Health Care Finance, Economics, and Policy for Nurses: A Foundational Guide

Foreword to the Second Edition
Foreword to the First Edition
References
A Note From the Author
How To Use This Text: A Note to Faculty
Note
References
Acknowledgments
Section I:  The Context of Health Care and Health Care Reform
Chapter 1: What Is Health Economics and Why Is It Important to Nurses?
Theoretical Economic Approaches
Social Determinants of Health
How Economics Differs from Financing and Reimbursement
Note
References
Chapter 2: A Story of Unintended Consequences: How Economic and Policy Solutions Create New Challenges
The Influence of the Flexner Report
Early Hospitals
Social Reform Addressing Unintended Consequences Of Employer-Based Insurance
Attempts to Change Financial Incentives to Contain Costs
The Affordable Care Act and New (and Renewed) Payment Models
COVID-19
Note
References
Chapter 3: The Patient Protection and Affordable Care Act of 2010
The Patient Protection and Affordable Care Act of 2010
Insurance Access—Employer Mandates and Medicaid Expansion
Insurance Access— Expanded Eligibility
What About Those Who Are Still Not Covered By One of These Mechanisms?
What Does the Health Care Exchange Do?
Where Can a Nurse Direct a Patient Who Asks Questions About How to Navigate the Complex Terrain of Health Insurance?
Insurance Lessons from Covid-19
Acknowledgment
References
Chapter 4: Payment Reform
From Volume to Value: Payment Models that Move Away from Fee-for-Service Reimbursement
Nursing Roles Within Emerging Payment Models
Note
References
Section II: Health Care Economics: An Overview
Chapter 5: How Health Care Markets Differ From Classic Markets
What Does it Mean to Bear the Consequences of Financial Decision-Making?
What Ideas Help Us Understand Overtreatment? The Example of Small-Area Variation and Supplier-Induced Demand
References
Chapter 6: The Role of Information in Health Care Markets and Decision-Making
The Need for Information
Data on Quality
Data Science
Information Science, Quality Science, and Data
References
Chapter 7: Market Entry, Exit, and Antitrust Law
Entering and Exiting the Market
Merge, Consolidate, or Stand Alone: An Overview of Antitrust Law
Is Consolidation the Same as Integration?
References
Section III: Ethics and Economicsin an Age of Reform
Chapter 8: What Is Ethinomics?
Can Economics Coexist With the Intention of “Doing Good”?
Social Determinants of Health, Health Disparities, Ethics, and Economics
Moral Conduct of Nurses in Contemporary Complexity
References
Chapter 9: Additional Models to Guide Ethical Decision-Making
Consequence-Based Decision-Making
Deontology: Rule-Based Decision-Making
Virtue Ethics
Using These Models in Clinical Decision-Making
Moral Distress
Ethics and Clinical Decision-Making During Pandemics
Ethics of Reform and Cost Containment
Sustainability is an Ethical Issue
Nurses on Boards and in Politics
References
Section  IV: Pulling it All Together: Using Your Knowledge of Health Finance,  Economics, and Ethics to Influence Health and Health Care
Chapter 10: Governance and Organizational Type
Role of the Board of Trustees
Types of Hospitals and Health Systems
Navigating Governance–Management Boundaries
The Relationship Between Organizational Structure and Organizational Values
The Role of Board Committees
The Sarbanes–Oxley Act
Note
References
Chapter 11: Building Skills for Board Membership
Zeal, Organizational Fit, and Philanthropy
Types of Board Appointments
What a Governing Board is Not
Other Types of Boards
Building the Skill Set for Board Membership
Next Steps
References
Chapter 12: Applying Health Economics to Influence Health Care Through Federal and State Policy Formation
Branches of Government
Influencing at the Committee Level
Timing Matters
Maintaining a Connection With Policy Makers To Influence Health and Health Care
Ways of Influence
Lobbying as Official Authority to Represent a Group View
Grassroots Lobbying
How to Contact Policy Makers
Overcoming Impediments to Involvement
Learning from Distant Others
Learning from At-Hand Mentors
Note
References
Chapter 13: Early Lessons from the COVID Pandemic and a Look to the Future
References
Chapter 14: Epilogue: Reflections on Living and Leading in a Changing Nursing World
Tell Me One More Time: What Does All This Financing, Economics, and Policy Have to Do With Nursing?
How to Retain and Expand on What You Have Learned
Chapter 15: Quiz Answers
Appendix A: Medicare Eligibility
Appendix B: Key Concepts in Health Finance, Economics, Policy, and Ethics: Level Setting Pre-Survey
Appendix C: The Policy Analysis Process
References
Glossary
Index