You will be graded on how well you demonstrate knowledge and understanding of the concept, and critical thinking pertaining to the applicability of the concept to your professional practice.

  1. Assignment Expectations:
    1. Address concept A and B in about 150 words each.
    2. You will be graded on how well you demonstrate knowledge and understanding of the concept, and critical thinking pertaining to the applicability of the concept to your professional practice. Points awarded will follow breakdown below.
    3. You will neither be required to, nor graded on responses to your peers. One posting will suffice.
  2. The Assignment: Given the readings and assignments in the course, identify and discuss two concepts or lessons learned that you believe will be most applicable to your professional discipline.
  3. Concept A (points 10/20):
    1. Identify /define (points 4/20): ……
    2. Your professional discipline: ……..
    3. How applicable (points 6/20): ……
  4. Concept B (points 10/20):
    1. Identify /define (points 4/20): ……
    2. Your professional discipline: ……..
    3. How applicable (points 6/20): ……

All information in the postings can be shared by all for the betterment of your project.

Module 1

Required Reading

Baicker K, & Chandra A. (2008). Myths and Misconceptions about U.S. Health Insurance. Health Affairs, 27(6), w533-43. Retrieved from ProQuest on 11/21/2012.

Blumenthal D. (2006). Employer-Sponsored Health Insurance in the United States – Origins and Implications. New England Medical Journal, 355(1), 82-88. Retrieved from ProQuest on 11/21/2012.

Bodenheimer, T. (2005). High and Rising Health Care Costs. Part 1:  Seeking an Explanation. Annals of Internal Medicine, 142 (10), 847-854. Available at:  http://annals.org/article.aspx?articleid=718406

Choudhry, N., Rosenthal, M. & Milstein, A. (2010). Assessing the Evidence for Value-Based Insurance Design. Health Affairs, 29 (11), 1988-1994. Retrieved from ProQuest on 11/21/2012.

Claxton, G. (2008). How Private Health Care Coverage Works: A Primer. A Henry J. Kaiser Family Foundation Report. Available at http://www.kff.org/insurance/upload/7766.pdf  (Retrieved 11/21/2012)

Eibner, C., Hussey, P., & Girosi, F. (2010) The Effects of the Affordable Care Act on Workers’ Health Insurance Coverage. New England Journal of Medicine, 363 (15), 1393-1395. Available at Trident University Online Library.

RAND Corporation. (2010). US Health Care Today: Coverage. Available at http://www.randcompare.org/us-health-care-today/coverage#current-levels-of-coverage (Retrieved 11/21/2012)

Required Website

Kaiser Family Foundation (2009). Health Insurance and Access to Health Care: the Evidence. Available at: http://kff.org/interactive/health-insurance-and-access-to-health-care-tutorial/

Module 2

Required Reading

Kaiser Family Foundation. (2010). Medicare: A Primer. Available at  https://www.kff.org/interactive/medicare-101-tutorial/

Kaiser Family Foundation. (2010). Medicare at a Glance. Available at  https://kaiserfamilyfoundation.files.wordpress.com/2014/09/1066-17-medicare-at-a-glance.pdf

Medicare Payment Advisory Commission. (2016). Context of Medicare Payment Policy. In Report to Congress: Medicare Payment Policy. Washington: The Commission. Retrieved from http://www.medpac.gov/docs/default-source/reports/march-2016-report-to-the-congress-medicare-payment-policy.pdf?sfvrsn=0

Newhouse, J. (2010). Assessing Health Reform’s Impact on Four Key Groups of Americans.Health Affairs, 29 (9), 1714-1724. Available at  https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2010.0595

Zarabozo, C., & Harrison, S. (2009). Payment Policy and the Growth of Medicare Advantage. Health Affairs, 28 (1), W55-W67. Retrieved from ProQuest on 11/21/2012.

Required Website

Kaiser Family Foundation (2010). Health Reform and Medicare: Overview of Key Provisions. Available at: http://kff.org/interactive/health-reform-and-medicare-overview-of-key-provisions-tutorial/

Kaiser Family Foundation (2009). Medicare 101: the Basics. Available at  https://www.kff.org/medicare/event/medicare-101-what-you-need-to-know-2015/

Module 3

Required Reading

Kaiser Commission on Medicaid and the Uninsured. (2011). Key Questions About Medicaid And Its Role in State/Federal Budgets and Health Reform.  http://www.kff.org/medicaid/upload/8162.pdf  (Retrieved 11/21/2012)

Kaiser Commission on Medicaid and the Uninsured. (2011). Top 5 Things To Know About Medicaid.  http://www.kff.org/medicaid/upload/8139.pdf  (Retrieved 11/21/2012)

Kaiser Commission on Medicaid and the Uninsured. (2010). Medicaid: A Primer. Available at  http://www.kff.org/medicaid/upload/7334-04.pdf   (Retrieved 11/21/2012)

Kaiser Commission on Medicaid and the Uninsured. (2010). The Medicaid Program at a Glance. Available at https://reachhealth.org/wp-content/uploads/2010/09/7235-04.pdf   (Retrieved 11/21/2012)

Mortensen, K. (2010). Copayments Did Not Reduce Medicaid Enrollees’ Nonemergency Use of Emergency Departments. Health Affairs, 29 (9), 1643-1650. Retrieved from ProQuest on 11/21/2012.

Sommers, B. (2010). Enrolling Eligible Children in Medicaid and CHIP: A Research Update. Health Affairs, 29 (7), 1350-1355. Retrieved from ProQuest on 11/21/2012.

Decker, S.. (2009). Changes in Medicaid Physician Fees and Patterns of Ambulatory Care. Inquiry, 46(3), 291-304. Retrieved from ProQuest on 11/21/2012.

Required Website

Kaiser Family Foundation (2010). Health Reform: How will Medicaid Change? Available at:  http://kff.org/interactive/health-reform-how-will-medicaid-change-tutorial/

Kaiser Family Foundation (2009). Medicaid 101. Available at:  http://kff.org/interactive/medicaid-101-tutorial/

Module 4

Required Reading 

Medicare Payment Advisory Commission. (2016). Medicare Payment Basics:  Hospital Acute Inpatient Services Payment System. Available at: http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_16_hospital_final.pdf

Medicare Payment Advisory Commission. (2014). Medicare Payment Basics: Outpatient Hospital Services Payment System. Available at  http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_16_opd_final.pdf?sfvrsn=0

Centers for Medicare and Medicaid. (2010). Hospital Outpatient Prospective Payment System. The Medicare Learning Network Payment Systems Fact Sheet Series. Available at  http://www.cms.gov/MLNProducts/downloads/HospitalOutpaysysfctsht.pdf (Retrieved 11/21/2012)

Centers for Medicare and Medicaid. (2009). Acute Care Hospital Inpatient Prospective Payment System. The Medicare Learning Network Payment Systems Fact Sheet Series. Available at  http://www.cms.gov/MLNProducts/downloads/AcutePaymtSysfctsht.pdf (Retrieved 11/21/2012)

Medicare Payment Advisory Commission. (2014). Physician and Other Health Professionals Payment System. Available at  http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_16_physician_final.pdf?sfvrsn=0

Centers for Medicare and Medicaid. (2014). Medicare Physician Fee Schedule. The Medicare Learning Network Payment Systems Fact Sheet Series. Available at  https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedcrephysFeeSchedfctsht.pdf

Guterman, S., Davis, K., Stremikis, K., & Drake, H. (2010). Innovation in Medicare and Medicaid Will Be Central to Health Reform’s Success. Health Affairs, 29 (6), 1188-93. Retrieved from ProQuest on 11/21/2012.

Lesser, C., Fineberg, H., & Cassel, C. (2010). Physician Payment Reform: Principles That Should Shape It. Health Affairs, 29 (5), 948-952. Retrieved from ProQuest on 11/21/2012.

Wilensky, G. (2009). Reforming Medicare’s Physician Payment System. New England Journal of Medicine, 360 (7), 653-655.  This item is available in full text via the University library.

 

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