Healthcare Funding in the US

Based on the following scenario, please create a 2 –3 page board brief in APA style, including at least 2 scholarly citations:

You are a healthcare administrator in need of an additional funding source to provide to your uninsured and underinsured patients. You are creating a brief for your board advocating for the addition of a private or public funding source to meet the needs of your patients. Your brief should also explain how the funding source you selected relates to the Affordable Care Act.

Describe the current funding sources that are accepted in your healthcare setting. Then explain the features and benefits of one private or one public funding source you would like to offer to underinsured or uninsured patients in your healthcare setting. Then explain why the funding source you selected has more advantages than others that you considered and how the source you selected relates to the Affordable Care Act.

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Solution

 Acceptable Healthcare Funding Sources in My Health Care Facility

The current funding sources that are acceptable in my healthcare setting include private insurance, out-of-pocket payments, and government insurance programs. Patients are free to purchase private insurance programs from nonprofit or for-profit insurance companies. Despite the existence of numerous health insurance companies across the US, every state will therefore have a limited number of insurance companies. Organizations purchase most private insurance plans as a benefit to their employees. The cost of such private insurance is then shared between employers and employees. The amount of money that employers decide to spend on their employees’ health insurance will not be considered taxable income. The government does typically this to incentivize both employers and employees to procure health insurance (Liaropoulos & Goranitis, 2015).

The second funding source that is acceptable in my healthcare setting is government insurance programs. Such programs include Medicaid and Medicare. Medicaid supports health care for disabled and elderly people. On the other hand, Medicaid covers health care for low income people and who may not have sufficient funds or a job that provides private insurance (Cai et al., 2020).

My health care facility also accepts other different forms of government insurance programs such as state children’s health insurance program, Veterans health administration, children and youth with special health care needs, and federal employee health benefits program. The state children’s health insurance program focuses on providing health insurance coverage for uninsured children who might come from families that have below-average incomes but an income that does not allow them to qualify for Medicaid (Hatzigeorgiou & Joshi, 2019). The Health Insurance program is therefore funded by both the federal and state governments equally. My health care facility also accepts children and youth with special health care needs insurance programs. This government-funded insurance program pa for all individuals with special health needs access to care. My healthcare facility also accepts veteran’s health administration, a government-funded healthcare insurance system that provides services to all eligible military veterans. The Veteran health administration currently has more than nine million veterans who utilize it. Finally, our health care facility also accepts the federal employee health benefits program (FEHB). This program allows various private insurers to offer health insurance plans to individuals based on the guidelines that will be stipulated by the government (Hatzigeorgiou & Joshi, 2019).

The third form of funding that my health care facility accepts is out-of-pocket payments. Any health insurance programs do not cover people who utilize out-of-pocket payments for their healthcare. Such individuals normally utilize their own savings to pay for healthcare services. Out-of-pocket payments also include a flexible spending account and a health savings account. The flexible spending account allows individuals to choose a flexible amount of money that can be consistently set aside from their salary to pay for healthcare expenses when they visit healthcare facilities (Gaffney et al., 2020). However, money saved in a flexible spending account does not earn any interest in a bank, and if the money is not used, an individual can get it back at the end of the year. Employees might also use a health savings account to make out-of-pocket payments in a healthcare facility. Money saved in a health savings account normally earns with the money that might be unused not being lost. However, for an individual to be eligible for a health savings account, they also need to have an insurance plan that provides lower premiums and high deductibles (Gaffney et al., 2020).

Features and Benefits

The ideal private health insurance plan that can be offered to underinsured or uninsured patients in my healthcare setting is the United Healthcare plan. The main features of the United Healthcare plan are that it provides health insurance coverage that is compliant with the Affordable care act and also offers short-term health insurance plans. The central benefit of the United Healthcare insurance plans is that it provides short-term health insurance services that can be suitable for underinsured and uninsured insured people who do not have sufficient resources for insurance and might have an inconsistent flow of income (Liaropoulos & Goranitis, 2015).

On the other hand, the ideal public funding source for underinsured and uninsured people would be Medicaid. This is because Medicaid covers all the health care needs of people living below the poverty level, with many people who are underinsured or uninsured belonging to the low-income groups. The main benefit of Medicaid is that individuals are not required to make any contributions (Cai et al., 2020).

Description of how the selected funding source relates to the Affordable Care Act

The UnitedHealth care plan has many benefits for the underinsured and uninsured population Because of offering the option of short-term health insurance. The option of short-term health insurance is important among the underinsured and uninsured population, who are normally low-income individuals with no reliable jobs. United Healthcare also offers plans that are compliant with the Affordable care act (Gaffney et al., 2020).

On the other hand, Medicaid has numerous advantages for the underinsured and uninsured because the government program targets low-income populations and does not require any contributions from enrolled individuals. Therefore, as a government plan, Medicaid complies with the Affordable Care Act (Liaropoulos & Goranitis, 2015).

References

Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J. S., & Kahn, J. G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine, 17(1), e1003013. https://doi.org/10.1371/journal.pmed.1003013

Gaffney, A., Himmelstein, D. U., & Woolhandler, S. (2020). COVID-19 and US Health Financing: Perils and Possibilities. International Journal of Health Services, 50(4), 396–407. https://doi.org/10.1177/0020731420931431

Hatzigeorgiou, M. N., & Joshi, M. S. (2019). Population Health Systems: The Intersection of Care Delivery and Health Delivery. Population Health Management, 22(6), 467–469. https://doi.org/10.1089/pop.2019.0066

Liaropoulos, L., & Goranitis, I. (2015). Health care financing and the sustainability of health systems. International Journal for Equity in Health, 14(1). https://doi.org/10.1186/s12939-015-0208-5