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National Health Coverage Plans Instructions Examine the relationship between healthcare coverage (insurance), quality care, and reimbursements (payments)

May 19, 2025

National Health Coverage Plans

Instructions

Examine the relationship between healthcare coverage (insurance), quality care, and reimbursements (payments) to healthcare organizations. Select two major U.S. national insurance health plans (e.g., Medicaid, Medicare, HMO, PPO, or private insurance plans). You may choose your personal insurance plan if preferred.

Review how each plan facilitates or limits access to care. Examples include:

Medication coverage
Primary/specialist physician office visits
Emergency care
Lab/blood work & diagnostics
Wellness care, preventive services, or surgeries

Explore the role of Diagnosis Related Groups (DRGs) and charity care within healthcare facilities and their impact on vulnerable or uninsured populations. Conclude with nursing interventions to ensure high-quality, safe care using nursing-sensitive indicators.

Key Components

National Health Coverage Plans, Reimbursements, and Quality

Understand baccalaureate-level knowledge of healthcare policy, finance, and regulatory environments (AACN, 2008).

Introduction & Healthcare Coverage and Vulnerable Populations

Describe the importance of healthcare insurance.
Include a clearly worded purpose statement.
Discuss two benefits of healthcare coverage for vulnerable/uninsured populations.

Diagnosis Related Groups (DRGs)

Describe the purpose and impact on:
- Length of stay
- Payment of services
- Quality indicators and measures

Plan 1: [Insert Plan Name]

Summarize two care options that facilitate access to care.
Summarize two care options that limit access to care.

Plan 2: [Insert Plan Name]

Repeat the above analysis for the second plan.

Nursing Interventions

Summarize four priority nursing interventions to promote self-care and ensure quality, safe care.
Provide a rationale for each intervention.

Conclusion

Summarize the key findings and takeaways.

Additional Instructions

Title page and reference page required
Minimum of three scholarly resources
Adhere to grammar, spelling, punctuation, and APA formatting
Follow the chosen Submission Options for assignment delivery
Note: Cost and deductibles are not part of this assignment

Health & Medical

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