NU665 RC Week 16 Healthcare Access & Quality Determinants Presentation Healthcare Access and Quality Determinants Create a PowerPoint based on the foll

NU665 RC Week 16 Healthcare Access & Quality Determinants Presentation Healthcare Access and Quality Determinants

Create a PowerPoint based on the following:

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You are a psychiatric-mental health nurse practitioner who is practicing as part of a team in a medical home model facility. Patients on the panel are as follows:

68-year-old patient, diagnosed with depression, who has Medicare
34-year-old patient, homeless, diagnosis of Schizophrenia, who has Medicaid
43-year-old patient, diagnosed with Bipolar Disorder, private/work-provided health insurance
22-year-old patient, undocumented immigrant, diagnosed with PTSD and anxiety, who is uninsured

In your PowerPoint, address the following:

Provide an overview of the health care payment system in the United States.
How do the current (2017) changes in the ACA impact the patient profile? How do these policy changes impact the provision of care you provide?
Integrate the concept of quality determinants to with the conversation related to care provision and management. How is quality determined, measured, and documented?
What are the barriers to accessing healthcare in the United States?
Identify one policy issue related to psychiatric and mental healthcare that is currently being addressed by your national professional organization and discuss how NPs can become policy-aware, as well as act as patient advocates.

Your PowerPoint should be 15 to 20 slides (no more and no less). Your slides should not be narrative; rather, the use of bullets, charts, and pictures are encouraged. Please use the notes section of the PowerPoint to add narrative. APA formatting of all components is required, including a references list.

I have attached a sample power point assignment Sheri Saluga, MSN, RN
U.S. Healthcare System Payment Structure
• Cost of healthcare in the U.S. is higher than any other
• Healthcare cost “$3.3 trillion dollars”
• “Cost per person was $9900”
(Schreck, 2018).
(Schreck, 2018).
• High cost healthcare has several negative ripple effects
U.S. Healthcare System Payment Structure
Health care providers are paid by:
• Private insurance
• Government insurance programs
• Personal, out of pocket
• Government directly provides
some health care
(Schreck, 2018).
(Haughom, 2014)
Affordable Care Act
The Affordable Care Act (ACA) was enacted in 2010 by President
Barak Obama.
Purpose1. Availability
2. Affordability
3. Expansion of the market
4. Incentives for employers
5. Requires the purchase private health insurance
(Schreck, 2018).
Affordable Care Act
How it applies to mental health benefits:
• Mental Health Parity and Addiction Equity Act (MHPAE)
• Mental health and substance abuse treatment equal to
medical/surgical treatment
• Applies to small group, individual plans, and
• Large group plans and Medicare excluded
• Prescription medications
(APA, 2019).
Affordable Care Act
ACA changes from 2017
• Repeal of the individual mandate
• Eliminating cost sharing reductions
• Increased used of Medicaid waivers
• Increase in the association health plan
• Short-term limited duration insurance
(Solnick, 2017
Case Scenarios
68– year-old patient
Diagnosis- depression
80% Covered by Medicare part B
Provider must accept Medicare
Medications per preferred drug list
Co-pay and deductible applies
Coverage varies by state
Falls under the parity law
Provider selection may be limited
Medications per the preferred drug list
Insurance- Medicare
34- year-old patient (homeless)
Diagnosis- Schizophrenia
Insurance- Medicaid
43–year-old patient
Diagnosis- bipolar
Insurance- private/work provided insurance
22- year-old patient (undocumented
Diagnosis- PTSD/anxiety
Insurance- uninsured
Depending on size of company (50+
• Not required to provide mental health
coverage (large insurance plans)
• If mental health coverage is provided, falls
under the parity law
• Co-pay may apply
• Unlimited or medically necessary visits
• Prescription coverage may vary
• Emergency services covered, under federal
• Will have to pay for services
• Community health centers provide low-cost
Provision of Care
• ACA has expanded the provision of care
• Care should be equitable
• Private practice doctors
• Medicare and Medicaid
(Bresnick, 2016)
Quality Determinants
• Creation of Accountable Care Organizations (ACO)
• AHRQ develops healthcare quality measures
• Structural
• Process
• Outcome
(Agency for Healthcare Quality and Research [AHQR], 2015)
Quality Determinants
• IOM six domains of quality healthcare
• Safe
• Effective
• Patient-centered
• Timely
• Efficient
• Equitable
(AHQR, 2015).
Quality Determinants
•AHQR three aims for improving healthcare
1. Achieving better care
2. Achieving healthy people and communities
3. Making care affordable
(AHQR, 2017).
• Centers for Medicare and Medicaid core measures
Barriers to Healthcare
• Availability of appointments
• Geographic
• Provider shortages
• Transportation
• Language
• Financial
• Cultural
(Rayome, 2017)
Issues Related to Advance Practice
• Consensus model of nursing
• Regulatory requirements for
APRN’s vary
• Obstacle to portability
• Preventing access to care
(NCSBN, 2019)
Getting Involved
If your state is not in the consensus model
• Sample letter to legislator
• Sample letter to board of nursing
• Other ways to support the consensus model
(NCSBN, 2019).
American Nurses Credentialing Center. (n.d.). APRN consensus model. Retrieved from
Agency for Healthcare Research and Quality. (2015). Consider culture, customs, and beliefs: Tool #10. Retrieved from
Agency for Healthcare Research and Quality. (2015). Types of health care quality measures. Retrieved from
Agency for Healthcare Research and Quality. (2017). Overview of quality and access in the U.S. health care system. Retrieved from
American Psychological Association. (2019). What you need to know about mental health coverage. Retrieved from
Beaton, T. (2018). Affordable care act changes may bring a rocky 2018 for payers. Retrieved from
Centers for Medicare and Medicaid Services. (n.d.). Core measures. Retrieved from
Commonwealth Fund. (n.d.). The U.S. healthcare system. Retrieved from
Gold, J. (2011). Accountable care organizations, explained. Retrieved from (2019). How Obamacare improved mental health coverage. Retrieved from
Heath, S. (2018). Top challenges impacting patient access to healthcare. Retrieved from
Holland, S. (2018). New health plans discriminate against mental illness. Retrieved from
McCoy, J. (2006). Obligation to provide services: A physician-public defender comparison. Ethics Journal of the American Medical Association , 8(5), 332-334. (n.d.). Is my test, item, or service covered? Retrieved from
References (n.d.). Is my test, item, or service covered? Retrieved from
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming language barriers in healthcare: A protocol for investigating safe and
effective communication when patients or clinicians use a second language. BMC health services research, 15, 371. doi:10.1186/s12913-015-1024-8
National Alliance of Mental Health Ilness. (2019). Types of health insurance. Retrieved from
NCSBN. (2019). APRN consensus model. The consensus model for APRN regulation, licensure, accreditation, certification and education. Retrieved from
Office of Disease Promotion and Prevention. (2019). Access to healthcare services. Retrieved from
Schreck, R. (2018). Overview of health care financing. Retrieved from
Substance Abuse and Mental Health Services Administration. (2018). Medicaid coverage of medication-assisted treatment for alcohol and opioid use disorders and
of medication for the reversal of opioid overdose. Retrieved from
Substance Abuse and Mental Health Services Administration. (n.d.). What immigrants and refugees need to know about the Affordable Care Act. Retrieved from
U.S. Department of Health and Human Services. (2013). Affordable care act expands mental health and substance abuse disorder benefits and parity protection for
62 million Americans. Retrieved from
Emergency preparedness
Joint Commission
Mission statement
Sexual harassment
Succession planning


Bresnick, J. (2013). Why mental healthcare is key to population health management. Retrieved from
Haughom, J. (2014). Whats good about U.S. healthcare. Retrieved from
NCSBN. (2019). APRN consensus model toolkit. Retrieved from
Rayome, A. (2017). The top 10 barriers to digital transformation. Retrieved from
Solnick, C. (2017). Free affordable care act seminar. Retrieved from

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