The Law And Policy Of Healthcare Financing

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares tax-funded Beveridge systems and insurance-based Bismarck systems. Containing contributions from national experts, The Law and Policy of Healthcare Financing charts and compares the merits of healthcare systems throughout 11 countries, from the UK to Colombia.

As a contribution to the search for suitable and sustainable solutions to finance rising medical care expenditures, the book proposes a typology of healthcare financing and insurance schemes, based on the dimensions of basic vs. supplementary services and mandatory vs. voluntary coverage, to analyse the design and the complex interactions between various financing and insurance arrangements in several OECD countries. This study provides a better understanding of the strengths and weaknesses of the financial and organisational structures of different countries’ healthcare financing and insurance schemes. Its main contributions are the development of a novel and rigorous theoretical framework analysing the economic rationales for the optimal design of healthcare financing and insurance schemes, and an empirical and institutional analysis investigating the consequences for efficiency and affordability of the complex interactions between basic and supplementary sources of financing.

First Edition Awarded Second Place in 2013 AJN Book of the Year Awards! The second edition of this award-winning text, designed specifically for the DNP course in health care economics and finance, remains the only book to embed economic and financial concepts in the context of nursing practice and nursing health care systems. Well organized and clearly written, the second edition is updated to encompass key changes to reimbursement and health care regulations and provides revised statistics throughout. It offers new information on ambulatory care, cost and ratio analysis, additional examples of financial statements, and an updated sample business plan. Enhanced teaching strategies include real life case studies, challenging critical thinking questions, learning games, key words in each chapter, and an extensive glossary. New PowerPoint slides add to the text’s value as a robust teaching tool. Written by experienced DNP executives for DNPs, the book emphasizes critical skills nurse leaders need to participate in strategic health care planning. It delivers a practical approach to business, finance, economics, and health policy that is designed to foster sound business and leadership. The text clearly explicates the relationship between cost of care, quality of care, and ethics, and examines the economic and financial implications of evidence-based practice and quality. Also included is a special section on finance for independent practitioners. Additionally, the book delivers required competencies of the AACN Essentials and the AONE. New to the Second Edition: Updated statistics throughout New information on ambulatory care A cost and ratio analysis Additional examples of financial statements Updated business plan Enhanced faculty support PowerPoint slides

This book is designed for a specialized health law course focusing on the organization and finance of health care. It is also well-suited for health law courses in health administration or management programs. The 7th Edition focuses heavily on the many changes that the Affordable Care Act is bringing about in the regulation of health care and health insurance. The book begins with an introduction to fundamental concepts affecting health law and policy, and then explores conventional and emerging methods of quality control regulation applicable to health care professionals and health care institutions. The next section of the book examines in depth the policy and legal issues presented by varying approaches to providing access to health care and controlling its cost. This section explores in depth the provisions of the Affordable Care Act that are expanding access to health care, and analyzes the challenges to that law, including the National Federation of Independent Business Supreme Court decision. This section also considers legal issues presented by private health insurance, managed care, Medicare, and Medicaid, as well as obligations to provide medical services under state and federal law. The final section of the book explores legal issues that affect health care institutions and the relationships between professionals and institutions, including medical staff privileging, physician-hospital contracting, accountable care organizations, employment and labor law, tax exempt organization law, fraud and abuse issues, and antitrust law. The 7th edition has been completely updated, covering recent developments involving consumer-driven health care, ERISA, antitrust enforcement, labor law, and tax-exempt organization law, in addition to the Affordable Care Act developments.

The Law of Health Care Finance and Regulation is based on Part III, “Institutions, Providers, and the State,” of parent book Health Care Law and Ethics and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law. Key Features: Based on material in Part III of the popular parent book, “Institutions, Providers, and the State,” along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs. Includes cases and material not found in the parent book on: • Judicial and administrative review of Medicare decisions. Certificate of need laws. Review immunity. Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information. Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet.

The recent expansion of health insurance coverage in the USA under the Affordable Health Care Act, and current threats to reverse the benefits of this reform, have once again focused the world's attention on the difficult challenges faced by other countries trying to provide better access to healthcare to their population at an affordable cost. This textbook provides a comparative review of financing universal access to healthcare in the Organisation for Economic Co-operation and Development (OECD) countries. The first two chapters of the book provide a framework for financing universal access to healthcare. The remaining eight chapters present case studies of eight OECD countries that have successfully introduced reforms to finance universal access to healthcare for their population through landmark legislative reforms. A concluding chapter focuses on the lessons learned from the OECD and recommendations from policymakers and others who are planning similar reforms. The book is designed as a learning tool for students and as a user guide for policymakers. Contents: Introduction Principles and Practice The UK Canada Australia New Zealand Denmark Norway Sweden Finland Summary of Lessons Learned Readership: Graduate and research-level students and instructors of healthcare financing, healthcare policymakers, and healthcare professionals and investors. Keywords: Universal;Health Financing;Health Insurance;Health Reform;Financial Protection;Political Process;HealthcareReview: "The International Hospital Federation (IHF) is committed to advancing the UHC agenda throughout the world, giving billions of people better access to critical hospital care and basic health services when needed, no matter their income or geographic location in the world. Since its establishment in 1929, the IHF recognizes the essential role of hospitals and health care organizations in providing health care, supporting health services and offering education to health care providers as a critical partner in during the drive for UHC throughout the world. This volume is a tribute to the renewed effort in achieving 'Health for All'." Eric de Roodenbeke Executive Director International Hospital Federation Geneva 2018 "This year, as we commemorate the 40th Anniversary of the Alma-Ata Declaration of 'Health for All' in Almaty, Kazakhstan, 1978 and the 70th Anniversary of the UK National Health Service, 1948, we also celebrate the great achievement over the past decades in bringing access to affordable and quality health care for billions of people across the world since the 1950s. Looking forward, at the recent Universal Health Coverage Forum 2017 in Tokyo Japan, the international development community — including both bi-laterals and multi-laterals — committed to the 'Tokyo Declaration on Universal Health Coverage: All Together to Accelerate Progress towards UHC'. This text book makes a valuable contribution by reviewing the political, policy and implementation challenges that countries face in achieving this agenda. The approach used to analyze the eight case studies presented in the volume is a seminal work in comparative health policy." James Christopher Lovelace International Health and Development Advisor Former Director, Health Nutrition and Population, World Bank Former Assistant Deputy Minister of Health, Government of BC, Canada Former Director General of Health, Government of New Zealand Key Features: The main distinguishing feature of this book is to compare OECD countries that have successful experiences in addressing the policy challenges and p

Essentials of Health Policy and Law helps readers understand the broad context of health policy and law, the essential policy and legal issues impacting and flowing out of the health care and public health systems, and the way health policies and laws are formulated. Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition.

Given the prominent role played by policy and law in the health of all Americans, the aim of this book is to help readers understand the broad context of health policy and law. The essential policy and legal issues impacting and flowing out of the health care and public health systems, and the way health policies and laws are formulated. Think of this textbook as an extended manual.introductory, concise, and straightforward.to the seminal issues in U.S. health policy and law, and thus as a jumping off point for discussion, reflection, research, and analysis.