National Health Coverage Plans, Reimbursements, and Quality
Baccalaureate education includes learning opportunities of healthcare policy, finance, and regulatory environments (AACN, 2008).
Complete the Nursing Quality Indicators (NQI) virtual simulation activity to explore the impact of nursing designs on quality measures, including cost, systems, processes, and outcomes of various points of care. The goal of this activity is to think about basic quality and safety investigations that are used to create and measures outcomes of quality improvement processes.
Introduction & Healthcare Coverage and Vulnerable Populations
Describe the importance of healthcare coverage (insurance). End with a clearly worded purpose statement for this project. Discuss two ways healthcare coverage is beneficial (helpful) for the vulnerable/ uninsured populations.
Diagnosis Related Groups
Describe the purpose of Diagnosis Related Groups (DRGs). Explain the impact of DRGs on length of stay and payment of services. Discuss how payments for DRGs are now impacted by quality indicators and measures.
Select a Major Healthcare Plan
(Label heading with the name of the plan Ex: Preferred Provider Option Plan)
Select one of the patients from the cases you reviewed in NQI. Summarize two care options provided by the plan that facilitates access for your selected patient. Summarize two care options that limit access to care for your selected patient.
Select a Second Major Healthcare Plan
(Label heading with the name of the plan Ex: Medicaid)
Repeat this activity with the same patient. Summarize two care options provided by the second plan that facilitates access for your selected patient. Summarize two care options that limit access to care for your selected patient.
Impact of Nursing Interventions
Summarize at least four priority nursing interventions or considerations to promote self-care for your selected patient to provide high quality, safe healthcare considering nursing-sensitive indicators. Provide a rationale for each of your selected nursing decisions.
Summarize the key points of your project.
**You will not discuss the deductibles or costs of the insurance plans as this is not the focus of this this assignment.
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