National Health Coverage Plans
Instructions
Examine the relationship between healthcare coverage (insurance), quality care, and reimbursements (payments) to health care organizations. Select two different major national (U.S.) insurance health plans.  You may choose Medicaid, Medicare, HMO, PPO, or private insurance plans.  You can choose your own personal insurance plan if you prefer.  Review healthcare coverage options offered by both plans that benefit (facilitate) and hinder (limit) access to care.  Examples of healthcare coverage (insurance) options that facilitate, or limit access include medication coverage, primary care physician office visits, specialist’s physician office visits, emergency care, lab or blood work and diagnostics, wellness care, prevention services or surgery (these are just a few examples). You will also explore the role of Diagnosis Related Groups (DRGs) and charity care within healthcare facilities (hospitals) and how charity care impacts the vulnerable or uninsured population. Finally, summarize nursing interventions or considerations for your selected patient to provide high quality, safe healthcare considering nursing-sensitive indicators in his/her unique scenario.
National Health Coverage Plans, Reimbursements, and Quality

Baccalaureate education includes learning opportunities of healthcare policy, finance, and regulatory environments (AACN, 2008).  

Introduction