Finance Series: The Cost of Healthcare in the US
This course is intended to educate nursing leaders about various managed care models within the U.S. healthcare delivery system and how they affect the quality and cost of care. It should also describe various relationships between providers and payers.
This course is intended to educate nursing leaders about various managed care models within the U.S. healthcare delivery system and how they affect the quality and cost of care. It should also describe various relationships between providers and payers.
American Nurses Credentialing Center
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Nurses will receive 1.00 Nursing Contact Hours after successfully completing this course.
Arkansas State Board of Nursing
Arkansas State Board Of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
California Board of Registered Nursing
Provider approved by the California Board of Registered Nursing, CEP# 13791
Nurses will receive 1.00 contact hours for participating in this course.
District of Columbia Board of Nursing
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Nursing
Florida Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Georgia Board of Nursing
Georgia Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Kentucky Board of Nursing
Kentucky Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Mississippi Board of Nursing
Mississippi Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
New Mexico Board of Nursing
New Mexico Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
North Dakota Board of Nursing
North Dakota Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
South Carolina Board of Nursing
South Carolina Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
West Virginia Board of Registered Nursing
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Identify various models for payment of medical care within the U.S. healthcare delivery system and how those models affect cost and quality of care.
Recognize the relationship between various types of healthcare providers and payers.
Define strategies for maximizing reimbursement within the U.S. healthcare delivery system.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: State of Healthcare Payment Models
Who Pays for Healthcare?
State of Healthcare Reform
Affordable Care Act
Summary
Section 3: Payment/Reimbursement Models
Fee-for-Service Reimbursement
Value-Based Care
Health Care Disparities
Alternative Payment Models
Population-Based Payment Models
Episode-Based Payment Models
Transparency
Summary
Section 4: Strategies for Maximizing Reimbursement
Overview
Future
Summary
Section 5: Clinical Vignette
Case Study
Section 6: Conclusion
Course Summary
Course Contributors
Resources
References
Deborah K. Zastocki, DNP, Ed.M. MA, RN, retired NEA-BC, FACHE(r) is the founder and president of Legacy Healthcare Management Consulting in North Carolina and an executive coach and content expert for the Healthcare Experience Foundation.. She received her BSN from the University of Rhode Island, both master's degrees from Teachers College Columbia University, and her DNP from the University of Medicine and Dentistry of NJ. Dr. Zastocki has over 30 years of experience, with a professional career that included a journey from staff nurse to nurse executive roles, authorship, adjunct faculty, and healthcare executive leadership. Dr. Zastocki is the former president and CEO of Chilton Medical Center and became a health system executive with Atlantic Health System in New Jersey, after system integration.Writer: Kimberly Workman, MA
Ms. Workman is an Instructional Designer at Relias. She has a Master of Arts in Technology and Communication, as well as graduate certificates in Public Health, Epidemiology, and Digital Communications. Ms. Workman has a background in writing and designing online continuing medical education for physicians and other health professionals on multiple educational platforms, including web-based, game-based, and immersive learning environments. She has also used simulation training extensively to connect learning to real-world environments.
The target audience for this course is: Nurses; in the following settings: Acute Care Facility.
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.
