Consumers of healthcare are expected to pay for goods and services at the time of service (Nickitas, Middaugh, & Feeg, 2019). Today, mostly due to the Affordable Care Act, private insurers are aimed more at managing populations than underwriting risks (Nickitas, Middaugh, & Feeg, 2019). Nurses are in the forefront and directly tied to patient outcomes that impact healthcare reimbursement. This week’s module examines healthcare costs and financing and how they impact healthcare providers and consumers. The history of how private health insurance and managed care evolved will be discussed. The impact of consumer-driven healthcare and the role nurses play in empowering healthcare consumers will be a primary focus.

Discussion Question:

Discuss managed care, the initiatives implemented by private insurers to transform healthcare, and the various roles nurses play to improve quality patient outcomes tied to healthcare reimbursement. What are some strategies nurses can use to advocate for healthcare consumers and reduce the increasing cost of healthcare?

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