1. HEALTHCARE FINANCE Tracy Grant Viterbo University

2. OBJECTIVES Define healthcare finance Discuss goals of financing Discuss how it has evolved How government plays a role in healthcare financing Give a brief overview of Government run insurance plans Nursing implications

3. DEFINITION A branch of finance that helps patients and health care beneficiaries pay for medical expenses in the short and long term. Health financing refers to the “function of a health system concerned with the mobilizations, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system” (WHO, 2008).

4. GOALS OF FINANCING Maintain and improve on human welfare. Seek to raise sufficient funds for health care. Allowing people to health related services without the risk of severe financial hardships. (WHO, 2008)

5. HOW GOALS ARE OBTAINED Finance policy is involved to deal with how to raise funds. Regulations are set forth with disbursement of funds. Taxes and insurance premiums are raised.

6. EVOLUTION Fee for Service Development of pooling contributions to create insurance Creation of insurance Government involvement in developing coverage to individuals

7. GOVERNMENT FUNDED PROGRAMS Medicare- established in 1965 to cover those who are over 65 and have severe and/or chronic disabilities. Four parts to coverage: A,B,C, and D. Medicaid- established in 1965 to cover those who were the poorest and could not afford insurance or healthcare. Children’s health insurance program (CHIP)- established in 1997 to help cover health related expenses to those who could not obtain Medicaid and also who could not afford private insurance. Patient Protection and Affordable Care Act (PPACA) also known as Obamacare- signed into law in 2010. It covers the cost, quality, and access to healthcare.

8. FACTORS THAT INCREASE HEALTHCARE SPENDING Rising incomes Advances in technology Aging population Higher Prices Changes in financing and management of healthcare, (Fan, V. Y., Savedoff, W. D, 2014)

9. IMPACT ON NURSING Provide nursing care in the most cost effective manner. Understand what purchasers and consumers want from nursing and take steps to satisfy them (Ridge, 2016). Promote health system changes.

10. QUESTION In looking at your own practice, what can you do to change your practice that would have an impact on the patient population you care for, in regards to healthcare finance?

11. REFERENCES Fan, V. Y., Savedoff, W. D., (2014). The health financing transition: A conceptual framework and empirical evidence. Social Science & Medicine, 105, 112-121. doi:http://dx.doi.org/10.1016/j.socscimed.2014.01.014 Ridge, R. A. (2016) Economic issues in nursing and health care. In Friberg, E. E., Creasia, J. L. (Eds.), Conceptual Foundations The bridge to professional nursing practice, (pp. 122-159) St. Louis, MO: Elesevier. World Health Organization, (2008). Toolkit on monitoring health systems strengthening. Health System Financing, pp 1-13. http://www.who.int/healthsystems/financing