Healthcare Utilization and Finance

COMPETENCIES

734.3.4 : Healthcare Utilization and Finance

The graduate analyzes financial implications related to healthcare delivery, reimbursement, access, and national initiatives.

INTRODUCTION

It is essential that nurses understand the issues related to healthcare financing, including local, state, and national healthcare policies and initiatives that affect healthcare delivery. As a patient advocate, the professional nurse is in a position to work with patients and families to access available resources to meet their healthcare needs.

REQUIREMENTS

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, or Switzerland, by doing the following:

1. Identify one country from the following list whose healthcare system you will compare to the U.S. healthcare system: Great Britain, Japan, Germany, or Switzerland.

2. Compare access between the two healthcare systems for children, people who are unemployed, and people who are retired.

a. Discuss coverage for medications in the two healthcare systems.

b. Determine the requirements to get a referral to see a specialist in the two healthcare systems.

c. Discuss coverage for preexisting conditions in the two healthcare systems.

3. Explain two financial implications for patients with regard to the healthcare delivery differences between the two countries (i.e.; how are the patients financially impacted).

B. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

C. Demonstrate professional communication in the content and presentation of your submission.

File RestrictionsFile name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRICA1:COUNTRY TO COMPARE

NOT EVIDENT

A country for comparison is not identified.

APPROACHING COMPETENCE

The identified country for comparison is not from the given list.

COMPETENT

The identified country for comparison is from the given list.

A2:ACCESS

NOT EVIDENT

A comparison of healthcare system access is not provided.

APPROACHING COMPETENCE

The comparison does not accurately describe access to healthcare systems in both the U.S. and the country chosen in A1 for one or more of the given groups of people, or the comparison does not logically describe both the similarities and differences between access to each of the healthcare systems for all of the given groups of people.

COMPETENT

The comparison accurately describes access to healthcare systems in both the U.S. and the country chosen in part A1 for children, people who are unemployed, and people who are retired. The comparison logically describes the similarities and differences between access to each of the healthcare systems for all of the given groups of people.

A2A:COVERAGE OF MEDICATIONS

NOT EVIDENT

A discussion of medication coverage in both healthcare systems is not provided.

APPROACHING COMPETENCE

The discussion of coverage is not accurate or is not relevant to one or more of the healthcare systems.

COMPETENT

The discussion of coverage for medications is accurate and relevant to both the U.S. healthcare system and the healthcare system of the country chosen in part A1.

A2B:REFERRAL TO SEE A SPECIALIST

NOT EVIDENT

A determination of specialist referral requirements is not provided.

APPROACHING COMPETENCE

The submission does not accurately determine the requirements to get a referral to see a specialist for one or more of the healthcare systems.

COMPETENT

The submission accurately determines the requirements to get a referral to see a specialist for both the U.S. healthcare system and the healthcare system of the country chosen in part A1.

A2C:COVERAGE FOR PREEXISTING CONDITIONS

NOT EVIDENT

A discussion of preexisting condition coverage is not provided.

APPROACHING COMPETENCE

The discussion of coverage for preexisting conditions is not accurate or does not relate to one or more of the healthcare systems.

COMPETENT

The discussion of coverage for preexisting conditions is accurate and relevant to both the U.S. healthcare system and the healthcare system of the country chosen in part A1.

A3:FINANCE IMPLICATIONS FOR HEALTHCARE DELIVERY

NOT EVIDENT

An explanation of 2 financial implications for the patient is not provided.

APPROACHING COMPETENCE

The explanation does not logically discuss 2 financial implications for the patient in regards to healthcare delivery differences, or the explanation does not include both the U.S. healthcare system and the healthcare system of the country chosen in part A1.

COMPETENT

The explanation logically discusses 2 financial implications for the patient in regards to the delivery differences in both the U.S. healthcare system and the healthcare system of the country chosen in part A1.

B:SOURCES

NOT EVIDENT

The submission does not include both in-text citations and a reference list for sources that are quoted, paraphrased, or summarized.

APPROACHING COMPETENCE

The submission includes in-text citations for sources that are quoted, paraphrased, or summarized and a reference list; however, the citations or reference list is incomplete or inaccurate.

COMPETENT

The submission includes in-text citations for sources that are properly quoted, paraphrased, or summarized and a reference list that accurately identifies the author, date, title, and source location as available.

C:PROFESSIONAL COMMUNICATION

NOT EVIDENT

Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.

APPROACHING COMPETENCE

Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.

COMPETENT

Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.