Legislative and Regulatory Actions for Healthcare Expenditures

How might legislative and regulatory actions affect healthcare expenditures?

It may come as no surprise that the rising costs of healthcare from both a provider and consumer perspective, remain a major challenge in the U.S. healthcare system. While healthcare costs from a consumer perspective may have been temporarily alleviated with the implementation of the PPACA, providers still face many challenges when delivering effective and quality healthcare services to their patients. How might healthcare leaders streamline healthcare delivery costs without compromising the quality of healthcare delivered?

For this Discussion, review the resources for the week. Consider how legislative and/or regulatory actions may affect healthcare expenditures for HSOs. Reflect on how legislation or regulatory actions may differ at the state and federal levels.

Post an explanation of what additional legislative and/or regulatory actions might be taken to limit increases in healthcare expenditures at the state and federal levels. Be specific and provide examples.

Discussion 2: Influence and the Policy-Making Process

The policy-making process is not free from politics (far from it). That is, certain groups and individuals from the public and private sectors may exert an influence on the type of legislation that emerges from the policy-making process. While healthcare policy does not in itself represent the best interests of anyone entity, the ultimate goal of healthcare policy should be to enhance quality, increase access, and reduce costs. Consider for example, while the implementation of the PPACA may have opened up previously inaccessible healthcare services, the new mandate also requires employers and healthcare providers to become even more cost-conscious given the downward pressure on reimbursement rates and employer coverage requirements. While the mandate opened up channels for consumers of health to obtain access, it similarly inhibited certain providers to maximize the services such access could provide.

For this Discussion, you will be assigned to one of two groups that will adopt either the a) employer or b) government perspective in the policy-making process. Review the resources for the week and consider how employers and the government may influence healthcare policy in the policy-making process. Reflect on how the influence of employers and the government may impact population health and healthcare delivery.

Discussion 2A

Post an explanation of how employers and healthcare providers influence healthcare expenditures and the impact on population health.

Discussion 2B

Post an explanation of how the government influences healthcare expenditures and the impact on population health.

The following questions are to be answered:

Post an explanation of what additional legislative and/or regulatory actions might be taken to limit increases in healthcare expenditures at the state and federal levels. Be specific and provide examples.

Discussion 2A

Post an explanation of how employers and healthcare providers influence healthcare expenditures and the impact on population health.

Discussion 2B

Post an explanation of how the government influences healthcare expenditures and the impact on population health.

Furrow, et al. (2018). Health Law: Cases, materials, and problems (8th ed.). St. Paul, MN: West Academic Publishing.

• Chapter 10, “The Regulation of Insurance and Managed Care” (pp. 552-624)

Laureate Education (Producer). (2009). Legal issues involving payers and outside agencies [Video file]. Baltimore, MD: Author.