HLT 205V Week 7 Policy Interview Analysis

HLT 205V Week 7 Policy Interview Analysis

 

HLT 205V Complete Work Latest-GCU

HLT 205 Week 7 Topic 7 Discussion 1

Describe how state Certificate of Need (CON) programs and Medicare Prospective Payment Systems (PPS) help decrease health care spending. Cite references to support your response.

HLT 205 Week 7 Topic 7 Discussion 2

In the U.S. health care system, what are the two basic challenges to access which will not be resolved by a mere expansion of health insurance to the uninsured? Cite references to support your response.

HLT 205 Week 7 Assignment Policy Interview Analysis

Details:

Important Notice:

It is important for students, as they progress through this program, to learn from those currently working in health care. For this assignment, students will interview a health care professional. It is important that you start a search for potential candidates to interview at the beginning of the course as many health care professionals have limited availability due to their schedules. It is recommended that upon finding a candidate for the interview that you schedule a meeting a few weeks in advance. You may complete the interview face to face, over the phone, or through an e-mail correspondence if necessary.

The Interview:

Identify at least 10 questions around governmental policy that are critical to understanding current and future issues in specific delivery settings. Refine your questions so that they are relevant to the person or policy that the interview is based on. Conduct the interview at the agreed upon time in a professional manner.

Summary Paper:

After you have completed the interview, write a 750-1,000 word paper that summarizes your findings. Cite at least two resources in addition to your textbook for this class.

Prepare this assignment according to the guidelines found in the GCU Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 

 

MORE INFO 

Certificate of Need (CON) programs and Medicare Prospective Payment Systems (PPS)

Introduction

The purpose of this article is to explain the CON program and how it can help control health care costs.

The need for health care facilities

The need for health care facilities is a key component of CON programs. It must be determined that the population in the area has a need for services, and that these needs can only be met by building or expanding a health care facility.

CON programs are typically used to support the development of new projects (1) in order to meet unmet community needs and (2) to expand existing institutions, such as hospitals and nursing homes. If you’re thinking about starting up your own CON program, here are some questions you should ask yourself:

• How many people live in this area? You’ll want at least 100 households per square mile—or 5,000 people total—to make sure there’s enough demand for your facility(s). If you don’t have enough people living in your service area but still want them covered by CON rules (and get paid more), then consider making changes so that more residents qualify under PPS rules instead of CON ones.* What percentage do I think will use my facility within five years? This will help determine how much funding should go toward constructing it or buying equipment needed when it opens its doors later on down the road.”

Prospective payment for Medicare services as a way to control costs

Medicare PPS is a form of prospective payment that was designed to control costs. It’s not the only way to control cost, but it’s one way to do so and has been widely used by hospitals and other providers since its inception in 1992.

Certificate of Need (CON) programs

Certificate of Need (CON) programs are state-based and vary by state. They’re intended to control the supply of health care services, while protecting public health and safety by preventing unnecessary expansion of hospital beds, physicians’ offices, nursing homes, home health agencies and other providers.

The federal government plays an important role in helping states develop CON programs that meet these objectives. The Centers for Medicare & Medicaid Services (CMS) works with states on this process through its program integrity workgroups that include representatives from CMS and other federal agencies such as the Department of Health and Human Services (HHS), Office of Inspector General; Agency for Healthcare Research & Quality; National Institute for Occupational Safety & Health; Food & Drug Administration Office of Prescription Drugs & Medical Devices Branch; Consumer Product Safety Commission; Environmental Protection Agency Office Of Air Quality Planning And Standards Division; Bureau Of Labor Statistics Employment Projections Statistics Division etc..

Health care facility expansion and other health care services not covered by Medicare PPS and CON programs

There are other health care services that are not covered by Medicare PPS or CON programs, such as:

• Services for the elderly, who have limited mobility and may need assistance with activities of daily living (ADLs) such as bathing, dressing, eating and toileting. In addition to providing basic needs like food and shelter, these services also include helping older people stay safe in their homes by providing medical equipment such as walkers or wheelchairs;

• Home health care provided by licensed professionals at home rather than through hospital-based facilities. The most common need here is help with ADLs but other types of assistance may include physical therapy after an injury or surgery;

• Health maintenance organizations (HMOs) offer preventive services including screenings for cancer prevention purposes;

Takeaway:

CON programs are not the only way to control health care costs, nor should they be. There are many other ways to improve efficiency and reduce waste in the health care system.

CON programs can be counterproductive because they may have a negative impact on access to care or quality of life for patients. For example, if CON requirements cause hospitals to raise their prices too much, more people will go uninsured or seek out cheaper alternative providers, which could result in worse outcomes for them (and their families). Furthermore, if a hospital incurs additional costs due to CON laws but does not recoup those expenses from consumers through higher premiums or fees charged by those insured members who choose alternatives outside that hospital’s network—then these institutions may simply pass along these costs onto others through higher prices paid by everyone else who buys insurance plans through insurers based out of state where there are no such restrictions placed on them; this means that there will always be someone else picking up some slack when it comes down time crunching together all those numbers together into one big equation!

Conclusion

Medicare PPS and CON programs are designed to help hospitals and other health care facilities expand their services and improve their quality of care. These payment systems are intended to make it possible for new or expanded health care facilities to operate without the need for taxpayer funding. However, those who argue against these programs argue that they will put financial burdens on taxpayers because they require them to pay more than what they receive in return from government subsidies.