Health Care Financing System as a Nurse Leader

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Health Care Financing System as a Nurse Leader My experience of the health care finance system in the US is that it is extensive and encompasses government programs of Medicare and Medicaid, out of pocket payment by patients, and private health insurance plans. As a nurse leader, I have learned that all these systems are critical to raising financial support for healthcare facilities in the US. Patients usually rely on insurance companies and the government to finance their treatment. However, from experience, some patients in need of critical health care cannot be covered by their insurance covers, forcing them to look for alternative sources of finance. Each insurance cover has specific areas that it covers. The universal cover is available for those who can afford it, implying that one's financial status impacts access to healthcare.

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Moreover, the US's health financing system is not harmonized, which creates challenges to timely payments for health services rendered. I have noted that some patients, especially illegal immigrants have no health insurance coverage and cannot access government insurance programs such as Medicaid (Paterson & Telyukov, 2014). The group has to finance the health care services it receives from pockets. On the other hand, government healthcare insurance plans are highly exploited by eligible persons. Private insurance companies are business-oriented; hence often look for any possible reason not to pay for their clients' health care coverage. As a consequence, this creates payment problems for affected patients. The functioning of healthcare financing depends on hospitals' ability to share accurate information relevant authorities to necessitate payment for health services rendered (Paterson & Telyukov, 2014). The cost of healthcare also influences the perception of health insurance companies towards particular health facilities. The costs should be within reasonable limits to promote positive relations between the health financing system and health facilities. In this respect, I noted that a nurse leader has to come up with cost-friendly treatment plans.

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Reference Paterson, M., & Telyukov, A. (2014). Healthcare finance and financial management: Essentials for advanced practice nurses and interdisciplinary care teams. DEStech Publications.

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Health Care Financing System as a Nurse Leader

Published on Sep 25, 2023

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My experience of the health care finance system in the US is that it is extensive and encompasses government programs of Medicare and Medicaid, out of pocket payment by patients, and private health insurance plans. As a nurse leader, I have learned that all these systems are critical to raising financial support for healthcare facilities in the US. Patients usually rely on insurance companies and the government to finance their treatment. However, from experience, some patients in need of critical health care cannot be covered by their insurance covers, forcing them to look for alternative sources of finance. Each insurance cover has specific areas that it covers. The universal cover is available for those who can afford it, implying that one's financial status impacts access to healthcare.