciplinary care is encouraged. An important function of interdisciplinary care is having interdisciplinary education.

After completing this unit, you should be able to:

Analyze implications of managed care. Assess the Affordable Care Act and cost shifting implications. Identify health care policies that use cost shifting.

Class 507 Unit 4 Overview and Outcomes